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Unsafe wait times for psychiatrist appointment

Posted By golfpx34

"Unsafe wait times for psychiatrist appointment"

About: Eating Disorders Program Perth Children's Hospital

(as a service user),

My child is an outpatient of the Eating Disorders Service. They waited 6 weeks for the first available appointment with the psychiatrist in the team. They have already been an inpatient on the medical ward for 4 of the preceding 7 weeks and had an emergency presentation to the hospital and short stay on the mental health ward 8 weeks before their first scheduled psychiatrist appointment. 

While we waited, my child presented to Emergency via ambulance. Numerous calls to ambulance and police to our home because they were repeatedly hurting themselves. Almost daily calls to the CAMHS Emergency Telehealth line. When my child is distressed they bang their head. I believe they have banged their head on virtually every hard surface in our house - doors, walls, furniture. Many of those surfaces have dents from the force they use. My child throws furniture. They break anything they can get their hands on. Our scissors and valuables are locked away. My child is physically abusive to family members. They scream and scream and scream begging us to help them. 

My child is incredibly unwell. Their levels of anxiety and distress are higher than any human being in my opinion, let alone a child, should have to manage on their own while they wait for medical help. The only advice we receive is to call emergency services or present to ED. On our most recent presentation to ED by ambulance, we waited 3 hours only to be advised that we were 3rd in line to see the psychiatric registrar and I felt it was probably a better use of our time to go to our outpatient appointment. 

I believe the system is leaving my incredibly unwell child to care for themselves or me to have all the skills of a mental health professional and care for them at home. In my opinion, the system is broken. 

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Responses

Response from Linda Hop, Acting Nurse Co-Director, Medical, Child and Adolescent Health Service 3 years ago
We are preparing to make a change
Linda Hop
Acting Nurse Co-Director, Medical,
Child and Adolescent Health Service

Submitted on 4/12/2020 at 11:48 AM
Published on Care Opinion at 11:49 AM

Dear golfpx34,

We are very sorry our service has not met your expectations of care. Emergency wait times for young people presenting for mental health reasons have been longer than we would like, due to an unprecedented surge in mental health presentations which is also being seen across Australia. To try and address this increased demand, an additional Psychiatric Registrar (Doctor) has been introduced in the PCH Emergency Department since 27 October 2020. They are on shift from 2-10pm to assist existing staff during the peak time for mental health presentations. We are currently in the process of recruiting more mental health liaison nurses, who will commence from January / February 2021. These are examples of some of the strategies that are being implemented to reduce our waiting times. Emergency presentations are difficult to predict, and despite the best efforts by our staff, long waits may occur. We thank you and all families using our services for your understanding at these times.

We encourage you to contact us directly via CAHS.Feedback@health.wa.gov.au or telephone on 6456 0032 to request a review of your child’s care by our leadership team. Without knowing all the information about your child’s unique presentation, we are unsure whether a six week wait to see a Psychiatrist is clinically appropriate. We appreciate as a parent this has been a very frustrating wait for you and are very sorry for the negative impact the wait has had on your family. Child and Adolescent Psychiatrists are in short supply in Western Australia currently and to ensure the most efficient use of their time, appointments are prioritised based on a triage system where patients most at risk are seen first. For an initial assessment this depends on the information in the referral, complexity of mental health and physical health concerns, and ongoing physical health reviews provided by the GP. We know our Eating Disorders team work very hard to ensure the best outcomes for the young people they care for with the resources they have available, and on behalf of the team, we hope you will accept our heartfelt apologies.

The CAMHS Emergency Telehealth Service (ETS) is a Psychiatrist-led service and was introduced on 13 July 2020 to provide advice to young people experiencing a mental health crisis. The CAMHS ETS also provides advice to parents, relatives, carers, health professionals and schools on caring for a young person experiencing a mental health crisis, and follows up each call received the next day. CAMHS ETS staff are able to conduct a comprehensive mental health assessment via Telehealth which determines what appropriate next steps might be. In many cases, callers can avoid an Emergency Department visit by following the advice given and utilising referrals made by the ETS to access mental health services in the community. Telehealth does have its limitations and while CAMHS ETS staff do the best they can to assist, parents have to make a judgement call on whether their child needs to present to Emergency or not. As a parent, you know your child best and there is no replacement for your intuition. Parents have the best sense of what is normal for their child and if they are at risk. In these circumstances, CAMHS ETS staff will always encourage you to visit an Emergency Department, as this is the safest option.

We thank you for taking the time to share your experience and encourage you to contact CAHS.Feedback@health.wa.gov.au directly so we may address your ongoing concerns.

Kind regards,

Linda Hop

Acting Co-Director (Medical)

Perth Children’s Hospital | Child and Adolescent Health Service

and

Simon Davies

A/Service Co-Director

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

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