Beds plunge to lowest level for mental health patients

The number of beds available for mental health patients nationwide has plummeted to its lowest count on record despite soaring demand.

St Vincent's Hospital emergency medical director Paul Preisz talks to staff in the hospital’ new mental health unit in Sydney. Picture: Nikki Short

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The number of beds available for mental health patients nationwide has plummeted to its lowest level on record despite soaring demand, as patients spend longer than ever before in emergency ­departments.

A national report card on public hospital mental health services compiled by the Australian Medical Association shows the sector has never been under so much pressure, with just 27 mental health inpatient beds per 100,000 Australians – the lowest per person capacity figure on record, and a reduction of 240 beds nationwide just in the past year.

Mental health patients in emergency departments also experienced the longest wait times ever – an average of seven hours, and more than 23 hours for one in 10 patients.

The AMA describes the situation, exacerbated by a critical lack of community care for the severely mentally ill, as “alarming”.

“This is a worrying trend of reduced system capacity at a time when the need for care is greater than ever (with the) longest ever wait times, severe workforce shortages and extreme bed block,” the report says. “The AMA is concerned by the increasing number of patients with severe, complex and chronic conditions, where mental illness may be one of a multitude of conditions. It is essential these patients receive the appropriate support for all their health needs – be they physical health, mental health or broader psychosocial supports.”

The report finds that since 2010–11, the number of Australians presenting to ED with a mental illness triaged as “emergency” has more than doubled from nine to 21 per 10,000 people, while the number of “urgent” presentations has grown from 37 to 57 per 10,000 people.

More than half of those patients in 2022-23 arrived at hospital in either an ambulance or escorted by police. That compares with only 26 per cent of all ­emergency department presentation presenting to hospital by ­ambulance.

“These numbers clearly highlight the fact that the needs of patients with severe mental illness are increasingly unmet by the community and primary care system, leading them to an ED as a last resort, when the situation is critical,” the report finds.

Mental health has been under intense scrutiny this year since the tragic events at Westfield Bondi Junction.

Health ministers recently came together to pledge to fix the dire shortage of psychosocial services for those with severe mental illness, with a report on unmet need compiled by senior bureaucrats from every state and territory finding there were around 240,000 people with severe mental illness receiving no psychosocial support at all. Over 600,000 with mild to moderate mental illness have also been left out in the cold.

AMA president Danielle McMullen said it was time for all levels of government to take mental healthcare seriously.

“We’re getting sicker patients and more of them, and yet we have our lowest capacity ever, so that maths really clearly doesn’t add up,” Dr McMullen said. “

“There’s a whole lot of people with severe mental health needs that just aren’t getting access to services.

“These are our most vulnerable patients in their time of need, turning up to our emergency departments and then being stuck in the wrong place because our hospitals are in bedblock and it’s delaying their access to care.

“It’s now up to new governments and the health sector to work together on solutions. We need to increase our mental health system capacity and staff, and we need to increase that end to end care for patients, particularly outside of hospitals. We need to boost support for general practice, psychiatry, wrap around mental health care for people with chronic conditions, as well as improving the situation inside our public hospitals, so that when people are acutely unwell, they can get the care they need.”