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Suicidal and psychotic patients spent days waiting in Melbourne emergency department cubicles this week as a shortage of mental health beds was exacerbated by the forced lock down of psychiatric wards at three hospitals.

There were 129 beds temporarily closed to new admissions at The Alfred, the Northern Hospital in Epping and Broadmeadows Hospital because a mental health worker who had worked in all three health services tested positive to COVID-19 and was linked to the Holiday Inn outbreak.

Of those, 50 beds at the Northern Hospital remain closed to new admissions, as a number of workers continue to isolate. The beds are due to reopen on Saturday.

A spokesman for the Victorian branch of the Royal Australian and New Zealand College of Psychiatrists, Killian Ashe, said some people had spent two or three days waiting in emergency departments because no mental health beds were available.

“There is extraordinary work going on to manage this and ensure people get the help need they deserve, but this constitutes a genuine moment of crisis,” Dr Ashe said.

Dr Sarah Whitelaw says “the mental health system is already shattered”.Credit:Simon Schluter

“Without extraordinary interventions, the system will collapse.”

Australian Medical Association Victoria’s emergency medicine representative, Sarah Whitelaw, said ambulances had to travel further with acutely unwell mental health patients due to the bed shortages.

Distressed patients were then spending days under the bright lights of unfamiliar hospital emergency departments instead of being cared for by staff who knew their medical history.

“The mental health system is already shattered. This is just grinding those pieces into dust in the ground,” Dr Whitelaw said.

“The moral distress among staff is the greatest of any issue I have ever seen right now … They are so concerned about the care of these patients.”

Dr Ashe said one of the services affected by the closure, North Western Mental Health, was particularly under-resourced and mental health services were already reporting a higher number of people presenting with acute mental distress due to the impacts of the pandemic.

The Andrews government has acknowledged that Victoria’s mental health system requires huge reforms, and the final report from the state’s royal commission into the issue is due to be tabled in less than a week.

“Our vital mental health services have for too long have been under significant pressure, including increasing demand for beds, which was why we announced $868.6 million in the recent state budget to rebuild our mental health system from the ground up,” a health department spokesman said.

“This includes $492 million for 120 additional acute mental health beds as a matter of urgency.”

The AMA in Victoria says the government needs to get on with delivering those beds.

Of the beds affected by the COVID-19 case, 79 are now operating normally again, including those at The Alfred, which reopened to admissions on Thursday.

Government data shows that Victorians with severe mental illness are routinely waiting more than eight hours in emergency departments before being admitted to a psychiatric care bed.

“These are people who are so disorganised in their thought that they often have trouble distilling what is real and what is not, and a very loud and vibrant and bright emergency department is a really difficult place for some of those patients to be,” said Australasian College for Emergency Medicine Victoria faculty chair Mya Cubitt.

“[Then there are] patients who have anxiety or who have suicidality, and being in an emergency department doesn’t give them the safety … that they need to try and heal from those significant mental illness issues.”

Dr Cubitt said, while she agreed it was necessary to temporarily close these affected wards, doctors had been warning for a long time that the system was not able to cope with any more knocks.

“The closure of inpatient beds really will create risk to patients, I think unacceptable risk to patients, and I don’t doubt that it will put patients and staff at risk,” she said.

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