26 Feb 2018

Doctors push to reduce wait time for mental health patients

6:49 am on 26 February 2018

Emergency doctors are calling for major improvements to the care of those with acute mental and behavioural conditions.

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Photo: 123rf.com

It follows the release today by the Australasian College of Emergency Medicine of a snapshot survey carried out in Australia and New Zealand last December.

It found that only 3.7 percent of those presenting to hospital emergency departments in this country identified as having a mental health need. However, those same patients comprised a quarter here (28 percent in Australia) of those caught up in so-called "access block" in hospitals.

That is, they received initial assessment and treatment in the emergency department, or ED, but waited there for more than eight hours for an inpatient bed or community care.

Read the full survey by the Australasian College of Emergency Medicine

Access block occurs when hospitals are unable to move patients from the ED into beds in wards. It's widely regarded as a barometer of the efficiency of the whole hospital system in individual hospitals.

The college's New Zealand faculty chair, Waikato Hospital emergency department head John Bonning, said that on its own access block was disturbing. "So when some of the most vulnerable people in our communities - patients with acute mental and behavioural conditions - become caught up in access block, it is time for action."

Those involved commonly had problems with depression and anxiety and may have attempted self-harm or suicide.

Dr Bonning said EDs were poorly designed to cater for those patients, and there was a lack of on-site emergency mental health staff to assess and look after the patients around the clock.

"It is challenging. These patients are stressed and they need specially designed areas to look after them. They need people to look after them; we call them safety partners. Patient-watch if you like, to make sure the patient is kept safe and does not abscond. A lot of these patients are very nervous, anxious, perhaps don't want to be there sometimes. They are sectioned under the Mental Health Act and we struggle to find the resources to have people to look after them."

He said it was time for district health boards, hospital employers and executives, as well as the government to address the issue and develop new policies to support shorter stays in emergency departments.

Dr Bonning said many mental health presentations to EDs were likely to occur as a result of "chronic underfunding". The college believed increased funding to community-based and inpatient mental health, alcohol and other drug services was also needed.

As well, Dr Bonning said it also supported reporting to the Health Minister or a health rights commissioner when access block meant a wait longer than 12 hours in the emergency department for a mental health patient.

Where to get help:

Need to Talk? Free call or text 1737 any time to speak to a trained counsellor, for any reason.

Lifeline: 0800 543 354

Suicide Crisis Helpline: 0508 828 865 / 0508 TAUTOKO (24/7). This is a service for people who may be thinking about suicide, or those who are concerned about family or friends.

Depression Helpline: 0800 111 757 (24/7)

Samaritans: 0800 726 666 (24/7)

Youthline: 0800 376 633 (24/7) or free text 234 (8am-12am), or email talk@youthline.co.nz

What's Up: online chat (7pm-10pm) or 0800 WHATSUP / 0800 9428 787 children's helpline (1pm-10pm weekdays, 3pm-10pm weekends)

Kidsline (ages 5-18): 0800 543 754 (24/7)

Rural Support Trust Helpline: 0800 787 254

Healthline: 0800 611 116

Rainbow Youth: (09) 376 4155

If it is an emergency and you feel like you or someone else is at risk, call 111.