The Royal Australian and New Zealand College of Psychiatrists (RANZCP) has backed Professor Mendoza’s call for a crisis plan to manage the ‘pandemic surge’ in the mental health system, but emphasised the deeper issues that must be addressed.
‘We absolutely need to manage the surge in demand due to the pandemic, but it would be a mistake for people to think the government only needs to open a few more acute beds to solve the issues in our mental health system’, said Dr Paul Furst, Chair of the RANZCP South Australian Branch.
‘Professor Mendoza’s plan is a great starting point and would have broad support across the sector, but the government needs to get serious about sitting down with the clinical directors from each LHN and working through it.
We still desperately need to make long-term, transformational investments in the mental health of the South Australian community and we need to seem some real commitment from government to improving the system.’
Commenting on individual aspects of the plan, Dr Furst made the following observations:
‘We would love to have enough mental health beds to manage demand in the forensic system, but South Australia is at least 20 beds short to cater for the current legislative framework’.
‘As we’ve previously called for, having a fully staffed, multidisciplinary, prison in-reach mental health service could help prevent many mentally ill prisoners from needing beds in the first place and is something the SA Coroner agrees is needed.’
‘The state government also needs to seriously consider some of the legislative changes proposed in the 2015 review of the Forensic Mental Health Service, especially the diversion of patients with intellectual disability from the mental health system to the disability sector and the responsibility of the Minister for Disability.’
‘We agree that psychiatric intensive care unit (PICU) beds and Hospital at Home options are what is required right now to manage the unfolding crisis and would reduce immediate bed blockage, but we also think we need a more balanced mental health system with more rehabilitation beds in the longer term.’
‘John is correct in saying we need to invest in the training and overseas recruitment of more staff. We have some community teams operating with less than 50% of positions occupied due to lack of qualified staff. How can they be expected to reduce emergency demand?
‘South Australia also badly needs a mental health workforce plan for psychiatrists, mental health nurses, psychologists and allied health staff, which is a key recommendation from both the Productivity Commission and the RANZCP submission to the upcoming State Budget.
‘That’s how you make our health system sustainable in the long term.’
‘Almost uniformly, psychiatrists across South Australia have indicated that the NDIS process is a bureaucratic nightmare and moves at a glacial pace, preventing patients with disability from accessing the community care they deserve, increasing the risk of aggressive behaviour in hospital and blocking access to specialist mental health beds.
‘SA Health needs to stop subsidising the NDIS and ensure that people with a disability get the community-based care to which they are entitled and mental health beds are available for mental health patients.’
Scaling up proven programs
‘This is a good start, but we should also be taking a serious look at how we might reform Community Mental Health Services to be more GP focused. GPs are overwhelmingly the first point of entry into our mental health system and need much more support.’
‘Having suitable accommodation is essential for patients to better manage their mental illness and any comorbid physical conditions. It is also essential to facilitate discharge from hospitals and allow community-based services to engage with the person.
‘If we can find accommodation for the homeless to manage COVID-19, then the failure to do so for our mentally ill population can only be attributed to discrimination or apathy.’
‘People in the mental health system have been calling for this for a long time. It’s more efficient, would save time and money, is better for the patients and would help free up ambulances.’
‘Bang on. Not much else to say here, we should be doing it.’
‘Professor Mendoza is the most recent voice, joining numerous others, in calling out the poor state of South Australia’s mental health system. He sadly isn’t the first and will most likely not be the last.
‘South Australians deserve a world-class mental health system where everyone has access to the right type and level of care, when they need it.’
The RANZCP SA Branch strongly encourages the South Australian Government to consider the recommendations outlined in their 2021-22 budget submission – Prioritising South Australia’s mental health.
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For all other expert mental health information, visit Your Health in Mind, the RANZCP’s consumer health information website.