Mental health in the Hunter

How many people reading this have suffered from depression? How many reading this have a son, a daughter, a sibling or a parent who has suffered from depression or from some other mental illness?

This might seem like an odd question to ask, but in the light of statistics (ABS 2007 National Survey of Health and Wellbeing) revealing 45% of Australians aged 16-85 years, (or 7.3 million people), have at some point in their lifetime experienced a mental disorder, I believe it’s a fair one.

It’s certainly an issue that affects my fellow Novocastrians. Hunter residents are hospitalized for mental health in higher numbers than any other NSW health district.

The Newcastle herald reported on the 10th of October 2012 that there had been 21 resignations by medical staff from the Hunter New England mental health service in the 18 months prior.

Why did these workers quit? Because caseloads for mental health workers in the hunter area are completely out of control.

I believe part of the blame for the desperate state of mental health care in the hunter lies with the NSW government’s short-sighted funding cuts and chronic neglect of the mental health sector. The hunter area has a desperate need for more funds to be able to employ the correct amount of community nurses, doctors and specialists in the Hunter New England local health district.

According to hunter workers quoted in the herald article, case loads have doubled in the past few years with staff having half the time to manage the cases in. One worker described the reality of working in hunter mental health as being increasingly crisis driven with staff spending most of their time “putting out spot fires”. “Rather than being proactive you are just heading things off at the pass” he told the herald.

Some Hunter community mental health workers have just two days a week to manage about 30 clients, where previously they have had caseloads of 17 or fewer.  With a case load of 30 patients it is extremely difficult for health workers to provide adequate care, especially when their time is also being taken up with triage, intake work, assessment and acute crisis management.

The NSW chairman of the royal Australian New Zealand College of Psychiatrists, Dr Adrian Keller said
“If you are trying to do all of these things, as many community health workers are being asked to do, that will necessarily lead to less time spent on the core activity of case-managing patients.”

According to Dr Keller “the failure to adequately provide care for this group of patients has a flow-on effect to the rest of the system, in particular to the emergency departments and acute psychiatric inpatient units”

The crux of the problem is we need more nurses. And thanks to savage funding cuts to public healthcare in this state, we can’t afford them.

As Michael Whaites, a spokesperson for the Hunter branch of the NSW Nurses Association puts it

“When you look at the lack of beds and the difficulties people have getting into hospitals, that means more acute patients are out in the community requiring the attention of the nurses. And it’s clear to us there’s nowhere near enough nurses in the community system”

We’ve come a long way in this state in addressing the stigma associated with mental illness. We know that mental disorders are an illness, just as real and damaging as their physical counterparts.

Mental illness can deeply affect a person’s ability to relate to family, friends and workmates and to function in the broader community. People who suffer from a mental disorder can experience significant distress and disability.

If you want to focus on the economics of the situation – it is clear that putting all social responsibility, community spirit and compassion aside, mental health funding and management in this state is an issue of vital economic importance.

Because according to the Australian Bureau of Statistics the annual cost of mental illness in Australia has been estimated at $20 billion.

A significant portion of that $20 billion is made up of lost productivity and lost labour force participation. So if you want to look at the issue of mental illness in this state purely in terms of money lost and gain, it’s incumbent upon the O’Farrell government, in the name of responsible fiscal management, to adequately fund mental health services, so that mentally ill people can get the help they need to remain functioning members of the workforce.

Matt Byrne, Organiser, NSW nurses and midwives association of The Hunter New England local health district highlighted the benefit of supporting the mental health sector when he said:

“There’s enough evidence to show that a person who’s well supported in the community may not require frequent hospitalisation in inpatient mental health care. That’s beneficial for everyone.”

The NSW Minister for Health, Jillian Skinner, needs to increase funding to mental health in the Hunter, to employ more medical staff and to reign in the “out of control” workloads that are making it impossible for our health care workers to provide the vital care for mentally ill people that is of fundamental importance to the Hunter community.