Push for more separate mental health emergency care after a string of assaults on clinicians

Recent attacks at the RAH ED have highlighted the shocking state of SA’s mental health system with chronic shortages in beds, staff and preventive services.

Calls are growing for dedicated emergency departments for mental health patients, separate from mainstream EDs, in the wake of repeated assaults on clinicians.

In the wake of the latest terrifying attack which left three people injured and staff and patients traumatised, Royal Adelaide Hospital ED consultants are understood to be asking for a review for a separate ED for mental health and drug affected patients.

The nurses’ union also wants an ED separate from the chronically full RAH ED where mental health patients face the stress of noise and bright lights then after treatment often face long waits, sometimes stretching into days, for suitable beds.

Doctors, Nurses and security guards have been attacked at the RAH. Picture: NINE NEWS

Mental Health Coalition of SA chair Paul Creedon noted the Urgent Mental Health Care Centre (UMHCC) in Grenfell St already is a separate ED for mental health patients.

He called for similar services to be available near, but not in, major hospitals, including in regional centres, stressing mental health patients have different needs to someone presenting with a physical injury or illness.

A similar service funded by federal and state governments opened last month in Elizabeth.

The free, walk-in Medicare Mental Health Centre is “a safe and welcoming place,” open seven days a week for extended hours, and is part of 61 such centres being rolled across the country including three in South Australia.

“We support the UMHCC as an alternative to hospital mental health services and developing them for other metropolitan hospitals and country regions,” Mr Creedon said.

“They should be done in non-hospital settings. They provide a soft landing into the system.”

While more such centres are needed, Mr Creedon said three quarters of people who need services are not getting them, then become so unwell they need emergency care.

He called for more community services to intervene before emergencies develop.

“We need to turn the tap off instead of building a bigger pond,” he said. “We could build any number of UMHCCs and still never meet the demand because we are not addressing the issue of prevention.”

Royal Adelaide Hospital staff have been attacked by patients. Picture: Keryn Stevens

Aftermath of an attack by a patient at the RAH ED. Picture: 7NEWS

Australian Nursing and Midwifery Federation state secretary Elizabeth Dabars called for a doubling of security teams and a separate ED for mental health patients.

“It’s like being in a war zone – it’s not fair on patients or staff but it is also not fair on mental health patients being treated for days on end in environments not conducive to their care and recovery,” she said.

“We are pleased to see management act to secure some additional duress alarms but none of this fixes the ultimate problem. All of these measure are simply a Band-Aid solution to a bigger issue which is the lack of available mental health beds, lack of available mental health staff and lack of available community health services.”

Health Minister Chris Picton is appalled by the violent attacks on healthcare workers.

“We know an ED is often not the best place for people in mental health distress and that’s why we are taking action by investing significantly to build more mental health hospital rehab and inpatient beds, as well as expanding mental health community services,” he said.

“We are building more than 100 dedicated mental health inpatient beds across the system, including three 24-bed mental health rehabilitation units, at the Queen Elizabeth, Modbury and Noarlunga hospitals.

“In addition to the Urgent Mental Health Care Centre, we have also opened Safe Haven in Salisbury – a free, walk-in mental health service – and we are building a Crisis Stabilisation Centre in the northern suburbs.

“We have also partnered with the federal government to open a new Mental Health Walk In Centre at Elizabeth.”

Mr Picton said additional mental health centres are to come at Mount Barker and Port Pirie, a Kids Mental Health Hub in Southern Adelaide, and an Aboriginal Mental Health and Wellbeing Centre in the CBD.

RAH staff have faced repeated attacks in recent weeks while regularly operating at well above official capacity, including:

A patient allegedly attacking a doctor, nurse and security guard who all needed treatment for serious injuries while traumatising staff and patients who witnessed the rampage last Tuesday night;

A nurse bashed around the head by a patient the previous Thursday;

A mental health patient who broke through security doors and trapped frightened staff in a tearoom before being subdued;

A serious assault on a junior doctor last month.

There also have been multiple assaults in regional centres including two nurses and three doctors needing treatment for injuries after a patient went berserk at Port Pirie Hospital, an attack by a patient at Riverland General Hospital that left nurses “ducking punches and projectiles”, and a violent patient who had to be tasered four times by police at Wallaroo Hospital.

The string of assaults comes as SafeWork SA has put RAH management on notice to improve health and safety for ED staff by Tuesday or face a $250,000 fine.

Their inspection was triggered by a report on work conditions by doctors’ union SASMOA where the situation was succinctly summed up by one doctor who told the union’s chief industrial officer Bernadette Mulholland: “Staff are f … ing broken.”

Originally published as Push for more separate mental health emergency care after a string of assaults on clinicians