16 April 2021
For three years the Australian Nursing and Midwifery Federation (SA Branch) has warned the Marshall Government of impending disaster should it continue to fudge on the issue of mental health care in this state.
We have advocated and agitated until blue in the face, but it appears all we get is a Marshall Government missing in action.
See the today's coverage in The Advertiser: Mental Health Coalition’s warning to Health Minister Stephen Wade – ‘get real’ and deal with this crisis now
“One of the key issues identified immediately after the Government took office was the need to address the surging mental health presentations in emergency departments, their inordinate length of stay - often days at a time - and the urgent need for alternative places of treatment, beds and community teams,’’ ANMF (SA Branch) CEO/Secretary Adj Associate Professor Elizabeth Dabars AM said.
“We warned Health Minister Stephen Wade again in a letter in late February that failure to appropriately address the problem of mental health patient flow through the system ‘will result in disastrous consequences for the future of health care in this state’.
“The results for patient care and for nursing staff in the emergency departments have been horrendous.
“Again, nothing was done and now our health system is at tipping point,’’ Ms Dabars said.
“The issues facing mental health are a microcosm of a very dire bigger picture and the direct result of an absence of a meaningful plan or strategy to drive decision making and the resourcing of health services.
“If and when the system does collapse the impact on the community will be catastrophic.
“The deluge in mental health admissions to emergency departments – in record numbers at the RAH - is just one piece in a house of cards and contributes in no small way to the lack of patient flow - and therefore care - throughout the system.
“They are all inter-related. Hospital overcrowding and overcapacity is now spiralling out of control and threatening lives.
“When our hospital system cannot even provide timely care to children, you just know that health in this state has reached a critical point.
“The problems facing the hospital system have only worsened over time and health professionals feel little is being done to address the chronic overcrowding and overwhelming demand for services, leading to ramping, delayed care, immense pressure on staffing and resources and discharge blockage.
“The overcapacity in EDs also leads to the inhumane treatment of people experiencing acute mental health issues. They are not receiving the care that they need and deserve, in appropriate settings by people with the specialist skills to ensure they will achieve the best outcomes. It is a disgrace.
“And it so often results in violence and aggression being levelled at nurses by people whose special needs are simply unable to be met, leading to frustration and agitation. As one nurse put it, “You shouldn’t have to be going to work to be called a #$@! every five seconds’.’’
The Advertiser reported there were more than 25,700 mental health presentations to emergency departments in Adelaide last year but about half of those did not need to be admitted to hospital.
“Presumably there was nowhere else to go as there are simply not enough inpatient beds or suitably skilled people in community care. These are consistent and significant gaps in the workforce across the state,’’ Ms Dabars said.
“Mental health is one of the most visible but there are a multitude of problems with health. The Marshall Government’s inability and apparent reluctance to deal with the systemic issues facing health care, including woefully inadequate patient flow and discharge processes, lack of aged care services and NDIS failures, are rapidly intensifying the pressure on our already overburdened emergency departments and acuity wards.
“We have been calling for a comprehensive workforce plan to address the anticipated staff shortages due to the predicted loss of nurses and specialist skills in an ageing workforce.
“It is expected that 50% of nurses and midwives will leave the workforce in the next 10 years, with a peak in retirements in 2025. Many of these staff are leaders and specialists in their fields which will put enormous stress on the South Australian health system given the significant loss of skills and knowledge.
“Despite our repeated calls for a plan to renew the workforce, we have not seen any significant policies or action.
“Instead, we see more attacks on the workforce, including increased use of temporary contracts and casual staff and, inexplicably, SA Health’s continued push for voluntary separation packages, which just beggars belief given the looming staffing crisis,’’ Ms Dabars said.
“Former mental health executive Adj Professor John Mendoza called SA Health ‘by far the most ossified and inept central portfolio agency in my 28-year state and Commonwealth public sector career and 15 years of consultancy work’, one which ‘couldn’t organise a chook raffle’.
“If that doesn’t prompt a push for urgent change, then never were truer words spoken.’’