industry & reform
Mind the gap
Mental health system under strain and facing a nurse shortage .
By Conor Burke
The mental health system is failing to provide treatment to the people who most need it .
That was the opinion of last year ’ s report on mental health by the productivity commission which found that , among other things , mental health is costing the Australian economy $ 220 billion each year .
“ Australia ’ s current mental health system is not comprehensive and fails to provide the treatment and support that people who need it legitimately expect ,” the report said .
The report found that almost one in five Australians has experienced mental illness in a given year , and many do not receive the treatment and support they need .
Since the report came out in November last year the world has been gripped by a pandemic which so far seems to have had an enormous effect on the mental health of the population .
Since March last year there have been noticeable rises in people trying to access mental health services .
Calls to Lifeline in the four weeks from 10 August to 6 September last year were up 15.3 per cent compared with 2019 . Contacts to Beyond Blue ( total of call , web chat and email ) were up 38.6 per cent over the same period while contacts to the Kids Helpline were up 24.5 per cent .
An ANU poll based on just over 3,000 respondents suggests that the proportion
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of the population experiencing severe psychological distress as measured by the Kessler 6 Scale rose from 8.4 per cent in February 2017 to 10.6 per cent in April 2020 .
Hospital admission also shows an increase in mental health needs over the last decade leading up to the pandemic .
In 2018 – 19 , there were 18,836 same day public admitted mental health-related separations with specialised psychiatric care . This increased from 16,258 in 2008 – 09 representing an average annual increase of 1.5 per cent over this period .
Similarly , the number of overall same day public mental health-related separations without specialised psychiatric care increased from 28,339 in 2008 – 09 to 41,052 in 2018 – 19 , representing an average annual change of 3.8 per cent over this period .
One recommendation from the report stated that we need to invest in the mental health workforce and that the Australian Government should develop a new curriculum standard for a three-year directentry undergraduate degree in mental health nursing . In addition , all nurse training courses should include a mental health unit .
In spite of these findings , mental health nursing is listed in the top three nursing disciplines that are likely to see a significant shortage in practitioners in 2021 and Dr Mike Hazelton , President of The Australian College of Mental Health Nurses , believes this shortage will be a huge obstacle to righting the mental health system .
“ On one hand the projections from organisations like Health Workforce
Australia is that we may not have a shortage of mental health nurses right now if what you ’ re doing is counting the people who work in mental health services . But we have a problem with the skill and capability of a lot of those people . That ’ s one issue ,” said Hazleton .
“ The other issue is that if you look at some of the findings that have been put forward over the last decade by organisations such as Health Workforce Australia , they predicted from about 2012 onwards there would be an increase in shortfall of psychiatric nursing , or mental health nursing positions , so that by about 2030 we would be somewhere between about 12 and 24,000 positions down within the sector . And that ’ s not taking into account COVID , for instance .
“ This was all predicted well before COVID came along . So , on some readings we have been moving into a workforce shortage anyway . It ’ s been compounded by COVID .”
Hazelton argues that there is a drastic need for nurses to be specifically trained in mental health practices and that filling the workforce shortage with untrained nurses would be problematic .
“ There is an absolute need for some sort of formal endorsement for someone to be a mental health nurse , so you can at least identify the difference between someone who has formal mental health nursing qualifications and skills , and someone who ’ s just working in the area , who may not even be a registered nurse . You have a lot of enrolled nurses working in mental health services these days . They ’ ve got