Too sick for a GP, but not 'sick enough for hospital', patient tells mental health royal commission
Updated July 10, 2019 22:54:34
Georgia Harraway-Jones spent months “in limbo” as one of about 300,000 Victorians falling through the gaps in the mental health system.
- Ms Harraway-Jones’s illness progressed as she waited for care, to the point she was threatened with involuntary admission
- The royal commission heard there are major gaps in service availability between GP care and crisis care
- Werribee Mercy Hospital warned the erosion of care was contributing to patients falling into a repeating cycle of illness
The 20-year-old was diagnosed with an eating disorder, depression and anxiety in July 2017.
Ms Harraway-Jones missed out on care because her illness was too serious for a GP, but not serious enough for hospital admission, she told the Royal Commission into Victoria’s Mental Health System on Wednesday.
She said she was forced to wait months to access community mental health services, including a three-month wait to see a psychologist.
“It was really isolating. I was stuck in this limbo, where I was too sick for places such as Headspace,” she told the hearing.
“But I wasn’t sick enough for the hospital. I was just stuck in this period between supports.”
Ms Harraway-Jones said her mental health deteriorated as she waited.
“In that time I feel like my eating disorder really tightened its grip around my throat. I lost a lot of weight to the point I was threatened with involuntary admission,” she said.
Eventually Ms Harraway-Jones did require hospitalisation, but after being advised it would be a three-month wait for a public bed she used her parents’ health insurance to access help through the private health sector.
“At that time, I was quite suicidal, I had a plan and all of that. I really wasn’t eating,” she told the commission.
“I don’t think I would have made it those three months if I had waited.”
Her evidence comes a day after the Victorian Government released its submission to the commission, in which it admitted major gaps in the availability of services.
‘A vicious cycle’
The commission on Wednesday heard from experts who said the community mental health care services were suffering from insecure and inadequate funding, a lack of planning for population growth, and fragmentation.
The clinical director of mental health at Werribee Mercy Hospital, Associate Professor Dean Stevenson, told the commission the system had seen a “slow shift” towards prioritising acute hospital care over community care, with problematic consequences.
“The whole model of community care breaks down, I guess, to be frank,” Associate Professor Stevenson said.
“People relapse in the community, there’s not sufficient early relapse prevention in the community, which then feeds into a higher demand at the acute end of services … it becomes a vicious cycle.”
Associate Professor Stevenson said while the community mental health model worked well 15 years ago, funding cuts and a lack of planning for population growth had led to an “erosion” of services.
“As the funding became tighter and demand grew, we were no longer able to meet the demand,” he said.
“We’d probably have to see at least a doubling of funding to community teams to adequately provide services to those who need it the most.”
A ‘very holistic’ solution
The commission heard about one community-based program aimed at helping people who require support, but who had not hit crisis point.
Designed as small home-like units for stays of up to 28 days, the Prevention and Recovery Care (PARC) centre model is one alternative to hospitalisation.
North Fitzroy PARC’s service coordinator, Ingrid Amman, told the commission the service helped people stay well, using a multi-disciplinary treatment approach.
This included building life strategies and skills, housing support, interpersonal development and medication management support.
“It’s a very much holistic view — how do you keep yourself well, given the stressful environment that you’re living in,” she told the commission.
Ms Amman said after a stay in a PARC centre a mental health plan would be drawn up and a client would have the option of returning in case of a relapse.
“What we have found is those individuals have not had a hospital admission since PARC has become their preventive plan,” she said.
The royal commission will continue exploring access and navigation of the mental health system on Thursday.
It is due to deliver an interim report by November, with a final report due in October 2020.
More coverage of the mental health royal commission:
- Day 19: Mental health royal commission’s final witness optimistic system can be rebuilt ‘with some humanity’
- Day 16: Every suicide death destroys 135 lives with ‘ripple effect’, mental health royal commission hears
- Day 15: Royal commission hears terror attack revived painful childhood memories for South Sudanese refugee
- Day 14: LGBTQI people under-reporting mental illness due to ‘distrust and fear’, royal commission told
- Day 13: Victoria’s Aboriginal mental health services ‘lagging behind’, royal commission hears
- Day 12: ‘A joke’: Farmer travelled hundreds of kilometres to see psychiatrist, royal commission told
- Day 11: Anna wasn’t diagnosed with a mental illness until she went to prison for killing her roommate
- Day 10: Victoria police responding to a mental health call every 12 minutes, top officer tells inquiry
- Day Nine: Too sick for a GP, but not ‘sick enough for hospital’, patient tells mental health royal commission
- Day Eight: ‘I was threatened with involuntary admission’, mental health royal commission hears
- Day Seven: A ‘doubling of funding’ needed for Victoria’s struggling community mental health model, expert testifies
- Day Six: Victorian Government looks to mental health models in Italy and Netherlands
- Day Five: Compulsory treatment ‘gets a bad rep’ but it saved Erica’s life
- Day Four: Mental health royal commission hears suicidal young women was ‘greeted with silence’
- Day Three: Victoria’s mental health system failed ‘incredibly terrified’ girl, royal commission told
- Day Two: Advocate tells commission of Victoria’s ‘punitive’ mental health system
- Day One: Former AFL player tells of wanting to take his own life after winning premiership
- In-depth feature: Chloe left hospital in a daze with a handful of pamphlets. Two days later, she was back
First posted July 10, 2019 19:17:02