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No replacement in sight for key Adelaide mental health unit

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The State Government has failed to find funding to replace an intensive treatment unit designed to prevent dangerously long emergency department waiting times for Adelaide mental health patients, the doctors’ union says.

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Late last year, SA Health closed the Lyell McEwin Hospital’s mental health short stay unit after a doctors’ union safety inspection report found it was “only matter of time” before a preventable death occurs at the “appalling and unsafe” facility.

Almost three months later, SA Health is refusing to say whether it has allocated any funding to replace the facility.

The South Australian Salaried Medical Officers’ Association (SASMOA) claims SA Health has identified no funding to replace the unit, can’t find a site within the Lyell McEwin Hospital grounds on which to build it, and is declining to refit the closed unit so that it is safe for mental health patients.

In recent years, patients with mental illness have endured clinically dangerous waiting periods in the state’s severely overcrowded emergency departments, sometimes stretching across multiple days, including at the Lyell McEwin Hospital.

The LMH’s short stay unit was among several that SA Health had set up within SA hospitals as part of its response to the crisis – achieving significant reductions in wait times.

But when SASMOA inspected the unit in December, senior industrial officer Bernadette Mulholland found a number of “extremely obvious ligature points” – features of the room that can facilitate strangulation and, as InDaily revealed, the department promptly shut the facility.

Doctors told Mulholland that several patients had attempted to take their own lives there.

At the time, a spokesperson for SA Health said the department was “looking at options” for a new short-stay unit at the hospital.

But according to a SASMOA newsletter, sent to members this morning and obtained by InDaily, Northern Adelaide Local Health Network (NALHN) management has advised the union that:

Mulholland says she believes that either her union has been misled by the department – and that there was never any funding for a new short-stay unit – or any funding that once existed has been withdrawn.

“It is SASMOA’s view that either the funding was never available for the NALHN (short stay unit), contrary to the advice provided by the NALHN CEO, or the Government withdrew funding as outlined by the NALHN CEO,” reads a letter sent from Mulholland to the head of human resources at the local health network, Helen Stevens.

The correspondence, sent last month and attached to this morning’s newsletter, also suggests the Government had already intended to de-fund the unit but used the union’s December safety inspection as an excuse to close it.

“SASMOA would be disappointed if the Safework SA notices were now being relied upon by NALHN to close the NALHN Mental Health SSU when it appears … NALHN had determined to close the SSU if funding did not become available from Government,” the letter says.

According to an October 2016 email from NALHN management to the union, quoted in a letter attached to this morning’s newsletter, SA Health had approval to begin building a permanent short-stay unit in June 2017.

SA Health refused to comment today, instead referring InDaily to its statement last month, which said that there was no change form its stated position in December: that the department was “looking at options” for a new short-stay unit.

SA Health has also refused to say how many patients attempted suicide at the short-stay unit before it was closed.

Mulholland told InDaily that the lack of a short-stay unit left Adelaide’s north – where a variety of other mental health services had been de-funded over the past several years – another six-to-eight mental health beds short.

She said the hospital was, fortunately, experiencing a dip in patient admissions – which often occurs outside the winter months – but that doctors feared the emergency department would be under increasing strain later in the year.

“It puts enormous pressure on the clinical workforce to provide the appropriate care,” she said.

“It does put pressure on the rest of the system.”

The Lyell McEwin Hospital short-stay unit was closed the same week that SA Health announced it would build a new short-stay unit at the Queen Elizabeth Hospital, which is managed by the Central Adelaide Local Health Network.

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