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Mental health reform floated after four-fold increase in emergency detentions

Dominic Giannini 8 November 2019 12
Ambulance

Anyone who is subject to emergency detention under the Act must be transported to an approved facility. Photo: File.

ACT Minister for Mental Health Shane Rattenbury has flagged reforms to the Mental Health Act after ACT paramedics have recorded more than a fourfold increase in the number of emergency detentions in one year.

Mr Rattenbury said he has asked chief psychiatrist Denise Riordan and Emergency Services Commissioner Georgeina Whelan to immediately investigate the unexplained increase in emergency apprehensions made by members of the ACT Ambulance Service (ACTAS).

A spokesperson from the Canberra Health Services (CHS) said they are working closely with ACT Ambulance to ensure that emergency services are responding to mental health crises in an appropriate way.

“The Health Directorate, CHS and the Chief Psychiatrist are currently investigating opportunities for reform to ensure this section of the Act is invoked as appropriate, and ways ACTAS and CHS services can collaborate to provide care to people experiencing mental health crisis,” they said in a statement.

“This will also consider whether any policy or legislative adjustments are needed.”

Laws introduced in March 2016 gave ACT paramedics emergency detention powers if a person with a mental disorder or mental illness “has attempted or is likely to attempt suicide or to inflict serious harm on themselves or another person; or … the person’s condition will deteriorate within three days to such an extent that they would require immediate treatment, care or support”.

Anyone who is subject to emergency detention under the Act must be transported to an approved facility, such as the Canberra Hospital Emergency Department, for assessment by an approved medical officer.

There has been a 60 per cent increase in emergency apprehensions on patients with mental health problems in the last year according to the Chief Psychiatrist’s annual report, with paramedics making 1,171 detentions in the 2018-19 financial year.

In previous years, 171 and 273 people were apprehended by paramedics, with last year’s total apprehensions totalling 1,271, marking a 430 per cent increase in emergency detentions by paramedics in 2018-19.

This diversion, coupled with an exponential increase in the emergency detention of people with mental illnesses has led to the inundation of Canberra Hospital’s emergency room. The hospital has admitted that it doesn’t have enough psychiatric beds to meet the demand, inflicting more stress on waiting times within the already resource-stretched department.

The CHS says it is working on a multi-faceted approach in order to reduce the number of patients who end up in emergency departments.

“We are also working extensively to set up the Police, Ambulance and Clinician Early Response (PACER) model of care.,” the CHS statement says.

“The model will see police, ambulance paramedics and mental health clinicians come together to provide a multidisciplinary response for the safe assessment and treatment of people experiencing acute mental health episodes,” it continues.

“It is designed to better support in-situ mental health assessment, treatment and care and is anticipated to reduce front-line service demands on emergency services and reduce presentations to hospital emergency departments.”

The annual report also reveals a steady increase in the number of emergency detentions authorised for up to three days, as well as a steady increase in the number of 11-day extensions being granted. Proportionally, there has been a slight increase in the granting of these extensions from 43 per cent and 44 per cent in the 2015-16 and 2016-17 financial years, to 47 per cent in the last two years.

One-third of these extension orders required involuntary treatment, care and support via a psychiatric treatment order.

Mental health funding was at the centre of the Barr government’s latest budget, expanding operating hours of mental health consultation services at the Canberra Hospital, opening a specialist clinic for eating disorders and establishing an electroconvulsive therapy service to treat depression.

The budget also included funding for four full-time school psychologists and one administrative support worker to help tackle and prevent mental illness among students.


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12 Responses to Mental health reform floated after four-fold increase in emergency detentions
mickos mickos 2:44 pm 13 Nov 19

Apart from ICE being a contributing factor , ever increasing inequality along with even more prejudice dished out by the ignorant government. There are far too many people in Canberra with severe and persistent illness who do not fit the Canberra ‘ mould’ of being a public servant on at least $80K per year. They do not fit in to the clique. Yet all government will ever do is look for more ways to punish those with a mental illness. Government will never understand that Canberra does not cater to certain demographics ,yet this excuse for a city was planned by government in this way. Canberra is a factory of mental illness as a result ,and worse still, many marginalised live in ACT public housing and cannot leave Canberra for employment reasons so must stay on welfare with no future at all even if they get a start elsewhere. For them it’s a choice between having somewhere to live or starting a new job/life in a proper egalitarian environment. How is it productive or beneficial to society for government to force people who don’t belong here to continue living here with no future?
At least a poor tenant of NSW public housing can transfer when/if employed . Mental health reform can only ever be achieved if ACT government employees abstain from their culture of prejudice( Stories in CT surrounding bullying within ACT ‘health’ suggest they can’t respect each other, let alone patients), as well as as a holistic co-ordinated approach to mental health by NSW/ACT authorities, INCLUDING the public housing system. ACT mental health NEVER demonstrates an understanding of how life on a beauracratic island can affect peoples health, yet this knowledge is quite often well understood by a NSW health Dr. Wake up Government

Cary Elliot Johnson Cary Elliot Johnson 8:25 am 13 Nov 19

Linda Moore. Let's see if they "actually" do something

Carmen Bartley Carmen Bartley 6:25 pm 10 Nov 19

Two reasons. 1. The drug ice and the psychosis it causes. 2. Lack of funding to CATT so they do not attend most calls for help. There, saved ya an inquiry. Now fix it.

    Mark Strickland Mark Strickland 7:30 pm 10 Nov 19

    Carmen Bartley if only it were that simple

    Maree Anne Pavloudis Maree Anne Pavloudis 7:57 pm 10 Nov 19

    Hopefully the PACER programme will be up and running soon.

    Carmen Bartley Carmen Bartley 8:23 pm 10 Nov 19

    Maree Anne Pavloudis what's that?

    Chris Cross Chris Cross 9:56 pm 10 Nov 19

    Diversion. Stop them arriving at the hospital in the first place.

    Maree Anne Pavloudis Maree Anne Pavloudis 11:19 pm 10 Nov 19

    Carmen Bartley The article says : “We are also working extensively to set up the Police, Ambulance and Clinician Early Response (PACER) model of care.,” the CHS statement says.

    “The model will see police, ambulance paramedics and mental health clinicians come together to provide a multidisciplinary response for the safe assessment and treatment of people experiencing acute mental health episodes,” it continues.

    “It is designed to better support in-situ mental health assessment, treatment and care and is anticipated to reduce front-line service demands on emergency services and reduce presentations to hospital emergency departments.”

    I went to a presentation of the PACER model. It will be a specially designed Ambulance vehicle that will be staffed by police, ambulance and a clinician to respond to Mental Health crisis. They will have special training and will be the first responders.

    Carmen Bartley Carmen Bartley 11:31 pm 10 Nov 19

    Maree Anne Pavloudis they need to do this. And have quite a few of them!

    William Brooks William Brooks 7:48 pm 11 Nov 19

    Carmen Bartley replace ice with alcohol and have teams that can deal with the effects of alcohol and you might be on to something.

    Carmen Bartley Carmen Bartley 8:00 pm 11 Nov 19

    Don't replace it. Make it alcohol and ice. Both causing huge problems

    Carmen Bartley Carmen Bartley 9:01 am 12 Nov 19

    Joshua Smith they are the mental health crisis assessment and triage team. That is literally there job, to respond in a mental health crisis

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