Surveys reveal extent of understaffing in mental health facilities.

Asurvey of NSWNMA members employed in mental health shows the safety of patients and staff is at “critical levels”, said NSWNMA General Secretary Brett Holmes.

Reasons include inadequate budgets, a non-specialised and inexperienced mental health workforce and failure to retain senior mental health nurses, Brett told the parliamentary inquiry into management of health care delivery in NSW.

He said 340 members completed the survey in September and October 2017.

It produced similar results to a survey done around the same time by the Australian College of Mental Health Nurses in conjunction with Flinders University.

High dependency beds underfunded

Brett urged inquiry members to read “ brutally frank and honest” survey comments from nurses.

“I quote one very telling comment: ‘There is only so long that people can put up with endless abuse, violence, physical assaults, working understaffed, being made to work overtime, being bullied by management, working with wards over census. It is not an attractive place to work.

‘Over census means they admit more patients into the ward than they have beds for them, and then at night, if they are able, they sleep them out in some other wards or beds or find other arrangements to try and fit them into wards, which just adds to danger and risk.’”

Brett told the inquiry that NSW had only 62 mental health ICU beds properly funded as intensive care beds and patients could wait many weeks to be allocated such a bed.

Therefore, high dependency unit beds or observation beds, which get lower funding, had to serve as mental health ICU beds.

As a result, staffing was in-adequate for these types of patients.

“We were informed in 2015 by Mr Peter Carter, Acting Director, Mental Health and Drug and Alcohol Office, that mental health intensive care beds catered for the most disturbed mental health patients who are unable to be cared for safely with local health districts’ acute care options.

“In order to look after those patients, more nurses are allocated to the high dependency unit and that means fewer nurses are available in the acute care parts of that particular unit.”

NSW mental health services had 270 high dependency or observation beds that were underfunded and under-resourced to cope with highly aggressive patients who needed a higher use of seclusion.

In the NSWNMA survey…

68.93% said a lack of nursing staff to care for high acuity patients prevented a reduction in the use of seclusion and restraint.

18.05% Only 18.05 per cent often, and 4.14 per cent always, had appropriate nursing staff numbers for acuity of patients that allowed reduced seclusion and restraint.

68.93% of respondents were left in the position of high exposure to a foreseeable risk.

81% of respondents said their workplace had unfilled nursing positions.

5.9% said they were staffed to full capacity.

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