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Care Opinion

Psychiatric assessment delay

Posted By golfpx34

"Psychiatric assessment delay"

About: Perth Children's Hospital / Emergency Department

(as a parent/guardian),

My adolescent child was brought to Perth Children's Hospital by ambulance because of a suicide attempt. We waited more than 7 hours to be assessed by the psychiatric registrar because there is only one for all of ED.

My child had been discharged from the hospital earlier that day. Even so, from late in the night to the morning, we waited. There is nowhere for parents to sleep, my child is getting poor sleep and both of us are exhausted.

How is this system providing adequate mental health care to my child or supporting me to care for them?

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Responses

Response from Sue Baker, Nursing Co-Director (Medical), Child and Adolescent Health Service - WA 3 years ago
Sue Baker
Nursing Co-Director (Medical),
Child and Adolescent Health Service - WA

Submitted on 6/10/2020 at 5:31 PM
Published on Care Opinion at 5:32 PM

Dear golfpx34,

I am very sorry to hear of the challenges your family have experienced in seeking help for your child’s mental health emergency.

I regret that the delay in receiving treatment has had such a negative impact on your family at such a crucial time. It is reasonable to expect that health services will be there to help your family when you need it most, and I apologise the wait time has left you feeling so unsupported. Seven hours is an unacceptable amount of time to wait in an emergency department and certainly not in line with the level of service we want to deliver.

We have recently experienced a significant surge in demand for emergency and mental health inpatient services and we have increased staffing levels to meet the additional demand, with plans to further increase the staffing in the coming weeks. Please do not hesitate to contact the Child and Adolescent Mental Health Service (CAMHS) Emergency Telehealth Service (ETS) on 1800 048 636 between 8am to 2.30am or present to the PCH Emergency Department at any time.

I want to thank you for taking the time to share your experience and start a conversation about what is important to you and your family when seeking mental health help for your child. If you have any specific concerns around your child’s unique situation and treatment, please do not hesitate to contact the Consumer Engagement team by calling (08) 6456 0032 between 8.30am-4.30pm Monday to Friday or email cahsfeedback@health.wa.gov.au.

Kind regards,

Sue Baker

Nursing Co-Director (Medical)

Perth Children’s Hospital | Child and Adolescent Health Service

and

Trish Sullivan

Mental Health Service Co-Director

Child and Adolescent Mental Health Service | Child and Adolescent Health Service

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Update posted by golfpx34 (a parent/guardian)

Dear Sue and Trish

Thank you for your reply.

It saddens me to report that I believe the staff changes you foreshadowed have not significantly improved the delivery of mental health services in the PCH Emergency Department.

Recently my child was again taken to PCH ED by ambulance and we arrived around mid-morning. My child was distressed enough to be banging their head on their knees and pacing the room. For about 30 minutes no staff member checked on us. A few walked passed and, I believe, had puzzled looks but no one came to see if we were ok. Eventually, I pressed the call button and a nurse came in. I explained the situation to them, they did some obs and left. About an hour later a junior doctor came in, asked a couple of questions, particularly about my child's involvement with the eating disorders service, and then the doctor left.

More than 2 hours after our admission a senior doctor came in to speak with us. They explained that we were third in the queue to see the psychiatric registrar and would likely have to wait several more hours. As we had an appointment in the outpatient clinic later that afternoon, this doctor suggested we discharge from ED and go to our appointment. So that is what we did. The outpatient appointment did not resolve the issue and ambulance and police were called to my home the next day. On that occasion, I declined transport to PCH because I felt nothing good had come from any of the previous presentations to ED.

I do not want to use up precious ED resources for my mentally unwell child but there are no other options for me when they are so distressed that they are hurting themselves and other people. I only call the ambulance when I have tried everything else and my child's distress has been going on for hours. Before I call the ambulance I call their outpatient clinic and the CAMHS emergency Telehealth service. The response I get is consistent - if they are so distressed present to ED or call the police.

In my opinion, there are still not enough mental health staff in the ED to safely treat the number of mental health patients that present to ED. I believe this is made more concerning by CAMHS and PCH encouraging parents of mentally unwell young people to present to ED.

Response from Matthew Holmes, Director of Consumer Engagement, Child and Adolescent Health Service - WA 3 years ago
Matthew Holmes
Director of Consumer Engagement,
Child and Adolescent Health Service - WA

Submitted on 10/12/2020 at 7:56 PM
Published on Care Opinion on 11/12/2020 at 11:24 AM

Dear golfpx34,

I am truly sorry to hear that you are continuing to experience difficulties in accessing timely care for your child. While I am aware the PCH Emergency Department uses a standardised triage protocol for assessing patients who present for review, it is likely that the significant surge in numbers recently has resulted in many patients experiencing longer waiting times. I am saddened to hear that no staff member had checked up on you and your child, and acknowledge that this must have increased the distress you were experiencing.

While continued efforts are being made to address the mental health resources in the hospital, I appreciate that these may not yet be resulting in the desired effect, but hopefully will improve over time as the recruitment process for additional staff continues over the coming months.

As suggested in the above initial response to your feedback, I would encourage you to contact us directly via CAHSFeedback@health.wa.gov.au or telephone on 6456 0032 between 8.30 am - 4.30 pm Monday to Friday to request a review of your child’s care by our leadership team. This will allow us to take a detailed look at your concerns and the options available for your child.

Kind regards,

Matthew Holmes

Director of Consumer Engagement

Child and Adolescent Health Service

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