Tasmanian MH system in disarray - what do we need?

[sadboyhours]

Well if you haven't heard, the Hobart Clinic is closing the inpatient service and the Mind Hub is likely to follow.

This leaves us with 12 beds in Launceston (I don't know anyone who's been to Calvary so have no idea about the quality), the trauma program at NWPH which only does planned admissions as far as I know, and public services of varied quality and extreme problems with availability.

We shouldn't be forced to rely on private health services anyway, and across Australia the two-tiered mental health system is getting worse. We are now, ironically, in a situation where the more densely populated areas of Tasmania have less access to inpatient and sub-acute treatment than people in the North.

I am working towards (trying to) talk to MHCT, MHLET, and people from the state government - or maybe skipping to a petition - as the government needs to pull their socks up!! We deserve better. I wrote to the minister back when St Helens closed and of course got a generic response but I feel I have to keep trying...

So, what do you think we need? I think:

- step up step down units

- more Safe Haven-type drop in centres

- accelerating development of the MH precinct plans

- more inpatient beds including expanding the Hospital@Home program

- ED options that ease the strain and stress for MH and physical health staff and patients

In the long term, there are so many other things, like making the inpatient and ED spaces trauma informed (not actively traumatising), and of course we have to keep investing in community care and prevention. Still, I simply cannot see another press release from the government saying that they are giving headspace more funding and ignoring the reality that is some people will always need a higher level of care!

Anyway, I hope everyone is coping okay with the news and is able to get the support they need. Hope that people have feedback for me as well! 🙂

[RachSANECEO]

Great to get your insight on the Tas system. @tyme do we have many Tasmanians on the forums? Would be great to get a good discussion going on the issues and areas for improvement, maybe we can take something forward to the Tas Minister for Health. Please tag other Tas folk in and share this thread with our partnerships team.

[tyme]

@mr-robot-75 @Zoe7 @Wesco5454 @MAMMAFE @Irina @Jen_WHT and any other Tasmanians - open to hearing your thoughts about Tasmania's MH system

[NightFury]

I'm in Tasmania.

I've not been involved in the mental health system here for long. From my own experience, my supports come from interstate. My EAP counsellor is based interstate, SANE is interstate, and my psychologist is based interstate. 

I know that when I sought help from an urgent care clinic here - due to being a crisis point with my mental health (having experienced five weeks of insomnia) - they turned me away, telling me that they couldn't help me. They advised that I see my GP. It took two weeks to get an appointment with my GP. I felt extremely powerless. 

I wouldn't know who or where to turn if I needed that level of help again, and it's concerning that clinics and supports are disappearing here. 

@sadboyhours @tyme @RachSANECEO 

[Till23]

Hi @RachSANECEO the problem of Mental Health services inadequacy is also abysmal outside of any capital city in any state.

Just recently, the closest university to where I live in NSW (University of Newcastle) has decided to downgrade their psychology department.

People who train in regional areas are more likely to service regional and remote areas. 

Overall MH services are a mess, there is a lot of grants going to small operators who are frankly reinventing the wheel.

There needs to be a properly considered overall framework for MH, with local services branching off from that.

There are so many organisations fighting for the meagre MH budget. Rural and remote communities, who do not have the numbers to campaign are missing out (as is typical in everything the further from a capital city the lower the services).

I am a Lived Experience person for adult survivors of CSA for my local health district. It turns out each health district is pretty much starting off doing the same thing - this is unnecessary duplication. Better would be to do a NSW wide or even Australia wide consultation and then build a framework and then go to local areas for the specific needs.

There is woefully inadequate MH funding and then it's wasted by duplication, fragmentation (so underfunding of the service - which therefore eventually folds) and poor communication.

How many times on these forums have I seen people "finding out" about things from other members, sometimes years into their MH journey because services are so poorly communicated. 

Sorry for rant but we need to do better for Mental Health.

@tyme 

[sadboyhours]

Thanks for pointing out the Urgent Care situation - I forgot about that particular facet of the system. In the original briefing for the UCCs, mental health conditions were meant to be in scope - but they are absolutely not an appropriate setting for mental health crisis. I think they definitely could be set up to be a useful resource though!!

I have had a bit more experience with the Queensland system than here and I was heavily involved in the youth mental health reform. The funding situation is very different but I don't think that's an excuse. We have tons of psychologists, but barely any availability; an incredible trauma recovery facility that nobody has heard of; and the public system building systems like the Tasmanian Eating Disorder service and then gutting it almost immediately...

I hope you don't find yourself in that situation again and that if you do, you can find some appropriate services.

[sadboyhours]

@RachSANECEO Thankyou for your response, I am just one person not currently affiliated with any consumer orgs but still do a bit of community advocacy. I believe there is power in citizens talking to their elected reps but there is probably more ability to bring actual change via a united front of advocacy groups so if SANE is willing to put up a fight for people with persistent mental illness that is awesome.

[chibam]

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@sadboyhours wrote:

Still, I simply cannot see another press release from the government saying that they are giving headspace more funding and ignoring the reality that is some people will always need a higher level of care!

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Not to mention that Headspace is only for people under the age of 25 (unless that's changed?) Many of us are not so young...

Sad to say, but my impression is that Tasmania's woes in this regard are about par for the course, nationwide, if not worldwide.

As far as I know, we here in NSW are still in the midst of that fight between psychiatrists and the state government over pay rates. It strangely vanished from the media a long time ago, and I never heard about how it ended up, so just this last week I googled it. From what I can understand, the beaurocrats are still chewing over what their gonna do about it.

I could've sworn, when the story was doing the media rounds, that I heard something about there being a deadline in May that the issue had to be resolved by. Either I misunderstood, or that deadline's been blown right away.

So yeah, it's all just one big mess nationwide. Governments don't have a clue on how to provide a quality mental health system, and it doesn't look like their gonna figure it out any time soon...

[chibam]

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@sadboyhours wrote:
@RachSANECEOThankyou for your response, I am just one person not currently affiliated with any consumer orgs but still do a bit of community advocacy. I believe there is power in citizens talking to their elected reps but there is probably more ability to bring actual change via a united front of advocacy groups so if SANE is willing to put up a fight for people with persistent mental illness that is awesome.

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@sadboyhours  Have you heard about Lived Experiance Australia (Link)? Their probably the best advocacy group I've encountered.

Australians For Mental Health (Link) are another one. They seem to be mainly focussed on funding issues.

Also, there are the state-based advocacy orgs like VMIAC (Vic) & Being (NSW). Not sure what the Tasmanian equivalent is, but might be worth a look?

[sadboyhours]

Hi @chibam thanks for your response and the organisation links above. You're absolutely right that headspace is only for 12-25, and only covers mild-moderate presentations, yet young people with moderate-severe and complex presentations get referred there constantly. Adults have fewer options and almost zero no-cost options, and press releases are similarly pushing us to the new 'medicare mental health centres' despite information on what they can actually provide being scant...

Unfortunately Tasmania has the second lowest ratio of public MH beds to people and the lowest ratio of private MH beds by about half, despite the prevalence of mental 'disorders' being about the same as other states. We also have a severe lack of non-hospital services compared to some regions but that data is harder to compare.

We definitely need service improvement across the country, but Tasmania is at a real tipping point here with the near-total collapse of the private sector and the government claiming that they can handle the overflow when they objectively cannot. I am hoping to show that there are things the state government can do right now to reduce the impact of the closures, instead of kicking the can down the road to new buildings and/or pointing to completely unrelated community services as a substitute for acute care.

I also haven't heard much about the NSW psychiatry situation, but apparently earlier this month the government offered a 3% pay rise backdated to July 2024 and the doctors rejected it, so I suppose the May deadline was missed!