The Australasian College for Emergency Medicine (ACEM; The College) NSW Acting Chair Dr Rachael Gill said: “Tragically, these issues, concerns, and consequences for patients are not new and are indicative of a situation which is only getting worse. For years, ACEM has repeatedly called for urgent reforms to alleviate the mental health crisis which is seeing Australia’s mental health system repeatedly failing people presenting to EDs.”
“Our members working in these EDs consistently report, and our data confirms, that people presenting for emergency mental health care routinely experience unacceptable and dangerously long waits for inpatient beds or psychiatric care,” she said. “The current system is highly fragmented and difficult to navigate for health professionals, never mind patients and their loved ones."
This situation is largely caused by ‘access block’ – where people requiring hospital admission are waiting in the ED for longer than eight hours for an inpatient bed, after their initial ED assessment is complete. Access block is not caused by EDs but is a whole-of-health-system issue created by many factors. These can include insufficient inpatient beds, a lack of staffing, limited resourcing and ineffective systems that are otherwise aimed at improving patient flows through the hospital. Access block can affect all patients, but disadvantages patients with mental health-related presentations to an even greater extent.
"Currently the mental health care system is failing to meet community expectations of an adequately resourced publicly funded mental health care system to provide for the essential needs of the people of NSW. Our community is not receiving the care they deserve," Dr Gill said.
ACEM’s 2020 report Nowhere Else To Go: Why Australia’s health system results in people with mental illness getting ‘stuck’ in Emergency Departments outlines this situation in detail. This report’s recommendations are as relevant today as they were five years ago — but unfortunately very little has changed in that time and their implementation is needed now more than ever.
“While the Four Corners program focused on NSW, these issues are occurring in EDs across Australia,” ACEM President-Elect Dr Peter Allely said. “ACEM is now calling for all Australian governments to act urgently to improve this situation. The College has developed a range of evidence-based solutions to access block, violence in the ED and mental health wait times and is committed to working with governments, hospitals and health systems to create meaningful change and make these solutions a reality.”
The College is currently developing a follow-up to the 2018 report The Long Wait, due for release later this year. More information on mental health care in the ED can be found here.
Background:
ACEM is the peak body for emergency medicine in Australia and Aotearoa New Zealand, responsible for training emergency physicians and advancement of professional standards. www.acem.org.au
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