Mental health system in ‘crisis’ as youth referrals jump by 50 per cent in five years – ABC News

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Western Australia’s youth mental health system is in “crisis” and Perth teenager Emma* is just one of many suffering as a result, according to WA’s Chief Mental Health Advocate.

When 17-year-old Emma went to her GP on October 21 to get a referral to WA’s Child and Adolescent Mental Health Service (CAMHS), she was told the next available appointment for just an initial assessment was December 29.

Less than a week later, Emma had seriously self-harmed and was taken to Rockingham Hospital’s emergency department, where she would spend the next four days because there were no mental health beds available.

Emma had struggled with her mental health since primary school, but she hit a new low this year when the combination of Year 12 pressure, a family breakdown and the uncertainty that came with COVID-19 compounded her anxiety and depression.

“The Emergency Department was giving her additional stress because it was not a calm environment,” Emma’s mother Lisa* said.

Lisa was encouraged to take Emma home because there were no beds available, but she was afraid her daughter would injure herself again or even take her own life.

With some help from the Mental Health Advocacy Service, they were able to secure a mental health bed at Fiona Stanley Hospital — where Emma spent two weeks.

She was discharged from hospital on November 16 and had her initial assessment with CAMHS three days later, but was told the soonest she could start her actual treatment plan was February 2021.

Growth in referrals to specialist services for young people

Emma’s story came as no surprise to WA’s Chief Mental Health Advocate Debora Colvin.

An unidentified teenage girl sitting on a bed with her legs cross and hair obscuring her face, with vinyl records on the wall.
Young people can face wait times of up to several months for an initial assessment with CAMHS.(ABC News: Rhiannon Shine)

“We’re told six weeks’ wait to get an appointment is common,” Ms Colvin said.

“And we actually do now have some others who have recently been given a 12 to 13 week wait.

Ms Colvin said referrals to CAMHS had increased 51 per cent in the past five years.

“You can see this massive growth, but no growth in the services provided,” she said.

“It’s unacceptable. We’re in a situation where we need to drastically reduce those wait times.

“It’s in a crisis situation.”

Review into suicide of 13-year-old girl

In August the WA Government announced the state’s chief psychiatrist would undertake a targeted, independent review into how the public mental health system cared for 13-year-old Kate Savage, who died by suicide.

The review, expected as soon as this week, was expected to focus on clinical care and comment on how to improve mental health services for young people across inpatient and community-based clinical services.

The findings of the review will form part of the broader Young People Priority Framework, already underway by the Mental Health Commission, which will make recommendations for both the public health system and non-government services.

A woman in a studio smiles for a photo
WA’s Chief Mental health Advocate, Debora Colvin, says wait times need to be drastically reduced.(ABC News: Hugh Sando)

“And that does require funding, it requires commitment, it requires building up a staff with the right skills.

“But if we can do that, it’s like spending money to save money.

“It will be good for the state’s economy. But more to the point, it’ll be good for those individuals, and it’ll be good for society.”

In September the Commissioner for Children and Young People, Colin Pettit, published a report on the progress of WA’s youth mental health agencies.

In it, he stated that the WA mental health system did not adequately plan for, invest in, and support the mental health needs of children and young people, and their families.

“There is also limited evidence to determine whether mental health outcomes for children and young people are improving as a result of the services that they are receiving,” his report stated.

“I am concerned that despite the recommendations made by my office in 2011 and 2015, and those made through at least eight reviews and inquiries on the mental health system in WA, the gaps for children and young people remain.”

No better in the private sector

Lisa said she hoped to see a new strategy for reducing the wait times for an initial assessment.

“The initial assessment should be very soon because a GP cannot assess on a professional level how extremely the help is required,” she said.

“Our child needed the help sooner. And she [Emma] could only get that assessment in two months’ time… anything could happen in two months.”

Lisa said while they waited for Emma’s treatment plan to start in February, they had attempted to access private psychologists and psychiatrists — but there were long wait lists in the private sector too.

According to the Royal Australian and New Zealand College of Psychiatrists (RANZCP), WA had an overall workforce shortage of Child and Adolescent Psychiatrists (CAPS).

An unidentified teenage girl laying on her stomach on a bed, looking at a mobile phone, with long hair obscuring her face.
WA has an overall workforce shortage of Child and Adolescent Psychiatrists.(ABC News: Rhiannon Shine)

“Referrals to public CAMHS teams and private practice have been increasing significantly over at least the last five years without a corresponding increase in resource or capacity,” a RANZCP spokeswoman told the ABC.

“This has resulted in longer wait times across all sectors.

“Private CAPS report a further acute increase in referrals since July this year further adding to the chronic difficulties meeting the demand.

“Most private CAPS … report either having their books closed or having waits of approximately four to six months.”

CAMHS acknowledges challenge for families

In a statement, CAMHS chief executive Aresh Anwar said appointments were allocated according to need, and the service aimed to see the most at-risk children within one to two days.

A teenage girl with blonde hair holds a mobile phone with both hands, with the phone in focus and her face obscured.
Advocates say those waiting for an appointment with a CAMHS clinic can access other support.(ABC News: Rhiannon Shine)

“The median wait time fluctuates daily as it reflects the number of children referred to our services which changes from day to day,” Dr Anwar said.

“Wait times will be longer for children with less acute needs and at times of high demand, could be up to several months.

“We continue to explore opportunities to reduce this variation and provide more equitable access to our services.”

Dr Anwar said it was not possible to provide CAMHS wait list times for its psychologists and psychiatrists.

“We acknowledge that this is incredibly challenging for those families that are attempting to navigate the system and access mental health support and treatment.”

Where to find help

While waiting for an appointment with a CAMHS clinic there is some other support available.

This includes the CAMHS Emergency Telehealth Service (ETS) on 1800 048 636.

The service provides free advice to carers and health professionals in Perth as an alternative to attending an emergency department.

A red sign which reads: "Emergency Dept"
Emergency departments can often cause extra stress for young people who need mental health care.(Australian Story: Mark Farnell)

“If you think your child might be suicidal, talk with them about it, ask them about suicidal thoughts,” Dr Anwar said.

“Sometimes people are afraid that if they talk about it, this will make suicidal thoughts more real, and suicide more likely to happen.

“They can feel like there’s more empathy for them and that gives you an opening to explain the value of seeking professional help.”

Links to free resources and supports are also available via the Child and Adolescent Health Service (CAHS) website.

CAMHS advises that if you are worried that if you do not do something immediately your child will attempt suicide, you need to call 000.

*Names in this story have been changed to protect the privacy of those interviewed.

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