Mental Health Services (Proof)

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About this ItemSpeakers - Torbay Mr Richard Business - Private Members Statements, PRIV

MENTAL HEALTH SERVICES
Page: 81

Mr RICHARD TORBAY (Northern Tablelands—Speaker) [6.27 p.m.]: The tragic shooting of 25-year-old Elijah Holcombe in Armidale earlier this month highlights the need to improve access to crisis services for people with mental health problems. While I do not want to pre-empt the findings of an inquiry into the police shooting that led to Elijah's death, I do want to raise my community's concerns that the system let this young man down, as it has others. I feel sure that the situation in Armidale is not unique. I suspect it is repeated in centres across New South Wales experiencing a shortage of mental health specialist staff. Accident and emergency departments in these areas are generally not equipped to deal with people with mental illnesses seeking help at times of crisis.

There is some agreement that support services for people with mental health problems living in the community have improved through more government funding. There is also consensus that this improvement does not extend to people in crisis who present at accident and emergency departments, usually in the evening or at weekends. I have been told that unless people are suffering an asthma attack, a heart attack or are bleeding profusely, they are routinely asked to wait their turn in the waiting room, sometimes for long periods.

For people with mental health issues suffering extreme anxiety, the crisis may be the equivalent of a heart or asthma attack but that is not recognised in our system. One man told me he has been presenting at the accident and emergency department three or four times a year for the last 25 years. He is highly intelligent, regularly takes his medication but, despite that, develops sudden high anxiety and suicidal tendencies that need crisis treatment and hospitalisation. Although he is well known at the accident and emergency department, he is required to repeat his case history each time and then has to wait. He advised me that the last time it took six hours, from 7.30 p.m. to 1.30 am, for him to be admitted to hospital. At one stage when he expressed anger at the delay, a security guard was called but the patient still had to wait several more hours until admission. He believes the long waiting period worsened his symptoms, and he knows that many other people with mental illnesses have had similar experiences.

Another case reported to me concerned a young woman with serious chronic mental illness whose parents brought her to the accident and emergency department during a crisis. A doctor told them that she was not ill enough to be admitted and she was sent home. A Sydney psychiatrist later over-rode the doctor's decision. Her parents wonder why the records from the hospital's mental health unit were not available to accident and emergency staff.

Following Elijah's death, a woman with a history of mental illness called at my office claiming that after she could not access treatment at accident and emergency, she stepped into the path of a reversing car, was injured, limped into town and was later admitted to hospital by ambulance. There are countless other stories like this and I was told that carers, supporters and the people suffering chronic mental illnesses regarded an incident like Elijah's sadly as inevitable, given the inadequacy of resources for mental health crisis services in rural New South Wales.

Many suggestions have been made to improve the situation. These include involving carers more closely to give advance notice when bringing patients to accident and emergency to reduce waiting times, better risk analysis, a national patient data base be set up and made available to all accident and emergency departments, and carers be issued with special cards to present at times of emergency. Other proposals are that psychiatric nurses be on duty in accident and emergency departments after hours and at weekends when demand is highest; a psychiatrist be on call to give advice when required; waiting times be reduced; mental health patients not be left on their own without regular checking; accident and emergency staff receive additional training, support and resources in dealing more effectively with people with mental health issues; and that more mental health unit beds be provided in country hospitals.

There is a case for hospital and Government agency staff to work more closely with community-based mental health service providers, for improved communications, better education for GPs on appropriate medication to treat mental illnesses and regular follow-up after hospital discharge. If we do not want to see more tragic incidents like the one in Armidale, it is important that these matters be addressed. I certainly do not want to be critical of front-line staff. They work very hard and they do their best with the resources they are given.

If we can improve the information flow and the quality of the information on services that are available and look at supporting additional resources, everyone in the community will be better off. I am certainly willing to talk to and negotiate with both the Minister for Health and the Minister Assisting the Minister for Health (Mental Health) to ensure that this is a priority for our regional communities.