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Mental Health Crisis? We’ve got the answer

Geoff Harris, executive director of Mental Health Coalition South Australia, outlines how the health system can better support people in crisis and, in doing so, also reduce the pressure on our emergency departments.

Sep 27, 2024, updated Sep 27, 2024
Photo: Ahtziri Lagarde/Unsplash

Photo: Ahtziri Lagarde/Unsplash

It is coming up to almost 18 months since the state government released the report on unmet needs for psychosocial support services. Remember that one? It was the report that told us almost 19,000 South Australians living with complex mental health challenges in our community were not receiving the support they needed.

That same report told us it would cost just $125 million a year to fill that gap.

For the tens of thousands of South Australians currently missing out, receiving psychosocial support would be an absolute game changer. It would allow them to get well, stay out of crisis or hospital services and build full lives.

For a state health system under pressure, you would think that fixing this problem would be a high priority for the government. Instead, the Minister did as we predicted and just sent the report to Canberra hoping the federal government would fix it.

And so, 19,000 people and their families have had to wait for the same work to be done in the other states.

An August meeting of the Health and Mental Health Ministers from around the country agreed to release a national report and it confirms that the appalling level of unmet need in the South Australia is correct.

While waiting for the federal government to take action on this, we decided to turn our minds to a new dilemma. Currently only one in four people with severe mental illness is receiving the psychosocial support they need – so the question arose how to find and support the other three? 

We began in the Barossa – not the most likely place to start – but there was a vibrant mental health network, Enhance Barossa, who were happy to help us answer this question in their local area. 

We heard from people with lived experience and representatives from housing, domestic violence, police, mental health and many other service providers. They told us the key is opening up the referral pathways across primary, secondary and tertiary settings.

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And an important relationship is with the local GP. There was enthusiasm for locating a peer worker into General Practice to be the link to psychosocial support and also to ‘social prescribing’.

Social prescribing means that a GP, as part of a patient’s overall plan, can connect them into services which are able to assist them with other problems or pressures in their life that are also impacting on their mental health.

For some, this could mean connecting them to a housing provider, employment service, community centre for social connections, a domestic violence service or a drug and alcohol program. For others, it might be a sporting, recreational or volunteering opportunity. Instead of the GP with limited time having to determine how to refer in detail – they just need to refer the person to the peer worker in the practice. The peer worker would then work with the person on an individual basis.

In essence, this is what a psychosocial service does. Psychosocial support is proven to reduce the number and duration of crises by helping people work through difficult problems that are also impacting on their mental health. The other side of this is it will have a big impact on unnecessary admissions to hospitals. This reduces pressure on emergency departments and acute care services as people are supported to be more well, more of the time.

We know that investing in psychosocial support is far cheaper than continuing to invest in hospital-based services and with this approach it takes pressure off GPs to solve all of a person’s mental health challenges.

To scale up psychosocial support, we will face workforce challenges but not at the scale of other health specialists. The minimum qualification for a peer worker takes around 18 months and, while availability in rural areas is an issue, our recent scholarships program showed that a modest investment in workforce development can overcome the challenges.

We have since done similar work in the northern suburbs and what this does is give the government a solution for both regional and metropolitan areas.

We have presented our own report and model back to both the state and federal government. So now, they not only know the problem. They also have the solution.

Meanwhile – we wait…

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