At the Royal Hobart Hospital, psychiatric beds have been cut from 42 to 32 beds.
“It's a very good question to ask why we lost the beds because it was strongly resisted by the psychiatry staff at the Royal Hobart Hospital,” says Dr Frank Nicklason, Chair of the hospital’s Medical Staff Association.
“We've noticed problems since that time.”
The cuts left only 19 mental health hospital beds for every 100,000 Tasmanians. By comparison, NSW has almost double that number, at 36 beds for every 100,000 people.
The bed shortage has had a flow-on effect for the hospital, with patients waiting in emergency for up to six days to go up to the psychiatric ward.
At the Royal Hobart Hospital alone there have been several deaths attributed to the bed shortage. In 2016 a man who was told there were no available psychiatric beds at the hospital killed himself that afternoon after returning home.
The coroner found the lack of beds directly led to his death: “Had sufficient beds been available in the mental health ward of the Royal Hobart Hospital then doubtless he would have been admitted and it is likely that he would not have taken his life.”
Later that same year, a young man killed himself in the emergency department bathrooms while waiting to be admitted to the psychiatric ward.
A young man killed himself in the emergency department bathrooms while waiting to be admitted.
And just this year a woman took her life while being treated in the general service unit of the psychiatric ward. Days earlier, doctors warned overcrowding could cost lives.
Michelle, not her real name, is a psychiatric nurse at one of Tasmania’s hospitals. She knows firsthand just how dangerous bed shortages can be.
“We're faced with a heavy patient load of people who need a lot of input and need a lot of care and support that we just don't necessarily always have the staff to cope with,” she says.
“So people are being neglected or forgotten about and it’s not therapeutic, it’s not helping them it’s just sort of ignoring them.”
Adding to the pressure are private mental health clinics. Although they often have psychiatric beds available, they’re not necessarily able to take in the acute patients the public hospitals do.
“If a patient is seen to be an acute risk to themselves or dangerous or agitated in a manner that private system doesn't believe that they can cope with they will just refer them on to the emergency department,” she says.
Tasmania has no dedicated psych wards for children and adolescents
Perhaps the most affected by Tasmania’s mental health shortages are its young people. Tasmania has one of the highest rate of youth suicides in the country. Despite this, the state has no dedicated psychiatric wards for children and adolescents. The nearest facility is in Melbourne.
Advocates say local mental health services are so stretched that many young people are falling through the gaps.
Dian Medwin’s son, Christopher, was seventeen years old when he killed himself in 2016 at their home in Somerset.
After showing signs of depression Christopher was put on medication and referred to a community based mental health service for children and adolescents where he saw what Dian calls a string of fly in and fly out psychiatrists.
“Every time he saw a psychiatrist they’d put him on medication then they’d leave,” she says.
“Then they’d get another one that comes in and…they’d take him off the tablets, like he went cold turkey. And then he just went right down. Hit rock bottom.”
During this time Christopher tried to kill himself three times. Increasingly desperate, Dian tried to get him admitted into a nearby adult psychiatric ward but was told there were no available beds.
“I feel like I was just really let down,” she says.
“And after that, he did it. He killed himself.”
Dian says that had there been a psychiatric ward for young people like Christopher, things may have been different.
“He didn't have that extra support and we didn't get it and I feel that the government has let us down as well and I still think that they should be ashamed of themselves for not helping the people in Tasmania,” she says.
"We need a new approach," says Prof. Pat McGorry
Experts say there are two critical shortages in public health happening in Tasmania. One is the lack of psychiatric beds in hospitals. The other is adequate community based mental health clinics.
“There's nothing between the GP and the specialist acute care,” says former Australian of the Year and Executive Director of Orygen, the National Centre of Excellence in Youth Mental Health, Patrick McGorry.
He says more community mental health services are needed.
“There's a tide of people coming into emergency departments looking for beds and appearing to need admission, whereas if they'd been looked after properly in the community earlier then they wouldn't have presented in the first place.”
Prof. McGorry says what’s needed is a "new approach to mental health".
“We need strong, proactive community mental health hubs which have expert mental health professionals, drug and alcohol mobile teams, all of the things we know work on preventative health care for serious mental illness,” he says.
Tasmania’s Health Minister Michael Ferguson declined The Feed’s request for an interview, but said this in a statement: “We will continue to deliver and improve services over the next six years, including 25 new mental health beds and specialist inpatient child and adolescent mental health facilities in the north and south of the state, for the first time ever in Tasmania.” You can read Minister Ferguson’s full statement here.
But Dr Nicklason says urgent action is needed today.
“We have a problem that needs to be addressed right now….and it needs to be substantially more beds than we have at the moment,” he says.
Asked how optimist he is about the government’s commitment to fund that facility, he says, “I’m more determined than optimistic.”
After spending four days in emergency at the Royal Hobart Hospital, Theresa was finally admitted to the psychiatric ward. She was diagnosed with borderline Personality Disorder and discharged the next day.
“I've come to realise, and as horrible as it sounds, I can't go nowhere, my children need me,” she says.
“I survived, others didn’t and it’s not fair, you know...we shouldn’t die thinking were not worth something.”
If you would like to talk to someone about your mental health, here are some people ready for your call:
• SANE Australia Helpline 1800 18 SANE (7263) www.sane.org
• beyondblue support service line 1300 22 46 36
• Lifeline 13 11 14 www.lifeline.org.au
• MensLine Australia 1300 78 99 78 www.mensline.org.au
