Six Days in Emergency: Sydney Hospital Patients Face Alarming Delays for Mental Health Care
Acute mental health patients have spent up to six days waiting for transfer from the emergency department of Westmead Hospital in Sydney's west. One doctor described the situation as unprecedented, immoral and potentially dangerous.
As of Monday afternoon, 12 patients with acute mental illness had spent more than 48 hours in the department. Seven had remained beyond 100 hours, while the longest stay exceeded 148 hours.
A Westmead doctor, who requested anonymity to protect their employment, said the patients had psychotic illnesses and were being held involuntarily. All awaited transfer to Cumberland Hospital, a dedicated mental health facility.
Doctor Calls Delays Immoral
'One-hundred and fifty hours is something I have never, ever, ever seen or imagined,' the doctor said. They called the situation unconscionable and awful for patients.
The doctor compared the experience to being forced to stay in an airport. The department is 'constantly lit, constantly busy, constantly noisy' and is neither therapeutic nor restful.
The conditions can also affect nearby patients being treated for unrelated medical problems. The doctor warned of potential dangers to staff working in the department.
Why Waiting Threatens Recovery
Psychiatrist Dr Kamran Ahmed has previously said days-long emergency department stays are unacceptable because patients' conditions could deteriorate. Busy, noisy surroundings can worsen symptoms in distressed or agitated people.
In psychiatric wards, mental health nurses monitor patients and psychiatrists regularly review them, developing management plans that may include medication. Emergency departments do not provide the same level of specialist mental health care over extended stays.
The doctor described the emergency department as a 'holding measure' without that specialist care. For patients with acute mental illness, the environment and access to appropriate treatment matter while they await admission.
The Mayo Clinic says mental health conditions can become harder to treat when people delay seeking help until symptoms become severe. Untreated illness can also cause serious emotional, behavioural and physical health problems.
Pressure Mounts Across Hospitals
St Vincent's Hospital also had 17 mental health patients in its emergency department, including 15 awaiting admission to already-full psychiatric units and two who had been there for 10 days.
Dr Pramudie Gunaratne, chief executive of the Australian Society of Psychiatrists, said the figures pointed to wider problems. Community-based services, in particular, were not working well.
September figures showed Westmead had the longest emergency department waiting times in the district. Only 49.1 per cent of patients received treatment on time, with an average wait of 6.5 hours.
Officials Respond to Demand
A Western Sydney Local Health District spokesperson apologised to those affected, citing high demand for acute mental health care. Patients awaiting transfer receive treatment under a psychiatrist's supervision.
Mental Health Minister Rose Jackson said extended waits were 'well below the experience I want for anyone accessing our mental health system'. Patients awaiting transfer continued to receive care and clinical oversight.
The Westmead Centre for Mental Health, now under construction, is expected to deliver a 'substantial' increase in beds. Boosted funding for Mental Health Hubs is intended to offer alternatives to busy emergency departments.
Staffing and Funding Gaps
Psychiatrist Dr Ian Korbel, of the Australian Salaried Medical Officers Federation, said full-time specialist numbers had risen since threatened resignations last year. A shortfall of about 100 full-time positions remained.
Case managers have too many patients to provide the intensity of care needed, adding pressure on hospitals. An internal briefing note estimates an annual funding shortfall of A$550 million to A$600 million (£283 million to £309 million).
Nick Howson, a Cumberland Hospital nurse and NSW Nurses and Midwives' Association delegate, said complex factors were driving more hospital presentations. 'More needs to be done to keep people out of hospital in the first place,' he said.