Long waits for acute men­tal health care

Marlborough Express - - NEWS - CE­CILE MEIER AND LIZ MCDON­ALD

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.

In­volved process

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.

Health tar­get

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.

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