Police left to prop up ailing mental health system

In Australia's most populous State

Police, nurses, doctors and ambulance officers have joined forces to address the state's growing mental health crisis, describing a system that is out of control and unsafe for both staff and patients. Laying the blame on the State Government, they say a shortage of psychiatric beds and community care facilities meant emergency departments had become the only place for those with a mental illness to go, while much of the burden of transporting patients was left to already overworked police.

A survey of more than 500 doctors, nurses, police, health and emergency workers revealed the system's chronic under-resourcing. It forced patients to sleep on mattresses on the floor or be locked in seclusion rooms for days. More than 90 per cent of police said their ability to do their job was being affected by caring for mentally ill people and have described an average 20 call-outs a week because there was no mental health team available. The survey, by the newly formed Mental Health Workers Alliance, found police were spending up to 30 hours a week transporting mentally ill people in police cars, with more than 75 per cent feeling at risk and inadequately trained.

Inside hospitals, the survey found 60 per cent of doctors felt pressured to prematurely discharge those with a mental illness because of bed shortages. Almost 70 per cent were unable to get a bed for a patient with a mental illness in the past three months, while many were forced to keep patients in emergency departments for five days or more.

The alliance was established this year by unions representing nurses, police, doctors and emergency workers to express their concern about the decaying mental health sector. Toby Reaburn, a nurse unit manager at the Matthew Talbot Hostel for homeless men, said the incidence of acutely mentally ill rough sleepers - particularly young people - was increasing.

He spoke of finding people with mental illnesses living on the streets still in their prison greens, and of those prone to violence after being locked in a seclusion room for six days. "It was worse than a jail cell - all because the area health service could not provide an adequate secure facility for him," he told the Herald.

Australia's expenditure on mental health - 7 per cent of its public health budget - is less than half that of other OECD countries such as Britain at 19 per cent and the US with 22 per cent. NSW, which spends 8 per cent of its public health budget on mental health, ranks lower than any state except Tasmania.

Luke Hannon, a NSW police sergeant, said police were forced to "prop up" the system. "If they had the right staffing - nursing staff, case workers, support staff - for the people with mental illness who are out there trying to fit back into the community, we would be dealing with this issue a whole lot less," he said.

The senior industrial adviser at the Australian Salaried Medical Officer's Federation, Sim Mead, said doctors reported having to discharge people prematurely. He said: "They either end up in the emergency department or in jail - the jails have become de facto psychiatric institutions."

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.

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