Workers Lose Sleep Over Mental Health Nightmare

Fall-out from chronic underfunding of the mental health system is causing some workers to lose sleep at night over the things that they are seeing, reports student journalist Glenn Freeman.

In conversations with psychiatrists, nurses and others working with the mentally ill, a number of common problems are raised including bed shortages, lengthy delays admitting patients and under-funding.

Natalie Rutherford is a member of Australian Salaried Medical Officers Federation and a representative of the Mental Health Workers' Alliance (MHWA).

'The chronic under-spending means that patients aren't being looked after the way they should be,' said Ms Rutherford. This can have dire consequences.

One example was a case that was tried in the Supreme Court in April. Michael Kosowicz, who suffered from schizophrenia, was found guilty of murdering a five-year-old girl. He had been released from Liverpool Hospital only days earlier, despite doctors' warnings that he may be dangerous.

Gladys Berejiklian, NSW Shadow Minister for Mental Health, said that in her short time in this newly created role, she has heard from a number of people bitterly disappointed with the system.

'Some mental health workers are unable to sleep at night because of the things they are seeing,' she said.

She described the case of a 16-year-old girl in Coffs Harbour Hospital who, because of bed shortages, was placed in a room with two male psychiatric patients. One of the men was sedated because of his violent tendencies. 'Staff members were extremely disturbed by this situation,' she said.

Berejiklian said she was shocked at the state of the mental health system in NSW, believing that NSW has the worst record in the country.

According to figures from the 2004 Productivity Commission Report, NSW consistently falls at the bottom of the list.

Funding of the many non-government organisations (NGOs) that assist the mentally ill and their carers is well below par, according to Berejiklian. 'The state government only gives 2.4% [of the health budget] to NGOs; other states give around 9%.'

Douglas Holmes is Executive Officer of the Consumer Advisory Group on Mental Health (CAG). He believes that NSW Health lacks the strategic vision required to solve endemic problems within the system.

'The government has not tackled the structural changes [that are needed],' said Holmes.

He believes the issue of human rights for 'forensic patients', those who have been involved in a crime, is a particularly fraught area for NSW Health.

According to Holmes, there are over 270 diagnosed forensic patients in NSW. Many of these are hospitalised within general mental health wards. Only 90 are cared for within a forensic hospital. These lucky few are held in the only such facility in NSW, which is inside Sydney's Long Bay Correctional Facility.

Other community groups have similar concerns. SANE Australia is a national charity helping people with mental illness through campaigning, education and research.

'The government is not adopting the necessary broad-based initiatives,' said Paul Morgan, Deputy Director of SANE.

In late April they presented the State Government with a report titled 'There to Care'.

A central finding of their research was a desperate shortage of mental health nurses. According to Morgan, the incentives for nurses who specialise in mental health are simply not there. He said the lack of new nurses and doctors coming through the system will compound the problem.

Doctors in NSW are also unhappy with the system. Anthony Llewellyn, a psychiatrist for Hunter/Newcastle Mental Health at James Fletcher Hospital, is a member of the Health Services Union and MHWA.

Training of mental health staff has been his major area of concern for some time. '[There's been an] erosion in the level of service in mental health,' he said. 'This diminishes the care of patients and makes it less enjoyable for people working in the area.'

'[There is] no long term vision to ensure there is a constant supply of new mental health workers,' he said. Llewellyn believes that in the next five to 10 years there will be a crisis in the staffing levels of mental health professionals.

Referring to patient care, he spoke about the high rate of acute treatment followed by early discharge, explaining that this becomes a vicious circle. 'We're only able to do a patch-up job, we don't have the resources to focus on proper treatment,' he said. Ultimately they often end up treating the same patient a second time because they have not adequately addressed the problem initially.

'There is a whole layer of bureaucracy between [government] and what's happening on the ground,' he said.

Glenn Freeman is in his final semester of a Graduate Diploma in journalism at UTS. For inquiries contact gpf78@iprimus.com.au

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