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ACEM President Dr Simon Judkins said the report highlights many of the issues that emergency doctors have been raising, including the enormous pressure being placed on hospital emergency departments (EDs) to deliver frontline mental health services.
Dr Judkins said the College welcomed the draft report embracing many of the College’s recommendations, including:

  • Redesigning EDs to meet the needs of people with mental illness;
  • The need for increased inpatient mental health beds commensurate with demand for both adults and children/youth;
  • Alternative services for people experiencing mental health crisis, particularly after hours;
  • Increased sub-acute community residential mental health services;
  •  More incentives to reduce hospitalisations and repeat ED presentations;
  •  More flexibility for primary health networks in the commissioning of mental health services; and
  •  A more people orientated mental health system.

While the draft report’s recommendations are welcome, ACEM notes its call regarding mandatory reporting of 12 and 24 hour ED waits has not been included.
“We see too many instances of mental health patients waiting for 24 hours or longer in EDs to receive the treatment they need. ACEM once again calls for all states and territories to embrace a national standard which ensures that no patient is left waiting for 24 hours or more in an ED, with mandatory reporting of 12 and 24 hour ED waits to hospital CEOs and Health Ministers respectively,” said Dr Judkins.
Dr Judkins said governments and our healthcare systems needed to act on the recommendations now.
“While the recommendation of developing alternatives to EDs, particularly after hours, is very welcome, it is also important to recognise that for many, EDs will be the only available option. Much can be done to build the capacity of EDs and ED staff to streamline pathways, connect patients with outpatient services and stepped care, and improve early identification of problems, and diversion from EDs to more targeted services,” said Dr Judkins.
“These problems have long been acknowledged, but the reality is that the number of patients languishing in EDs is increasing. EDs often act as the front door to the country’s health and mental health system, with many turning to EDs for the help they cannot find elsewhere in the community at the time of their crisis.

“We are well past due for whole of system solutions to help ensure an integrated, working mental health system that truly meets the needs of patients and their families. ACEM supports strong collaboration and partnership between Federal, State and Territory Governments, and healthcare systems to help make that a reality.”
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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