Victoria’s mental health services are experiencing extreme pressure. Emergency departments (ED) are overwhelmed by a sudden surge in mental health cases. According to the most recent federal data, these cases are up 5 percent in just one year. That increase is primarily driven by the widespread use of drugs and the accompanying crises that ensue. The state government has stepped in, allocating $114 million to establish new mental health hubs. These hubs will be set up alongside existing emergency departments in Bendigo and Shepparton to provide more appropriate care for urgent mental health needs.
Laurie, a mental health nurse, highlighted the impact of increasing drug use over the last 10 years. She said this surge has created extremely challenging working conditions in EDs. She emphasized that drug use in and of itself drives people to violence. This practice not only puts patients at risk but directly endangers health care providers.
“It’s the association of violence and aggression that comes with drugs — towards us, towards emergency services and towards themselves,” – Laurie
Increasing Cases and Overwhelmed Resources
The Bendigo Health ED on average treats around 46 patients per week with mental health and drug-related issues. To put it in context, that number is tracking to surpass last year’s record numbers. Skye, another nurse, vividly described a recent incident where a patient sat hunched over, flanked by two police officers and two ambulance workers, visibly distressed and crying. This poignant scene illustrates the critical need for more focused care spaces.
Under the current model, each of Melbourne’s mental health hubs can only handle an average of six beds despite demand being much higher. Paul Healey, a mental health advocate, pointed out the alarming statistics regarding Victoria’s suicide rates, which are nearly double that of the state’s road toll.
“We’ve got a suicide rate in Victoria that is almost double the road toll, and it doesn’t seem to be going down,” – Paul Healey
He reiterated the reality that today’s youth are experiencing unprecedented levels of anxiety and depression. That points to a huge, scary chasm between the need for services and what’s out there.
“We’ve got an epidemic of anxiety and depression in young people, and we’re not building the services fast enough,” – Paul Healey
The Need for Specialized Care
Creating specialized emergency department hubs is an important step. It will go a long way to improve care for those who are at-risk for acute mental illness. Dr. Phil Tune explained that today’s emergency departments are intimidating places for people who are already under mental duress.
“Emergency departments are loud, bright, noisy, chaotic — less than ideal environments if you’re already feeling distressed and disturbed,” – Phil Tune
Silva King explained that mental health hubs create a less chaotic environment that’s more healing.
“The hubs are calmer and they’re more suited to people with acute mental illness,” – Phil Tune
Brooke, a 50-year-old patient who had previously attempted suicide, spoke about her own experiences in an ED. She then went on to describe her experiences of drowning in the noise, noise of the emergency department.
“I had my jumper over my head the whole time — just all the hustle and bustle of everything, it was really loud,” – Brooke
Beyond the meanness, she told us how the ambient noise of crying babies and chattering conversations exacerbated her panic. Yet once she was relocated to a more secluded place, an astonishing thing happened — her pain disappeared.
“Once I was moved to a quieter area, it was instantly better,” – Brooke
Call for Action
The mental health crisis in regional Victoria is showing itself by the day. Nurses like Laurie are spearheading efforts to make these specialized emergency department hubs a reality. Six hubs currently operate across Victoria—five in Melbourne and one in Geelong—and these are clearly inadequate to meet increasing demand.
Humanitarian Paul Healey made a powerful plea about the urgency of addressing these needs as we reach record levels of mental health emergencies.
“The ones in Melbourne have about six beds and demand is already outstripping supply. But they’ve been really helpful to get people seen quicker,” – Paul Healey
The dialogue on how to better the provision of mental health services in Victoria continues. In response, Bendigo Health management are pushing for a private space in emergency departments where people can identify with mental health emergencies.