SA records nation’s highest rate of mental health ED presentations

South Australian emergency departments have the highest percentage of patients presenting with mental health or behavioural problems in the country, the peak emergency medicine body has found.

Nov 09, 2022, updated Nov 09, 2022

The Australian College for Emergency Medicine’s inaugural “State of Emergency” report, released today, found that on average, 75 patients presented with mental health or behavioural problems at SA emergency departments per day in 2020-21 – up from 65 in 2016-17.

Patients presenting with mental health and behavioural problems now account for five per cent of all SA emergency department presentations – the highest rate in the country.

Nationally, mental health patients account for an average of four per cent of all emergency department presentations.

Emergency physician and the college’s SA faculty chair Dr Michael Edmonds told InDaily that the data should prompt policymakers to consider how mental health patients are best treated.

“We’ve been advocating for other avenues for people with mental health problems, and certainly better community supports to try and offer alternatives to come to emergency,” he said.

“We know that the emergency department is not the right environment for most people with mental health problems.”

Edmonds said the increase in mental health presentations correlated with the COVID-19 pandemic, but he didn’t believe there was a “causative pathway” between the two.

“Certainly, we have seen more people with mental health concerns coming to hospital and a greater number waiting for longer in the emergency departments rather than in an inpatient mental health bed,” he said.

In its report, the Australian College for Emergency Medicine (ACEM) described the country’s mental health system as “highly fragmented and unsustainable”.

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It said more appropriate, timely treatment options were needed to reduce the time that people seeking mental health care wait in emergency departments.

ACEM found in 2020-21, the length of stay for 90 per cent of patients who required admission to hospital was 12 hours and 46 minutes.

The college recommends that 90 per cent of patients who require hospital admission should spend no longer than eight hours in the emergency department.

Graph: Australian College for Emergency Medicine

Overall, the ACEM report found emergency departments across Australia were struggling to deal with overcrowding, ambulance ramping, long waits for care and worker burnout.

The college’s president, Dr Clare Skinner, said Australia’s health system “has never been in a worse state”.

“There have never been more people requiring acute healthcare, people have never had such complex health needs and the health system has never been so strained,” she said.

“It is bad everywhere, but it is worse in rural, regional and remote areas.”

Edmonds said in South Australia, doctors were feeling “a lot of frustration, stress and a degree of burnout” due to ongoing emergency department backlogs.

He said while doctors welcomed state government funding for extra doctors, nurses and hospital upgrades, those measures would take time to be implemented on the ground.

“This government has been listening, they’ve been saying all the right things and putting activity and resources towards the areas we think are probably going to make a difference, but there’s no quick-fix here. They’re all longer-term solutions,” he said.

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