The decline in mental health services across NSW is chronic and escalating.

Cumberland Hospital is the oldest and biggest psychiatric facility in NSW and its assessment centre (previously known as Admissions) has been a first port of call for people seeking mental health support in Western Sydney for decades.

However, the centre closed its doors to the public on January 21 – one of five wards and units “temporarily” shut down due to the mass resignation of psychiatrists in a pay and staffing dispute with the state government.

Three units including the assessment centre (a total of 27 beds) still remained closed in late April.

Enrolled nurse Fran Cavallaro, secretary of the NSWNMA’s Cumberland Hospital Branch, has worked at the hospital for 37 years and the assessment centre since 1996.

“I still have patients coming to my front door seeking help even though we’ve been closed for three months,” Fran said.

“I have to go out and tell them that I’m sorry, we are closed to the public, and if you’re in crisis you need to present to Westmead Hospital emergency department.

“Some of them are in a real crisis; they can’t sleep, or they’re suicidal and hearing voices.

“We have had Corrective Services turn up with court orders diverting people into treatment programs and we’ve had to explain that we’re closed, and they need to go to Westmead.

“I recently had a middle-aged man – a patient well known to us – crying and begging for help because he knows Cumberland, he knows our procedures.

“So, I’m sending him and others to an overwhelmed and hectic ED rather than providing prompt assessment and advice in a calmer, more settled environment.

“They could be stuck in the ED waiting room for many hours before there’s a bed allocated to them.

“Sometimes the people I have to turn away never make it up to the ED and may be lost to care. “It is distressing for us nurses because we are here to help people, not turn them away in their hour of need.

“I have told the district (Western Sydney Local Health District) that I have a moral issue with having to turn people away. “Where is the patient safety for those people that present to my door?”

COMMUNITY MENTAL HEALTH UNDERSTAFFED AND UNDER- RESOURCED

Fran said that even after three months of closure, there had been no update on when the units would reopen – “despite my efforts to get answers at the district and local level on behalf of the NSWNMA branch.”

“The level of transparency from the district to the local level is quite poor and employees are often kept in the dark on issues of vital concern to us and our patients.”

A total of 206 psychiatrists were reported to have submitted their resignations in the dispute with the state government.

The state’s minister for mental health, Rose Jackson, told The Sydney Morning Herald on 14 February that 29 psychiatrists had withdrawn their resignations, 105 had “deferred” their departure and 71 had taken higher-paid visiting medical officer contracts.

Around the same time, 84 admitted mental health patients were stuck in Western Sydney emergency departments waiting for a bed on a ward – with some waiting for as long as 90 hours, the Herald reported.

“Mental health staff say they have been left on hold for more than an hour calling NSW Health’s Mental Health Line to find a service that can take their patients,” the paper added.

Fran agrees that a lot of calls to the Mental Health Line may go unanswered. “Nurses often call the Mental Health Line to get their patients into an outpatient community setting.

“However, community mental health teams have long been understaffed and under-resourced. They continue to struggle with unmanageable workloads – and have been for a long time.”

LOST MENTAL HEALTH BEDS

The decline in mental health services across NSW is chronic and escalating.

The Herald reported that NSW public hospitals lost 150 mental health beds in the five years between 2016 and 2022, according to Australian Institute of Health and Welfare data.

“Mental health services have been in crisis for years and the doctor resignations put the spotlight on the problem and widened the cracks,” Fran said.

“In parts of Western Sydney such as the Hills district, population numbers have exploded over the last 10 years, but our bed numbers have declined.”

At a rally outside Cumberland Hospital in February, NSWNMA members called on the government to meet psychiatrists’ pay demands, urgently improve mental health staffing and reopen closed units.

The rally also raised the alarm about a Health Ministry proposal to treat psychiatric patients in general wards in order to overcome the shortage of mental health beds.

“The Ministry/LHD is considering placing patients whose primary diagnosis may be related to drug and alcohol issues or neurological conditions into general wards, even when they have a secondary diagnosis involving mental health,” Fran said.

“The ministry calls it remodelling but I call it rebranding. “This isn’t about patient safety – it’s about maintaining appearances. The recent resignations forced a review of current practices, but the consequences of these decisions could be serious and sometimes fatal.”

“The general ward is not a mental health unit, it’s not designed, staffed or resourced to provide the specialised care, supervision and support that mental health patients need.”