Mental health patients face record ED wait times

Patients are presenting to emergency departments (EDs) more unwell and waiting longer than ever before for mental health care, according to a damning new report.  
 
On Thursday, the Australian Medical Association (AMA) released its third annual report card on the nation’s mental health services, and the grades are not good.  
 
The Public hospital report card: mental health edition reveals a mental health system in crisis with longer wait times, less services and a resulting increase in severity of mental illness. 
 
It found that, on average in 2022–23, patients spent seven hours in an ED before being admitted to hospital, as public hospitals face a patient ‘logjam’.
 
Alarmingly, 10% of patients with mental health-related conditions spent more than 23 hours waiting. 
 
It found that in the past 12 years, the number of patients requiring ‘urgent’ attention has more than doubled, and those needing ‘emergency’ attention has increased by two thirds.
 
Dr Cathy Andronis, Chair of RACGP Specific Interests Psychological Medicine, said this is where GPs have an ‘extremely important but underacknowledged’ role.
 
She said the long waits in an ED can potentially traumatise patients further and be extremely disempowering.
 
‘EDs should be for emergencies and often people are just distressed and wanting human care and support from familiar others,’ Dr Andronis told newsGP.
 
‘For many people, GPs are the only people that they may have a relationship with so it’s important for emergency services to ask patients about who can help them with their current distress rather than assume that only ED is a safe place.’ 
 
Her comments come as the report found that ‘rather than being guided towards the emergency department by a GP, support service, friends or family, it is more often the case that an ambulance or police vehicle is called as a last resort’.
 
It said that in 2022–23, hospital stays averaged 14.3 days for mental health patients, compared to 5.3 days for non-mental health admissions.
 
It also found that with hospital mental health bed numbers continuing to decrease, Australia has its lowest per-person capacity figure ever recorded and waiting times for beds have blown out. 
 
Timely expert mental health care is already provided by GPs in the community, with the RACGP’s latest Health of the Nation report finding mental health remains the most mentioned concern in consults.
 
Recognising and strengthening the existing community based mental healthcare services provided by multidisciplinary primary health care teams including GPs, mental health nurses and allied health professionals is urgently needed. 
 
Integration of mental health services within whole person-centred primary health care is key to preventing further segmentation of care and fragmentation of the health care workforce. 
 
Additionally, there are critical benefits to be gained through expert, preventive and timely care from a GP, which can in turn reduce admissions.
 
Dr Andronis said people are wired to need connections with others and without community connections, isolation and loneliness are continuing to deepen, contributing further to ill health.
 
‘We have become a disconnected society, and loneliness is at pandemic proportions,’ she said.
 
‘The focus on individualism in our society sadly ignores humans innate need to connect with trusted others and loved ones. 
 
‘We all get more alienated from each other and then all of society suffers. Instead of supporting each other we become alienated and afraid.’
 
Dr Danielle McMullen, GP and Federal AMA President said this shows a health system that is ‘failing to provide care for some of the most vulnerable in our community’.   
 
‘The solution to the growing mental health burden on our hospitals is additional resourcing and real reform to the delivery and availability of mental health support at all levels.’ 
 
’As a GP, I understand all too well the importance of an interconnected and well-functioning mental healthcare system. 
 
‘The staff in these departments are brilliant – but emergency departments are not designed for mental healthcare.’ 
 
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