The dire state of WA's overstretched and under-resourced public mental health services was laid bare yesterday in a damning report that shows the system is failing people and costing lives.
Professor Bryant Stokes carried out the most comprehensive review yet of WA's public mental health services, interviewing almost 900 people over six months and investigating 255 suicides.
It revealed that in WA, 15 per cent of men and 20 per cent of women took their lives on the day they were discharged from a mental health hospital and a third committed suicide within a month.
"Because the system is under stress, a patient discharged from an acute mental health facility is required to be reviewed in a community clinic within seven days, and sometimes that's just not possible because of the tremendous demand, and that can lead to significant issues where a patient may fall through the cracks," Professor Stokes said yesterday.
He conceded that a lack of follow-up care in the community for patients released from hospital was linked to some suicides at Fremantle Hospital, while others were because patients were not listened to.
The review said mental health clinicians were so "severely overworked in almost all areas" that only basic mental health care was available in some parts of WA, particularly rural areas.
Professor Stokes said the mental health workforce was inadequate, with staffing levels only about half of what they should be and that better training was needed.
Almost double the 1711 mental health hospital beds and places were needed across the State, the review said, with fewer acute beds and more non-acute places in the community so people could get help before they became acutely ill.
Professor Stokes, a retired neurologist and former WA chief medical officer, warned that with a 24 per cent increase in mental health hospital admissions in WA in the past six years, demand outstripped provision.
He said patients found help was not there for them when they were most vulnerable and in crisis and they faced long waits to be assessed, were given little information about their treatment or health and found rehabilitation services were scant.
He said some carers of mentally ill people had the "unhesitating opinion" that "the system, by virtue of not providing adequate, timely and preventative care, was a major factor in a patient's suicide".
The review showed 63 per cent of patients were not properly assessed for their condition and suicide risk when they presented for help for mental health problems.
Professor Stokes said some clinicians doubted the value of risk assessments and did not do them, which "affects the patients' access to services and leaves mental health services and patients exposed". He was also concerned about the care of Aboriginal people, saying psychiatric care needed to be integrated with their family and community. Concerns were also raised about "insecure" services in the Kimberley, Pilbara and Goldfields where psychiatrists worked on a fly-in, fly-out basis.
Mental Health Minister Helen Morton asked Professor Stokes to do the review in response to mounting concerns about WA's mental health services, which were revealed in _The West Australian _.Mrs Morton and director-general of health Kim Snowball said yesterday that some reforms were already being introduced.