Emergency department waits of 35 hours for some SA mental health patients, AMA warns
The emergency department sign at the Lyell McEwin Hospital in Adelaide's northern suburbs. Photo taken October 25, 2023. (ABC News: Che Chorley)
In short:
An AMA report has found 10 per cent of mental health patients in SA emergency departments are waiting for "more than 35 hours".
The government says extra beds at Noarlunga will ease some of the pressure, but the opposition says ramping remains a significant driver of excessive wait times.
What's next?
The AMA's SA president is calling for both major parties to develop costed mental health policies heading into the March state election.
One-in-10 mental health patients in South Australian hospital emergency departments are waiting "more than 35 hours" for a bed, according to an Australian Medical Association (AMA) report.
The wait times, equivalent to a day-and-a-half, were the "worst result nationally for this metric" in the AMA's Public Hospital Report Card: Mental Health Edition.
The report, which compared wait times in 2023-24 to previous financial years, found an admitted mental health patient was waiting 11 hours and 18 minutes.
"That's not good, because we know the emergency department is not the best place for mental health conditions," AMA SA president Peter Subramaniam told ABC News.
Dr Subramaniam said a mental health patient's condition could often escalate during those long wait times.
"There is a certain group that will always require acute care," he said.
"[But] we need to see what we can do to provide the health care, the mental health care, or mental health support for patients before they require emergency departments."
Vascular surgeon Peter Subramaniam says new beds are welcome but additional hospital capacity alone will not fix the problem. (ABC News: Sarah Maunder)
According to the AMA report, the number of mental health public hospital beds respective of the population was "above the national average" — but so was the rate of mental health-related ED presentations.
"The median patient who is eventually admitted now waits nearly four-and-a-half hours longer than they did four years ago (2019-20) — a 70 per cent increase over the past decade," the report stated.
"Extended ED wait times and ambulance ramping are symptoms of a system in gridlock, where overworked staff are unable to admit new patients due to exit block, under-resourced facilities, and broader systemic pressures."
'Different model of care'
The report came ahead of 48 new hospital beds opening on Tuesday as part of a $74 million expansion of Noarlunga Hospital.
The extra beds include 24 new mental health beds which were first announced more than two years ago.
Health Minister Chris Picton said they would reduce pressure on the system.
"I wish we could have clicked our fingers and had these beds open three years ago, but building mental health beds and capacity takes a really long time," he told ABC Radio Adelaide on Monday.
"These are a different model of care, a lot of these extra beds, in that they're rehabilitation beds, so they're giving people a longer stay to make sure that when they leave hospital it doesn't become a revolving door and they bounce back into hospital shortly afterwards."
The SA government says new beds will soon be opening at Flinders Medical Centre, where the hospital is currently undergoing a major expansion. (ABC News: Che Chorley)
Mr Picton said 24 beds were "about to open" at Modbury Hospital, with another 12 at Flinders Medical Centre.
"The truth of the matter is, though, that the people who are … getting stuck waiting for beds in emergency departments, often they're people with conditions such as schizophrenia, people with acute psychosis," he said.
"They aren't necessarily the people we can easily get into a Medicare mental health centre or other service."
Dr Subramaniam said the new beds were welcome, but additional hospital capacity alone would not fix the problem.
He said increasing patient access to psychologists, acute care crisis teams and GP "shared care programs" were key to addressing the problem.
"You can't criticise the government for having additional beds because that's a step in the right direction," he said.
"But what we want — and seeing that we're coming up to a state election — is for both parties to have a clear community mental health program which is not just an announcement — it's funded, it's got the right workforce configuration, and has the capacity to [take] us into the future.
"This is a complex problem, but governments are elected to solve complex problems."
Opposition leader Vincent Tarzia said too many patients were "still falling through the cracks" and that there was a need for "many more resources dedicated to mental health in this state".
He said the opposition would be "announcing a suite of policies dedicated to mental health" but said ramping was a significant contributing factor to the excessive waiting times.
"For 41 months it's been the worst it's ever been and because of that you're now seeing that affect issues like mental health," Mr Tarzia said.