Mental health 'crisis' as unit spills to general ward

Data suggests the full mental health unit is a major contributor to Canberra Hospital's poor emergency department wait times.

Ministerial briefing notes for May 2019 showed the number of mental health patients left in the emergency department for more than 24 hours doubled compared to the same time last year.

This equated to almost one mental health patient a day made to spend more than 24 hours in the emergency department.

President of the Australasian College for Emergency Medicine Simon Judkins said long waits in emergency departments could be disastrous for mental health patients, calling for a national solution.

The briefing notes shows waits at Canberra Hospital were likely due to delays in a bed becoming available in the adult mental health unit, which, according to the notes "is at capacity".

The incoming minister briefs show mental health is the major contributor to bed block - the time a patient is waiting in the emergency department to be admitted to a bed in a ward - which has previously been blamed for long waits in the emergency department.

The average bed block minutes remains significantly higher than for non mental health patients.

"This is once again reflective of the capacity constraints of the adult mental health unit, and is also reflected in the number of mental health patients whose length of stay in the emergency department is greater than 24 hours," the briefings read.

The ministerial briefings said the hospital would look at using vacated ward areas in other parts of the hospital to put mental health patients.

In response to a question taken on notice received by the Canberra Liberals, Health Minister Rachel Stephen-Smith confirmed mental health patients waited on average 16.2 hours in the emergency department, before being admitted into a dedicated mental health spaces in 2018-19.

It meant in just one year, the wait time more than doubled.

She said in 2017-18 mental health patients waited on average 6.6 hours to be admitted to a dedicated mental health space.

Have you been affected by mental health capacity issues? Contact daniella.white@canberratimes.com.au

Wait times for mental health patients to be initially seen in the emergency department have also been deteriorating over the past few years.

While 70 per cent of mental health health patients were treated on time in 2013-14, by 2017-18 that figure was 40 per cent.

Recently released Australian Institute of Health of Welfare data for 2017-18 showed ACT had by far the longest median emergency department wait times for mental health patients at 47 minutes.

President of the Australasian College for Emergency Medicine Simon Judkins said the "disastrous" figures were in line with a national trend towards more 24 hour stays.

"The fundamental thing it comes down to is resources and capacity," he said.

"A person with a mental health care issues is not going to get better by spending over 24 hours 'imprisoned' in an emergency department.

"It's not an environment that is good for patients with mental health issues."

He said long waits for patients put extra stresses on the whole system.

"[Voluntary] patients get sick of waiting and leave, or they get upset so they get inappropriately restrained," Dr Judkins said.

"I don't think people really appreciate the impact it is having on healthcare and how risky it is to not be seen in this sort of environment."

Opposition spokeswoman for health Vicki Dunne said ACT's mental health system was in crisis.

"Critical delays to treatment are putting more mental health patients at risk, and exacerbating existing pressures in our emergency departments," she said.

"I'm concerned the Barr government is adopting dangerous strategies that aren't in the best interest of patients in order to reduce pressure on the adult mental health unit.

"The Barr government needs to acknowledge that the mental health system is in crisis.

"Unfortunately, the historical record shows the Barr Labor-Greens government cannot be trusted to deliver better mental health strategies."

A Canberra Health Services spokeswoman said occupancy for the adult mental health ward was consistently at 90 to 100 per cent.

To manage periods of high demand, four extra beds on a general ward have been used in recent months.

She said further increases in beds will be needed in coming years.

Despite the most recent national data showing ACT patients waited double national median wait time, the spokeswoman said it showed wait times were only "marginally higher" than other jurisdictions.

"There are a number of other variables to consider like: hospital availability per capita, population sizes, demographics, principal diagnosis for mental health presentations and other treatment options available for the mental health presentation category," she said.

"In addition, the hospital has experienced a much higher number of mental health presentations and this has put sustained pressure and demand on acute mental health services.

"However, it is important to note, that over the past two months mental health presentations to emergency department and wait times have reduced and capacity pressures have subsided."

Asked whether wait times will be worse when the next lot of national statistics are released, she said they could not speculate on what the 29108-19 data would indicate.

"We are confident that the wide range of work underway will help to improve performance across Canberra's health system, although due to the way data is reported by the [Australian Institute of Health and Welfare], it may take some time to see this work reflected in the data," she said.

"The ACT Government, Canberra Health Services and the Health Directorate are continuously striving to innovate and find ways to address the demand for mental health treatment, particularly in acute services, and improve the experience for mental health patients."