After-hours access challenging for adults with a mental health issue

The Bureau of Health Information’s (BHI) People’s experiences of mental health care in NSW revealed that 800,000 people across the state received more than 3.5 million Medicare-subsidised mental health services in 2017–18.
 
More than one-third of adults in NSW with a mental health issue (34%) said it was ‘very difficult’ to access medical care outside of office hours, which was twice as high as those not experiencing an issue (17%).
 
‘People presenting to EDs [emergency departments] with mental health-related issues waited longer for treatment, spent more time in EDs and reported less-positive experiences of care,’ BHI Chief Executive Dr Diane Watson said.
 
Dr Simon Judkins, President of the Australasian College for Emergency Medicine (ACEM), said the report confirms many of his college’s issues and concerns.
 
‘The report tells us that on every measure, mental health patients rated their experiences of care in the [ED] as lower than non-mental health patients,’ Dr Judkins said.
 
‘As patients experiencing mental health crisis continue to feel they have nowhere else to go in the community – especially after hours – hospital [EDs] and staff will continue to be placed under enormous pressure.’
 
Dr Judkins is also alarmed at data showing that patients experiencing a mental health issue waited in an ED for 24 hours or more.
 
‘That figure remains unacceptably high and only serves to heighten all the other risks we have so often raised regarding patient and staff safety and adequacy of care,’ he said.
 
NSW Greens MP Cate Faehrmann echoed those concerns.
 
‘It’s unacceptable that people who are already incredibly distressed not only wait longer but are reporting more negative experiences with the care they’re receiving,’ she said.
 
Dr Judkins said ACEM is calling for call 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] to receive the treatment they need’.
 
‘People in mental health crisis and their families need a system that offers comprehensive, coordinated, multidisciplinary care, 24 hours a day, seven days a week,’ he said.
 
 
The BHI report examined different ‘aspects of the care journey’, including care provided in the community, EDs and inpatient settings.
 
‘Almost all adults with a mental health issue in NSW [95%] had a regular doctor or place of care, which is important to help people access the services they need,’ Dr Watson said.
 
‘While around seven in 10 adults with a mental health issue were able to get help from a health professional when they needed, they found it much more difficult than adults without a mental health issue to access out-of-hours care.’
 
Other key findings:

• Nearly one in 12 people in NSW received mental health services from GPs in 2017–18
• Use of specialised community mental health services was higher among Aboriginal patients and in very remote communities
• Almost all adults with a mental health issue in NSW had a regular care provider, and the majority reported positive experiences
• Adults in NSW with a mental health issue were more likely than those in comparator countries to discuss their worries and stresses with their regular care provider

after hours emergency mental health