"Admission to health service"

My relative suffers from severe and enduring schizophrenia. They live independently in the community, with clinical care provided by the Subiaco Adult Community Mental Health Clinic (SACMHC) . They are "Case Managed” by an Occupational Therapist who I feel lacks empathy, seemingly has limited clinical knowledge and expertise, and apparently has little knowledge of the mental health service system. My relative’s 'Psychosocial Support' is provided by an NDIS service provider with, to my knowledge, unqualified unskilled workers who seem to have little or no knowledge or understanding of mental illness or the recovery model of care.

The above has had a significant negative impact on my relative’s condition and quality of life. Their condition has deteriorated significantly, and as a result, they hav repeatedly for months requested voluntary admission to the Sir Charles Gardiner Hospital Mental Unit.

I believe these requests have fallen on deaf ears until several weeks ago when the psychiatrist at SACMHC agreed to refer them for hospital admission. Two weeks ago, my relative contacted SACMHC to enquire about their position on the hospital waitlist and was told by the Duty Clinician that they were second. At that time, their case manager had been on leave for 3 weeks without being replaced.

Recently I tried to contact the case manager to advocate for my relative’s admission.. The case manager did not return my call but subsequently phoned my relative to tell them a bed had become available at Graylands hospital.

My relative has repeatedly stated that they do not feel safe at Graylands hospital, has specifically and repeatedly requested to be admitted to another hospital and was prepared to be waitlisted. However, the CM urged them to take the bed offered, saying they had less than an hour to make a decision, and if they declined they would be sent to the bottom of the waitlist. I understand the CM told my relative this advice was from the ]Bed Manager], added that it was a nice ward, and that this was the only bed they would be offered.

I believe my relative was clearly distressed and conflicted at being pressured to take the offer. I offered to advocate on their behalf and called the CM to seek more information. The CM was unable to answer my questions regarding the acuity of the patients at the proposed unit, the unit bed configuration, aces to outdoors , and etc.

I believe they repeatedly gave me false and misleading information which I feel was tantamount to coercion and consistently contradicted their own information. They then directed me to call Graylands.

When I called Graylands hospital the switchboard operator informed me it was the CMs role to find out the information I requested but put me through to the ward regardless. The ward phone was answered by a person who only provided their first name.. I was unable to identify if I had the correct ward or to whom who I was speaking. I asked to speak to who was in charge and again someone answered the phone only giving their first name and no identifying information. This individual briefly answered my questions, but throughout our conversation repeatedly stated that they were busy doing something else and added that my questions would be answered once my relative was admitted. They also said they knew who I was !

I relayed the information given to me to my relative, and they refused the bed.

I am (again) amazed, dismayed and disappointed in the apparent lack of professionalism I have witnessed in the WA mental health service. I believe the Case Manager used coercion to convince my relative and myself to agree with them – and not for the first time to my knowledge. They provided what I believe to be false and misleading information to a vulnerable individual and their Carer, and seemed unaware of my relatives deteriorating condition.

Previous meetings between my relative, myself and the CM resulted in agreed case management plans that have never been implemented.. The CM is often unable to answer my queries, and they appear to have little knowledge of mental health services and the NDIS/ mental health interface. I believe this CM lacks in knowledge, skills, understanding and empathy to effectively help my relative, and others with mental illnesses.

While the mental health system in WA continues to place Occupational Therapists and Social Workers in Case Management positions, and rely on the NDIS to provide mental health care, I believe the quality of care will continue to decline, the rate of hospital admissions will continue to climb, and vulnerable people will continue to suffer.

I feel the case manager has proved to be unprofessional, unreliable and untrustworthy. This combination has done my relative immeasurable harm, and I shudder to think of how many other people are in the same situation.

I believe that until recommendations from the Chief Psychiatrist’s Review Building rehabilitation and recovery services for people with severe enduring mental illness and complex needs - including those with challenging behaviour (2020) are actualised it seems to me that the mental system in WA will continue to fail its most vulnerable clients and their carers.