More options needed for people with complex mental illness

A lack of suitable long-term accommodation options for people with complex mental illness is leading to bottlenecks in an already over-stretched hospital system, according to the Community Visitors Annual Report 2020 tabled in Parliament today. (pp 55, 63, 67)

The Community Visitors Mental Health Board has called on the State Government to substantially increase investment in beds in acute, forensic, and community mental health settings, particularly for consumers with complex needs. (p. 55)

“There is a gross mismatch between capacity and demand for acute beds,” the report said. (p. 62)

People in mental health distress often present to emergency departments. One metropolitan health network advised Community Visitors they typically had 100 per cent bed occupancy and 25-30 people awaiting admission in the three emergency departments under their management. (p. 62)

In November 2019, staff at St Vincent’s Hospital told Community Visitors they were unable to discharge five or six consumers with complex needs because there were no other services available to support them. (p. 62)

For those living in rural and regional areas, a lack of mental health beds means those needing care may have to travel long distances, away from their usual support networks, to receive treatment in metropolitan hospitals. Community Visitors are aware of cases where consumers from Albury-Wodonga were referred to Box Hill Hospital’s Adolescent Inpatient Unit, a three-hour drive away. (p. 62)

“Staff at both metropolitan and regional hospitals reported there were times they had to discharge the consumers who were the least unwell, rather than when they were clinically ready for discharge,” the report noted. (p. 62)

This year, Mental Health Community Visitors reported 1927 issues from 1235 visits to 172 mental health units, compared with 1486 issues from 1670 visits to 170 units last year. Despite a 26 per cent reduction in the number of visits (due to COVID-19 restrictions leading to the suspension of face-to-face visits from the end of March), there was a 30 per cent increase in issues identified. (p. 56)

Incidents noted included serious physical and sexual assaults as well as several incidents where consumers injured themselves or were placed at risk because of insufficient supervision or medication errors. (p. 57)

Community Visitors acknowledge that most health workers are extremely committed to the safety and wellbeing of consumers, but they are sometimes operating in volatile and resource-constrained environments. (p. 57)

This year, in addition to long-standing systemic issues, mental health facilities had to deal with issues relating to the COVID-19 pandemic. Some rural services also had to deal with bushfires, floods and a major cybersecurity attack which brought down their computer network for months. (p. 56)