Emergency wards swamped with mental health patients

OVERSTRETCHED Hunter hospital emergency departments are being swamped by mentally ill patients – some forced to wait there for more than two days because of a lack of psychiatric beds.

Information obtained exclusively by the Newcastle Herald reveals one in every 36 emergency department patients in the Hunter last year was mentally ill.

At Calvary Mater Newcastle, it was one in every 15 patients.

Three psychiatric patients endured more than two days stuck in emergency departments at Maitland and Calvary Mater.

A further 20 spent more than 24hours in emergency departments at Maitland, Calvary Mater and John Hunter.

Many patients were so ill that they needed to be strapped down and sedated so they didn’t harm themselves or others.

Doctors told the Herald, the chaotic nature of emergency departments only increased distress in patients who were highly agitated or psychotic.

‘‘It is the completely wrong environment for so many of these people,’’ said a doctor, who did not wish to be named. ‘‘They get stuck there when there are no beds to move them to or if there are any, even minor, health issues.’’

In 2007, there were 2720mentally ill people treated at Maitland, Calvary Mater, Belmont and John Hunter emergency departments. This jumped 121per cent to 6023people last year.

The biggest increase occurred following the opening of mental health facilities at Calvary Mater in 2009.

Staff from Calvary Mater said there had been a ‘‘significant’’ increase in patients suffering mental health problems due to the rise in use of synthetic drugs over the past few years.

‘‘The mental health impacts for users have been extreme in many cases,’’ a nurse said.

According to data obtained under freedom of information laws (Government Information Public Access), there were 26,065mental health patients seen at Hunter emergency departments in the past six years.

Hunter New England Health’s acting director of mental health, Martin Cohen, said more people were seeking treatment because of a national push to change perceptions of mental illness.

Dr Cohen said initiatives to reduce the pressure on emergency departments included a 24-hour mental health telephone service for over-the-phone triage, community mental health services and the introduction of a psychiatry registrar after hours, based at John Hunter.

A nurse, who did not want to be named, said the increase in emergency department presentations reflected the lack of resources for mental health in the community and a shortage of psychiatric beds.

She said the situation was compounded by the large number of patients presenting with combined mental health and drug and alcohol problems.

‘‘Patients have to stay in the ED until the substances wear off and they are cleared to be moved,’’ she said.

‘‘We can’t sit them in the waiting room and we can’t send them to mental health, so they take up a cardiac, monitored bed.’’

Staff told the Herald of many violent incidents in which there was no choice but to strap down patients and sedate them.

In 2008-09, before the mental health unit opened at the Calvary Mater, a trial was conducted on sedation of patients with ‘‘violent and acute behavioural disturbance’’. According to the researchers, at that time the Mater had twice the national average of ED presentations of violent and aggressive patients, or 223people that year.

Sources said the number of patients in the ED needing sedation each year would have increased significantly since then.

Dr Cohen said local emergency departments had mental health assessment rooms designed as safe environments for patients.

It is understood there is one mental health assessment room at John Hunter that can accommodate one patient.

Dr Cohen said the extent of mental health problems in the Hunter was under-reported.

‘‘Unfortunately, there continues to be a stigma associated with mental illness and psychiatric hospitals that we believe deters a significant proportion of the general public from seeking help for mental health conditions.’’

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