There are concerns mental health patients have been overlooked in the South Australian Government’s health system shake-up with doctors describing conditions as “inhumane” for those spending days in emergency departments.
The Transforming Health consultation paper released this week outlined suggested savings in the health system across metropolitan Adelaide, but it did not include plans for mental health patients.
The proposed initiative would cost $252 million over four years and include a new $15 million “Centre for Excellence” for the treatment of post-traumatic stress disorder.
This would be established to replace services at ward 17 of the Repatriation General Hospital, which the Government no longer considered “fit for service” due to ageing facilities.
The State Government said it would deal with mental health separately, but some doctors say with patients being treated in emergency departments and many physically restrained or sedated for days while they wait for a bed, it should have been included in the latest blueprint.
David Pope, the past president of the South Australian Salaried Medical Officers Association and an emergency department doctor, said he was surprised mental health was not included in the State Government’s plan.
“It’s part of our health system which is failing to deliver for very unwell mental health patients,” Dr Pope said.
“They’re not getting the services they need to return to health and it’s creating enormous pressure on emergency departments, which flow on to the rest of the system.”
He said “horrendous and inhumane” conditions in the emergency department were not suitable for mental health patients.
“You’ve got people spending many days in emergency departments that are lit all the time, that are very noisy,” he said.
“They can’t sleep, they can’t get proper access to food and their mental health conditions get worse.”
Health Minister says issues to be dealt with separately
Health Minister Jack Snelling said it was the extent of the problems concerning mental health treatments that led to the decision to not include it in the Transforming Health paper.
“Basically it’s a body of work that needs to be done by this winter,” Mr Snelling said.
“Transforming Health is something that’s going to take two to four years to roll out completely. I can’t wait four years for the mental health issue to be fixed.
“I’ve set targets for the health system that I expect for us to have no mental health patients waiting in emergency departments longer than a day by the first of January next year.”
In a bid to overcome the delays, a new psychiatric short stay ward has been opened at the Flinders Medical Centre.
Mr Snelling said another one would be set up at the Royal Adelaide Hospital.
“It is a good way of getting people out of the emergency department as quickly as possible,” he said.
“Ideally what we’d like to see is for the majority of mental health patients being able to go straight to that ward rather than having to go through the emergency department.
“We need to do a bit more work before we can get there.”
Doctors call for more beds
The short stay ward uses existing mental health beds, but the Minister said an audit of how mental health beds were used was underway.
Dr Pope said while it was a good step, more work was needed.
“It’s certainly one step, but it’s not a big enough step to address the issue,” he said.
“The main problem with mental health [is] the very unwell patients need to be in hospital for a number of weeks, so short stays may help a very tiny amount but it’s nowhere near going to be enough to address the problem.”
He said additional beds were the only answer.
“Until that happens, we’re going to continue to see patients being dealt with inhumanely by being left in emergency departments for days on end.”
Dr Pope was also concerned some of the proposed reforms could increase the pressure.
Under Transforming Health Adelaide’s Repatriation General Hospital would close and its services would be run out of other hospitals.
The State Government was also planning to build a specialised post-traumatic stress disorder centre to replace ward 17 at the Repat Hospital.
Dr Pope was worried not all of the mental health beds would be retained.
“We’re seeing enormous pressure on the existing mental health beds and now we’re concerned that with the closure of Repat there will be a significant number of mental health beds that simply disappear from the system.”