Queensland’s emergency departments struggling to treat mental health patients

The “real” mental health crisis plaguing Queensland’s emergency departments is seeing patients being made to wait or turned away because there are no beds.

People in the midst of a mental health crisis seeking help in the state’s emergency departments are twice as likely to suffer a long wait and in extreme cases are turned away because there are no beds.

ED doctors say that treating people with mental illness and people at risk of suicide in hospital emergency departments because there is nowhere else for them to go is not only incredibly expensive, it can traumatise already distressed patients, with an unknown number being refused admission or leaving before being treated due to lengthy delays in assessment.

A landmark Productivity Commission inquiry into the country’s mental health system, released late last year, found that the rates of mental health presentations in hospitals were increasing among all age groups and that the ED is often the first and only available option for people experiencing a mental health crisis, either because they cannot afford care or because they cannot find it.

Territory Health in Crisis

The rate of mental health presentations at EDs has risen by about 70 per cent over the past 15 years.

Australian College for Emergency Medicine president John Bonning said the lack of inpatient beds in the state’s hospitals was a “real crisis” that needed addressing.

“A patient in mental health crisis has as much right to be in emergency department for their acute health needs as somebody with trauma or a medical issue,” he said.

Emergency staff could often stabilise a patient but spend unreasonable amounts of time waiting for a bed, Dr Bonning said.

“Mental health patients can wait protracted amounts of time (to be admitted) and sometimes need to be transported a long, long way away whether it be 100km across Brisbane or 900km from Mt Isa to Townsville for example,” he said.

MENTAL HEALTH CRISIS

Compared to people with other health conditions presenting at an ED, people with mental illness are: 

• nearly twice as likely to arrive by ambulance
• 10 times more likely to arrive by police or correctional services vehicles
• twice as likely to be in ED for more than 8 hours
• over represented among those kept waiting in ED for an inpatient bed
• even more over represented among those delayed in leaving ED due to an inpatient bed not being available. 

The Royal Australian and New Zealand College of Psychiatrists Queensland president Professor Brett Emmerson said the long waits were one of the reasons many people gave up on seeking help.

“I think despite what the emergency departments tell you, that everybody is welcome, emergency departments generally don’t like mental health patients so they will often leave them sitting in the waiting room for 8-10 hours and a lot of people just give up,” he said.

“Once you’re given the message that you are a low priority people will just leave.”

Prof Emmerson said he had heard complaints of long waits directly from consumers and carers.

He said the RANZCP acknowledged the commitment of emergency department staff supporting patients, and most delays in ED related to resource constraints such as lack of beds.

He echoed Dr Bonning’s call for urgent funding for mental health beds across the state, with an increase of people finding themselves in crisis amid the Covid-19 pandemic.

“The Government thinks there is no problem because we haven’t really had Covid here, but I can tell you look at the ED presentations in some hospitals there is definitely an issue and this government is just not hearing the professional groups, hence the need for an urgent inquiry undertaken by the mental health commissioner,” he said.

Originally published as Queensland’s emergency departments struggling to treat mental health patients