Long waits for acute mental health care
Patients face ‘’’unacceptable’’ long waits at emergency departments for mental health care, a new survey has revealed.
The Australasian College for Emergency Medicine did a snapshot survey of 65 emergency departments in Australia and seven in New Zealand in December 2017.
It found that despite only 3.7 per cent of patients being identified as mental health presentations, they comprised 25 per cent of patients having to wait for more than eight hours for a hospital bed or treatment. In some cases, patients waited up to 24 hours to get a bed or treatment, the survey found.
However, an advocacy group said faster did not mean better, and quality care and assessments for patients with mental health conditions took time in emergency departments.
The college said long waits for mental health care in emergency departments were unacceptable, discriminatory and likely to lead to serious deterioration in the wellbeing of patients. It called on the Government to address the issue and to urgently increase funding for community treatment settings and other mental health and addiction services.
It also recommended better data collection including reporting all mental health patients waiting more than 12 hours to the health minister and human rights commissioner, increasing mental health expertise in emergency departments and improving space design to better accommodate patients.
The college’s New Zealand faculty chair, Dr John Bonning, said wait times for mental health treatment were worse in Australian emergency departments than here. ‘‘But it is getting worse here. ‘‘Mental health presentations are going up, and up.’’ Rural areas were the worst affected.
He was concerned many emergency departments did not have dedicated mental health staff on site.
‘‘Suicide numbers are double the road toll but we don’t treat this with the same degree of urgency as road safety,’’ he said.
Last financial year, 606 people died of suspected suicide.
Last year, 379 people died on New Zealand roads.
Kieran Moorhead, a spokesman for mental health and addiction advocacy group Changing Minds, said properly assessing patients in line with the Mental Health Act was an involved process, and required time and more than one medical opinion.
A slower process through emergency departments could avoid mistakes, and the involvement of distressed family members or the police often complicated cases, he said.
Changing Minds would like to see research into the experiences and needs of patients with mental health issues, not just the time taken.
‘‘People have told us of both positive and negative experiences at emergency departments,’’ Moorhead said.
‘‘Just because they’re there a long time, that doesn’t mean it is negative if they are being assessed, cared for by staff, and listened to. It is good they are finally being responded to.’’
Mental health patients did not necessarily need more hospital beds and community-based care was often preferable, he said.
Moorhead supported the call for a calm atmosphere for patients with mental health issues, and said emergency departments could take ideas from psychiatric inpatient departments. Having staff with mental health training in emergency departments at all times was also essential, he said.
A Health Ministry spokeswoman said the ministry ‘‘recognises there is more to do to improve patient access to appropriate acute health care, whether it’s at home, in a primary care setting, or in hospital’’. The ministry had a health target focused on acute patients’ access to care. An inquiry into mental health and addiction is to report back to Government with recommendations by the end of October.