Change in hospital funding model critical for mental health

The AMA this week launched a confronting report into mental health presentations at Australia’s public hospital emergency departments. 

Melbourne ED doctor and the AMA’s Emergency Medicine representative, Dr Sarah Whitelaw, launched the AMA’s Public Hospital Report Card – Mental Health Edition this week.

The report card, the latest from the AMA’s Clear the Hospital Logjam campaign, shows the number of patients presenting to emergency departments with poor mental health has almost doubled to a troubling 121 per 10,000 Australians, up from 69 in 2004.

At the launch, attended by national media, Dr Whitelaw was asked how critical changing the public hospital funding model was to improving public hospital care for mental health patients.

Dr Whitelaw said it was critical that the federal government increase its share of funding from 45 per cent to 50 per cent “both for the public hospital system in general and its place within our health system, but particularly for these mental health patients who are really suffering”.

“That increase… from the federal government will allow hospitals to recruit more staff, and that is something that they need funding security for.

“No amount of temporary or patchwork siloed grant funding can actually allow our health system to recruit the staff that they need long into the future, and that is why it's crucial that the federal government makes a commitment to long-term increasing its public hospital funding to 50 per cent,” Dr Whitelaw said.

AMA President Professor Stephen Robson said the federal government needed to commit right now to an increase in public hospital funding to a 50 per cent share with the states.

“We need to remove that 6.5 per cent cap that prevents some of the state governments putting in the additional funding that they know is needed,” he said.

“We need to make sure that the state governments commit to using that extra 5 per cent funding from the federal government to put directly into the public hospital system. And we need all of the recommendations, the plans, the promises that are being made around Australia to deal with acute mental health illness both in the community but also in the public hospital setting, to be implemented right now. We simply can't wait any longer.”

The AMA’s Public Hospital Report Card - Mental Health Edition found that due to the hospital logjam, patients with poor mental health often have to wait longer compared to any other patient group presenting to Australia’s emergency departments.

The report showed a big drop in the number of available public hospital beds for mental health patients, as increasing numbers of more severely ill patients present to emergency departments after exhausting all avenues for help.

There has also been an almost 40 per cent decrease in the number of mental health beds in public hospitals per capita — from 45.5 to 27.5 beds per 100,000 population between 1992 and 2020.

The data show a rising reliance on ambulances to reach emergency departments with every second mental health patient (52.2 per cent) arriving by ambulance in 2020–21 compared with all other conditions, where one in three people arrive by ambulance.

On arrival, those needing admission are waiting an average of 12 hours in Queensland to 28 hours in Tasmania before they are admitted to hospital for treatment.