Legislative Council: Wednesday, May 12, 2021

Contents

Mental Health Services

The Hon. C. BONAROS (14:59): I seek leave to make a brief explanation before asking the Minister for Health and Wellbeing a question about mental health.

Leave granted.

The Hon. C. BONAROS: The crisis gripping our mental health sector is well known, primarily thanks to the whistleblowing of Adjunct Professor John Mendoza, who warned that the crisis is leading to people taking their own lives. He even went as far as to describe the mental health system in Adelaide, and I quote:

…the worst in the country and among—if not the worst—in leading OECD countries and regions…utter tragedy…

In response to the crisis, the government held a roundtable forum, which was subsequently labelled by some commentators as 'nothing but a gobfest'. One of the outcomes of that forum was the announcement that priority care centres across Adelaide would start taking mental health patients, with the objective being that such action would free up ED beds in our public system currently being occupied by mental health patients.

I am not sure that it's working. As of 1.30 today, CALHN had 24 patients admitted, waiting for a mental health bed, with 18 having waited more than eight hours. I note that last week on ABC, Dr McGowan made the startling confession that those centres—and I think there are four across Adelaide—are open only 8am to about 9 or 10pm, or so he thought.

My questions to the minister are: is there a dedicated mental health practitioner at the centres at all times? What is the point of a mental health patient presenting at a centre if they won't be treated by a dedicated mental health practitioner? As respected host David Bevan asked McGowan, and I quote:

Okay so if you are having a mental health episode, have it between 8am and 9pm.

How does the minister respond to that? For the record, what are the opening hours of those centres?

The Hon. S.G. WADE (Minister for Health and Wellbeing) (15:01): Currently, there are four priority care centres. There has been a pleasing increase in some of the daily tallies. For example, on 3 May I am advised that there were 79 patients seen by priority care centres. That's 79 patients that would otherwise be needing to present at an emergency department. As I have highlighted before, often patients who are taken to priority care centres are the type of patients who might otherwise spend time on an ambulance ramp.

I would disagree with the honourable member. Forgive me if I am taking the wrong interpretation and she doesn't mean this. One of the implications I was taking from her question is that a person with a mental health challenge needs to meet with a mental health specialist. I think one of the key challenges in our health system responding effectively to mental health challenges is actually to make sure that we broaden the base of health professionals who engage in mental health services.

Recently, I was talking to a leader of the general practice community—in other words, doctors—and she was stressing how important it is to make sure that we not only equip GPs to respond to mental health issues, including suicidal ideation, but also that we support them, that we might well have, through telehealth, psychiatrists who might, on an on-call basis, provide support. I would certainly not suggest that a GP-led practice or centre, such as a priority care centre, would not be well-equipped to respond to a whole range of mental health issues for the lack of a specialist mental health professional.

I would also stress that the priority care centre model engages a nurse at the priority care centre who is an emergency care nurse. These are the same highly skilled professionals that would be providing care at the front door, at the treatment bays, in a hospital. Just as a generalist nurse will respond to an ED presentation, including a person with mental health issues, there is a similar nurse with similar skills in the priority care centre. I stress that I don't agree with the suggestion that general practices are not a very valuable tool in providing that broad level of care that South Australians need to support their mental health.

The PRESIDENT: The Hon. Ms Bonaros, a supplementary.