Stuck In The Vortex of The Public Health System

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Last night I switched Alters and cut myself badly. It required stitching so we had to go to the local hospital Emergency Department. Now my Psychiatrist and Psychotherapist and GP had agreed if I cut again within the next two months, three weeks ago that I was to be admitted to the nearest Psychiatric Ward. They believed this would deter the alters from cutting as they hate the Public System and were at a loss as to how to stop the rampant cutting that had been occurring.

Well, it worked for three weeks since my discharge from the Private Clinic at Burwood. No cutting incidents had taken place. I was switching alters but they were damaging me but last night my seventeen year old alter was hell-bent on punishment and cut my arm really badly when my husband went out of the room to make a cup of tea. I don’t know where the blade came from. I must have put it in my pocket earlier in the day. My poor partner came back to a gruesome scene. He completely lost it. He ranted and raved at me but I was in a dissociated state and couldn’t answer him. I could just hear shouting.

We went straight to Emergency where they informed us of the letter they had received from the Psychiatrist saying I had to go Campbelltown Psychiatric Hospital. I was devastated. I had been there before and hated. It’s a horrible place. Really draconian. Full of really sick people who are vocal, act out and there’s no privacy as it’s shared wards. I became very distressed.  The doctor said there was no choice in the matter. He would Schedule me if I refused to go and that would be even worse so I would be better to go voluntarily. They stitched me and at 9.30 pm we set off for an hours drive.

We checked ourselves in at reception and were triaged. Time ticked by and patients came and went. It got to twelve o’clock and my partner went up to see what the delay was and the Nurse just told him, it was busy and we would just have to wait. So wait we did. The clock on the wall said one o’clock, then two o’clock and finally three o’clock. No one came to check on us or explain what was happening. I was exhausted and just becoming more and more agitated. Then my husband said, “This is ridiculous, this is doing you no good at all. We’re going.”

He went up to the Reception Desk and informed the Receptionist and we left. He decided if they were going to Schedule me they could send an Ambulance to our home but that this waiting for five hours in Emergency was pathetic mental health care for a suicidal woman. He wanted me at home in my own bed. He felt he could keep me safe and we would go to the Psychiatrist the next day and take it from there.

We both didn’t wake up until 1 pm today. Even the dog slept in. Poor horses didn’t get their breakfast until 2pm. Felt pretty guilty about that I can tell you. The hospital never rang. We missed the Psychiatrist appointment. She texted and said to come tomorrow instead. She doesn’t know any of the events that have taken place in the last twenty-four hours. She’s not going to be happy with me !!!! Going to be an awkward appointment.

During my research into the Mental Health System in Australia I came across this report:

The nation’s mental health system is “fundamentally broken” and in need of a decade-long overhaul to boost prevention and early intervention and ensure the mentally ill get the care they need, a major health group has said.

In a scathing assessment of current arrangements, peak body The Mental Health Council of Australia has detailed basic flaws in the conception, management and delivery of mental health services that compromise treatment and undermine attempts to improve care.

“There is no such thing in Australia as a mental health ‘system’ per se,” the Council said in a submission to the National Mental Health Commission’s Review of Mental Health Services and Programs.

“Instead, the mental health system is shorthand for the many systems and services that consumers and carers may encounter over a lifetime. For the most part, these services and systems are poorly integrated, overseen by different parts of government, based on widely differing organising principles, and not working towards a common goal for improved outcomes,” the Council’s submission said.

As the Federal Government ponders its role in the delivery of mental health services in the context of a fundamental re-think of Commonwealth-State relations, the Council has argued that there is a role for all levels of government.

While the principle of subsidiarity (that policies and services are conceived and delivered by the level of government closest to consumers, as far as is practicable) has guided the Commission of Audit’s view that mental health be fundamentally a State responsibility, the MHCA has taken a more cautious view.

It said that there was “a very strong case” for continued Commonwealth involvement, proposing that it “provide national leadership and hold responsibility for areas…in which national consistency is critical,” such as setting and monitoring service delivery standards, workforce accreditation and data specifications.

Alongside questions about the division of responsibilities between different levels of Government, the Commonwealth is also considering what services need to be publicly provided, and which needs can be best met through the operation of market forces.

In its submission, the MHCA argued that mental health care has been characterised by market failure, and people with mental illness are among those who truly need Government protection and assistance.

“Governments must think carefully before using market mechanisms to coordinate and deliver mental health services of one kind or another,” the Council said. “The mental health arena has, over time, been characterised by market failure, underinvestment and a chronic absence of services.”

It said the solution was not necessarily more money.

“After years of substantial spending by the Commonwealth and states, and increased rates of help seeking, mental health outcomes are not improving at the pace they should be,” the Council said. “Structural reforms would not necessarily involve major new spending by Government – in fact, significant progress can be made on a number of important fronts at little cost.”

What was needed, it said, was a shared, decade-long commitment to sustained reform that had as its goals improved consumer and career outcomes, priority for mental health promotion and prevention, matching needs with services, and the seamless integration and coordination of programs, policies and services.

“Major gains can be made by ensuring that the right governance conditions are in place, improving coordination within and across governments and service providers, and addressing gaps in services,” the MHCA said. “If we can take these steps, we will truly be able to say we have a cohesive ‘system’ which meets the needs of consumers and carers.”

“By contrast,” it warned, “if governments only tinker with the present system, but have no vision for a better system in the future or the path to reform, then improvements in outcomes will inevitably be piecemeal and fortuitous rather than far-reaching and deliberate.”

 

 

I would love to hear from you so please leave a comment. All feedback is much appreciated. Thank you. Erin

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