By: Dubby Henry
Mental health patients admitted to emergency departments wait longer than other patients to get proper treatment, new research has found – putting their lives and future health at risk.
Emergency departments aim to have all patients seen and moved out of the ED into the appropriate ward within six hours. Those that are stuck there for longer than eight hours are considered to be experiencing “access block” – usually due to lack of hospital bed capacity.
A snapshot survey at seven of the country’s emergency departments last December found that although only 3.7 per cent of ED inpatients present with mental health issues, they make up a quarter of the patients who experience access block.
The Australasian College for Emergency Medicine (ACEM) – which trains New Zealand and Australian emergency doctors and carried out the survey – is calling for the Government and DHBs to make urgent improvements to the hospital system to ensure the “discriminatory” practice stops.
“Chronic underfunding” was the likely reason for a spike in mental health patients presenting at EDs, ACEM’s New Zealand faculty chair Dr John Bonning said.
Many of those admitted are for overdoses, but they may also be experiencing psychosis, or other mental health conditions, Bonning said.
Police are also increasingly bringing them to the emergency department rather than forcing people with mental health to spend a night in the cells for their own safety.
“On its own, access block is a disturbing phenomenon, and illustrates a problem with the whole hospital system,” Bonning said.
“So when some of the most vulnerable people in our communities – patients with acute mental and behavioural conditions – become caught up in access block, it is time for action.”
Bonning said it was unlikely that ED doctors were discriminating against mental health patients, but they presented with complex needs and the hospital system could not cope with the volume arriving at EDs.
Any time a mental health patient stays in the ED for more than 12 hours it should be reported to the Minister of Health or a human rights body, ACEM says. The college also wants improved access to alternative models of care, such as mental health support after hours and more funding for drug and alcohol rehab services.
Better ED design, including quiet, low-stimulus spaces, would help mental health patients cope.
ACEM president Dr Simon Judkins said all community members have the right to timely, high quality emergency medical care in a respectful environment. This includes mental health care.
“Long waits for mental health care in emergency departments are unacceptable and discriminatory and are likely to lead to serious deterioration in the well-being of patients,” he said.
Where to get help:
• LIFELINE: 0800 543 354 (available 24/7)
• SUICIDE CRISIS HELPLINE: 0508 828 865 (0508 TAUTOKO) (available 24/7)
• YOUTHLINE: 0800 376 633
• NEED TO TALK? Free call or text 1737 (available 24/7)
• KIDSLINE: 0800 543 754 (available 24/7)
• WHATSUP: 0800 942 8787 (1pm to 11pm)
• DEPRESSION HELPLINE: 0800 111 757
Source: NZ Herald