Dr Mat Coleman provided an update on the new integrated mental health service at Geraldton Regional Hospital.
Things are finally changing in the Midwest. The system has been resource-poor for a long time compared with other regions. We are delighted to be taking the best parts of our existing system, including our Consumer engagement and respect for indigenous population into the new unit. We are looking forward to enabling delivery of care for acute psychiatric episodes locally. Mat outlined some of the challenges of implementing a design from 2018 which had not adapted to suit updated standards of care.
One of the significant improvements will be the ability to broaden the ECT service, which was also discussed this year. It has the highest rate of success of all treatments, particularly in the care of manic delirium.
There has been careful attention to embedding patient centred, trauma informed models of care. For example, the ‘Seclusion Unit’ has been repurposed as a de-escalation suite for patients to use voluntarily. The patients with highest needs are cared for in the Psychiatric Intensive Care, not a ‘Locked Ward’ or ‘Secure Unit’.
Suicide is difficult to predict, so all areas have appropriate precautions. Violence is easier to predict, using the DASA score developed by forensic units. Prevention of escalation is more effective than de-escalation.
Funding for Drug and Alcohol Unit is separate and does not include medical FTE. However, the integrated mental health service is clearly going to be caring for people with addiction problems which coexist with mental health issues. General Practitioners can seek support by calling DACAS (08) 6553 0520 or Mat mentioned a national equivalent. Sue didn’t find it: send feedback if you have more information.
Mat shared the floor plan and areas within the new building, explaining the role of each and how it has been adapted to suit our contemporary needs. There is an area which can be used to separate vulnerable people from others (those under 18, sexual abuse risks, culturally inappropriate groups etc). The entire inpatient unit is compliant with Mental Health Act requirements.
Nicotine addiction is managed proactively as smoking and vaping is not permitted anywhere in the unit, and inpatients cannot pop outside. This is not primarily to make them quit (although it can be helpful). Rather, doing so improves wellbeing and reduced aggression. The Mental Health Smoker’s Clinic is run locally by a general practitioner based on the work pioneers by Ian Hickey. Kylie Hodge has given a talk on this topic previously. 10% of all our hospital admissions are directly caused by addiction.
Treating eating disorders regionally is difficult, requires a multidisciplinary team, and methods of providing nourishment for severe cases (such as enteric tubes) provide ligature risks. Stay tuned for SCARP presentation on Eating Disorders in Term 4!
