The peak body for emergency medicine in Australia is building a coalition of health professionals, consumers and their advocates to call on Federal, state and territory governments to act urgently to improve timely access to mental health care.

Each year, more than a quarter of a million Australians present to emergency departments in mental distress and needing urgent access to care and support. A poorly coordinated and under-funded mental health system means more and more people are turning to emergency departments for care. Too often the emergency department is the only option available after hours or outside of city centres. A national shortage of mental health beds in hospitals and services in the community means that people in mental health crisis are left waiting for hours and often for days in the noisy and chaotic environmental of an emergency department. People in mental health crisis have the right to timely access to appropriate care regardless of the time of day, day of the week or where they live. Distressingly for emergency doctors and family members, some people choose to leave the emergency department before they are linked in with mental health care, or their agitation escalates into aggression and violence.

Working with The Royal Australian and New Zealand College of Psychiatrists (RANZCP), ACEM has today released the Mental Health in the Emergency Department Consensus Statement, identifying four actions that can be immediately implemented by governments to improve mental health care.

ACEM President Dr Simon Judkins said: “ACEM is building a coalition of health professionals because the long waits for mental health care experienced by people in crisis are the result of system failures, with many of the solutions residing outside the emergency department and requiring a commitment from many different stakeholders to making the system work.”

ACEM and RANZCP are calling for immediate action on the following:

  • All Australian Governments act urgently to engage people with lived experience in reforms that deliver timely access to appropriate mental health care, with an immediate focus on after-hours care in the community.
  • When psychiatric admission is required, processes need to be timely and streamlined so that acutely unwell people can access an appropriate inpatient bed any time of day or day of the week.
  • State and territory health departments adopt a maximum 12 hour length of stay in the emergency department, by providing accessible, appropriate and resourced facilities to allow for ongoing care beyond the emergency department, with mandatory notification and review of all cases embedded in the key performance indicators of public hospital CEOs.
  • All 24 hour waits in an emergency department should be reported to the Health Minister regularly, alongside any CEO interventions and mechanisms for incident review.

Download the Mental Health in the Emergency Department Consensus Statement

Health professionals, consumers, their advocates and key stakeholders can sign the Consensus statement here
ACEM called for mandatory Ministerial reporting of long ED stays in February 2018, and then held a Mental Health in the Emergency Department Summit in Melbourne late last year that saw more than 170 emergency doctors, psychiatrists, consumers, clinicians and key decision makers discuss and agree on seven key principles to tackle Australia’s mental health crisis.

ACEM issued a communiqué after the summit, vowing to set the agenda for policy reform.

Following the Summit, the Western Australian Government has said that it will introduce and support mandatory reporting of extreme wait times in emergency departments. The Northern Territory government has also announced a similar step towards improving patient care.
ACEM is the peak body for emergency medicine in Australia and New Zealand, responsible for training emergency physicians and advancement of professional standards.
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Andre Khoury
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