(Transcript from World News Radio)
A new mental health facility in Adelaide has been designed exclusively for clients from remote areas, with a special focus on Indigenous treatment.
Karen Ashford reports.
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It's a far cry from old-style asylums: a modern block of buildings not that different in appearance from a hotel, set in landscaped gardens the size of Adelaide oval.
Outside park benches nestle under gum trees with pink blossoms, inside, the facility is so new they haven't had time to hang artwork isn't on the walls yet.
South Australian Country Health's Rural and Remote mental health unit is a city facility with a distinctly country feel.
"Over half of the population of South Australia resides in rural and remote areas and at any point of time about 25 per cent of our beds will be occupied by Aboriginal people and we always prioritise our beds at rural and remote to cater for those people who are coming to Adelaide who are Aboriginal."
Rebecca Graham is Country Health SA's Executive Director of mental health.
She says the new facility is designed and operates in a way that recognises culture is central to wellness.
"We have also the ability for people from country, Aboriginal people to have people to stay with them, so we have allowed that capability with roll away beds. And also the staff in terms of the training have all had cultural competence training we have an aboriginal mental health team with two psychiatrists, two aboriginal health workers and a registrar, which is a doctor in training who have been specifically trained in dealing with aboriginal people in assessment and planning."
The 23 bed unit is part of a $130 million upgrade of metropolitan mental health services.
Aboriginal mental health liaison coordinator Karen Bates says the buildings are much better than the imposing red brick block that services used to be in.
"You see that everything opens up so there's actually airflow throughout the building, there's curves rather than edges, there's also access to the sky which I think is huge for Aboriginal people particularly from out bush, who can actually see the stars at night."
The facility has another distinction - Rebecca Graham says it's the state's only in-patient mental health facility to combine modern medicine with Aboriginal traditional healing.
"We're very comfortable with having traditional healers, nunkaris, come down and we'll be working with people from a spiritual healing component as well as part of their care."
The service draws on a pool of nunkaris from different places, depending on the client's background and needs.
Karen Bates says nunkaris are living proof that pills aren't always the answer to ills.
"We access quite often with traditional healers, and we bring them in, they see the clients on the ward - they're more than happy to see anyone really. Often we'll bring traditional healers in the see a specific Aboriginal client but then often they'll end up sitting down and talking with all the patients on the ward so it's quite, that's excellent I think it's a vital key."
In a deliberate departure from previous practices of confinement, this is an open access facility.
Clients can move around, make phone calls, and engage with others.
Each room has its own en suite bathroom and entry is by electronic swipe card - meaning clients can come and go as they wish from their room, without others accessing their private space.
Otherwise there are almost no locks on site, except for clinical areas where medications are kept.
Rural and Remote Network Manager Dan Donaghy says everything about the facility is designed to promote wellness.
"Whilst they're here we give people as many choices as we can - we have the open unit, people can walk out the doors as you've seen, it's not a locked facility, people can circulate around, we've got a variety areas where people can go. That's another great advantage of this building is that we have several different spaces where people can just be during the day, a number of them outside and some interior lounges where people can get some space from each other, because there are 23 people and they're thrown together, they wouldn't necessarily choose to be together. So we're already finding just the feeling of the unit is different, it's calmer, it feels better here."
Mr Donaghy says the change in clients when they transferred to the new unit was immediate.
"On the first day we were in one of the patients who in the old unit have never been out of his room the whole time apart from meals actually was sitting right here in this seat and spending time out and I notice while we're walking around today he's actually walking around the unit now as well, so I think it's a very therapeutic environment. The old unit was quite sterile, it was clean, it was fine but this is a really nice place, very therapeutic."
Another change has been around the use of modern technology.
Rebecca Graham says video conferencing means clients can stay in touch with family and community and this is making a significant difference to people's recoveries.
"We had an instance recently where a young chap from the APY Lands was in the rural and remote unit, and we were able to video conference to his family back on the Lands , so they came to the clinic up on the APY Lands and he was able to see members of his family while he was all the way down here in Adelaide. So that is fantastic, so having that connection by video conference is good and that helps bridge the gap so our staff continue to have a connection with country."
Where possible the preference is to keep people at home in their own comfort zone.
It means the clients who come to the facility at Glenside in Adelaide's eastern suburbs are those with acute needs that cannot otherwise be effectively addressed.
The treatment doesn't end when a client is discharged.
Special effort is made to understand what circumstances clients will return home to - something Rebecca Graham says is important to ensuring the gains made in Adelaide don't unravel out bush.
Ms Graham says staff, from psychiatrists to nurses, visit remote communities to build relationships and ensure they understand the practical challenges facing clients.
It's a commitment she says has made all the difference.
"Recognising the communities they've come from and what they need to return home safely - that's the trick that's really unique. And we recognise as well that a lot of people we're caring for in rural and remote are generally more acutely unwell than what you'd see in the other in patient units in Adelaide, because we do want to keep people home whenever we can."
As part of that effort to keep people as close to home as possible, a new six bed facility will be opened at Whyalla at the end of the month, with units in South Australia's Riverland and South East to follow.