Monash Health U-turns on compulsory discharge of mental health patients

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A major Victorian healthcare provider has been forced to withdraw a policy of discharging at least three mental health patients every day. 

Monash Health circulated a document on January 8 outlining a new “bed management system” which demands that all mental health wards discharge a minimum of three patients a day.

The document also directs that daily handover meetings be renamed “discharge planning” meetings. 

“The expectation of the daily discharge meeting is that no less than 5 patients are to be identified for discharge per day (in preparation for the next day),” the document, which Fairfax Media has seen, reads.

The document came to light on Friday morning and provoked alarm from the Australian Nursing and Midwifery Federation.

Pip Carew, assistant secretary of the federation’s Victorian branch, said mandating discharges would lead to patients being pushed into the community too soon. 

“Telling people they have to go home before they’re ready to be sent home just contravenes the principles of delivering safe patient care,” Ms Carew said.

“People would be discharged and would be at risk to themselves potentially, and also they will re-present through an emergency department or through a crisis assessment team.”

Monash Health medical director of mental health David Clarke announced on Friday that the directive would be withdrawn and rewritten, with the compulsory discharge numbers removed.  

“We would like to reword some aspects of it to make it more patient-centred and clinically relevant,” Professor Clarke told radio station ABC 774. 

“There are some things badly written in here and we are going to withdraw this document and rewrite it.”

Professor Clarke said mental health units would still plan to discharge three patients every day but it would not be compulsory.

Ms Carew said it was concerning that a policy change of such significance could be made without staff being consulted.