1 00:00:00,080 --> 00:00:03,360 Speaker 1: And now some of the worst ramping on a record 2 00:00:03,400 --> 00:00:08,760 Speaker 1: in South Australia, and the Psychologists Association here in essay 3 00:00:09,600 --> 00:00:15,400 Speaker 1: saying they're devastated but not surprised that ambulances were ramped 4 00:00:15,520 --> 00:00:20,720 Speaker 1: the night before last night at the RAH, including some 5 00:00:20,840 --> 00:00:24,800 Speaker 1: seven with the mental health patients. Let's have a chat 6 00:00:24,800 --> 00:00:28,600 Speaker 1: about that. Deborah MacLean is President, Essay, Psychologists Association. Deborah, 7 00:00:28,640 --> 00:00:29,840 Speaker 1: good morning, Thank you for your time. 8 00:00:30,520 --> 00:00:31,960 Speaker 2: Good morning, thank you for your time. 9 00:00:32,080 --> 00:00:36,360 Speaker 1: Certainly distressing to hear this that people with mental health illnesses, 10 00:00:36,920 --> 00:00:39,839 Speaker 1: including others of course who were there for other reasons ramped. 11 00:00:41,920 --> 00:00:45,800 Speaker 2: It's very distressing and mental health care being delivered to 12 00:00:45,920 --> 00:00:48,280 Speaker 2: our patients in the back of ambulances is not what 13 00:00:48,360 --> 00:00:51,800 Speaker 2: any family wants for their loved one and really South 14 00:00:51,840 --> 00:00:53,200 Speaker 2: Australians to live better. 15 00:00:53,120 --> 00:00:56,560 Speaker 1: Than this indeed, So what needs to happen are you'd 16 00:00:56,600 --> 00:00:58,279 Speaker 1: be calling on the government to make changes? I mean 17 00:00:58,320 --> 00:01:02,000 Speaker 1: everybody has been successive. It's only getting worse. 18 00:01:02,680 --> 00:01:05,720 Speaker 2: Absolutely, and people should be able to access the services 19 00:01:05,760 --> 00:01:08,720 Speaker 2: of any before this point of crisis. And for people 20 00:01:08,760 --> 00:01:13,160 Speaker 2: who are experiencing mental ill health, the primary and frontline 21 00:01:13,200 --> 00:01:16,800 Speaker 2: services that they should have access to is psychology, which 22 00:01:16,880 --> 00:01:19,600 Speaker 2: in FA health is an ever dwindling workforce. 23 00:01:20,800 --> 00:01:23,800 Speaker 1: So what does that mean ultimately is that now we 24 00:01:23,880 --> 00:01:26,399 Speaker 1: understand bed block is a reason you're saying there's not 25 00:01:26,680 --> 00:01:28,160 Speaker 1: enough psychologists on duty. 26 00:01:28,920 --> 00:01:31,640 Speaker 2: Absolutely not. There has been a mass exodus of psychologists 27 00:01:31,640 --> 00:01:34,920 Speaker 2: out of the public sector and this has significantly restricted 28 00:01:34,920 --> 00:01:39,039 Speaker 2: South Australia's access to psychology services that can improve and 29 00:01:39,160 --> 00:01:42,800 Speaker 2: preserve positive mental health and reduce the need for hospitals missions. 30 00:01:42,800 --> 00:01:47,160 Speaker 2: And what we need is immediate, urgent and meaningful change. 31 00:01:47,319 --> 00:01:51,960 Speaker 1: So having you've made a call for public sector psychology 32 00:01:52,000 --> 00:01:54,800 Speaker 1: services out of hospitals, so what does that look like? 33 00:01:54,880 --> 00:01:56,000 Speaker 1: What's that model going to be? 34 00:01:57,200 --> 00:02:01,000 Speaker 2: So if more Jinian has had access to public sector 35 00:02:01,040 --> 00:02:05,800 Speaker 2: psychology services within their own communities, there would be less 36 00:02:05,920 --> 00:02:08,880 Speaker 2: need for people who are experiencing mental ill health to 37 00:02:08,960 --> 00:02:11,880 Speaker 2: rely on hospital services as the only way that they 38 00:02:11,880 --> 00:02:15,400 Speaker 2: can receive health. For many people, the gap that they 39 00:02:15,680 --> 00:02:18,840 Speaker 2: require to pay for private services where they're limited to 40 00:02:18,919 --> 00:02:22,600 Speaker 2: ten sessions is just not sufficient to meet the complex 41 00:02:23,280 --> 00:02:27,480 Speaker 2: and acute needs that they're experiencing with their own mental health. 42 00:02:27,840 --> 00:02:31,240 Speaker 1: Has it all gone downhill since? And we point to 43 00:02:31,280 --> 00:02:34,400 Speaker 1: this as an easy kind of explanation, but the closure 44 00:02:34,440 --> 00:02:37,519 Speaker 1: of Blend's side and the dismantling of that system then 45 00:02:38,320 --> 00:02:41,160 Speaker 1: and putting mental health services into public hospital So I 46 00:02:41,160 --> 00:02:43,680 Speaker 1: mean it seems as if that was a big turning 47 00:02:43,680 --> 00:02:45,160 Speaker 1: point or part of transforming health. 48 00:02:45,160 --> 00:02:48,160 Speaker 2: Of course, I think that was part of the turning point. 49 00:02:48,400 --> 00:02:52,400 Speaker 2: I think also the psychology landscape within South Australia and 50 00:02:52,480 --> 00:02:56,840 Speaker 2: certainly Australia wide has changed. For the introduction of Medicare rebates, 51 00:02:57,200 --> 00:03:00,359 Speaker 2: the NDIS has played a part as well. So there 52 00:03:00,360 --> 00:03:03,640 Speaker 2: has been this move from psychologists out of the public 53 00:03:03,680 --> 00:03:10,000 Speaker 2: sector into positions in the primary health networks, NDIS and 54 00:03:10,040 --> 00:03:16,320 Speaker 2: the private sector where their remuneration reflects their skills and 55 00:03:16,760 --> 00:03:19,480 Speaker 2: the services that they provide. And FA Health has simply 56 00:03:19,600 --> 00:03:21,680 Speaker 2: just become a non competitive employer. 57 00:03:22,280 --> 00:03:23,840 Speaker 1: So it's as simple as that. It's the pay. 58 00:03:25,160 --> 00:03:28,200 Speaker 2: It is the pay. It's also the conditions. The psychologists 59 00:03:28,200 --> 00:03:31,480 Speaker 2: who remain working in the public sector are there because 60 00:03:32,080 --> 00:03:35,520 Speaker 2: they see the value of being able to provide psychology 61 00:03:35,560 --> 00:03:40,360 Speaker 2: services to all South Australians and we're fifty percent vacency 62 00:03:40,440 --> 00:03:43,400 Speaker 2: rates in some of our local health networks. They're simply 63 00:03:43,440 --> 00:03:46,760 Speaker 2: not able to access the services that they so desperately need. 64 00:03:47,080 --> 00:03:50,640 Speaker 2: They're asking for them, but they're just not there to 65 00:03:50,720 --> 00:03:51,360 Speaker 2: be accessed. 66 00:03:51,880 --> 00:03:56,400 Speaker 1: There are some mental health units I suppose it's the 67 00:03:56,440 --> 00:03:59,160 Speaker 1: word or centers that people can go to. I know 68 00:03:59,200 --> 00:04:02,960 Speaker 1: there's one in Grenville Street, for example, and that is 69 00:04:03,360 --> 00:04:05,600 Speaker 1: well utilized. Do we need much more of that to 70 00:04:06,080 --> 00:04:09,280 Speaker 1: clear mental health patients out of hospitals? Is that the answer? 71 00:04:10,000 --> 00:04:13,800 Speaker 2: I think the focus on inputting our services at the 72 00:04:13,880 --> 00:04:17,279 Speaker 2: crisis end, at the pointy end, is of high value. 73 00:04:17,360 --> 00:04:21,600 Speaker 2: I also think there's been a real lack of focus 74 00:04:21,680 --> 00:04:25,000 Speaker 2: on assessing early and treating early so that we prevent 75 00:04:25,120 --> 00:04:29,440 Speaker 2: crisis and people aren't needing to be transported into our 76 00:04:29,560 --> 00:04:34,400 Speaker 2: hospital units via ambulance and be trying to access mental 77 00:04:34,440 --> 00:04:37,039 Speaker 2: health services from the back of a ramp gambulance. 78 00:04:37,120 --> 00:04:41,120 Speaker 1: Okay, assessing and treating early, that depends on the patients 79 00:04:41,160 --> 00:04:44,280 Speaker 1: willing to cooperate with that or maybe self diagnosed to 80 00:04:44,279 --> 00:04:44,880 Speaker 1: some extent. 81 00:04:45,960 --> 00:04:48,400 Speaker 2: To some extent, yes, but to be able to access 82 00:04:48,440 --> 00:04:52,800 Speaker 2: those services is so critical for our South Australian community, 83 00:04:52,880 --> 00:04:56,159 Speaker 2: and to be able to access them publicly in a 84 00:04:56,200 --> 00:04:59,760 Speaker 2: really timely way that are locally based for people. Is 85 00:05:00,000 --> 00:05:01,360 Speaker 2: any what Southistinis are after. 86 00:05:02,320 --> 00:05:05,080 Speaker 1: I'm sure that's absolutely right, and we do know. I 87 00:05:05,080 --> 00:05:07,279 Speaker 1: mean it's a fact that's been talked about many times. 88 00:05:07,320 --> 00:05:12,640 Speaker 1: The mental health cases in hospitals where people are rightly 89 00:05:12,680 --> 00:05:15,400 Speaker 1: needing care, no argument with that whatsoever. But of course 90 00:05:15,440 --> 00:05:19,279 Speaker 1: by being there rather than in a specific facility for them, 91 00:05:19,960 --> 00:05:24,000 Speaker 1: care center is causing that problem with the ramping, and 92 00:05:24,080 --> 00:05:27,120 Speaker 1: then ultimately everybody, mental health or otherwise is caught up 93 00:05:27,120 --> 00:05:27,440 Speaker 1: in it. 94 00:05:28,240 --> 00:05:32,440 Speaker 2: Absolutely, and really prevention is the key here. The solution 95 00:05:32,640 --> 00:05:36,400 Speaker 2: to reducing mental health presentations in emergency departments is to 96 00:05:36,440 --> 00:05:40,840 Speaker 2: provide well resourced and evidence based community services where psychologists 97 00:05:40,839 --> 00:05:44,719 Speaker 2: as the frontline workers, can treat problems early before patients 98 00:05:44,760 --> 00:05:45,480 Speaker 2: are in crisis. 99 00:05:45,960 --> 00:05:49,359 Speaker 1: What's it mean for mental health patients who are stuck 100 00:05:49,360 --> 00:05:51,679 Speaker 1: in the back of an ambulance for up to twelve hours. 101 00:05:51,720 --> 00:05:54,400 Speaker 1: I mean, it's ridiculous waiting to get into a hospital. 102 00:05:55,839 --> 00:05:58,200 Speaker 1: Conditions muster to here. I mean it does for everybody, 103 00:05:58,279 --> 00:06:01,960 Speaker 1: doesn't matter who you are. For people with mental health 104 00:06:02,560 --> 00:06:05,200 Speaker 1: issues having to go to hospital and then not being 105 00:06:05,200 --> 00:06:06,680 Speaker 1: able to get in the door, being in the back 106 00:06:06,720 --> 00:06:09,239 Speaker 1: of the ear that's not good for them, for the 107 00:06:09,279 --> 00:06:12,559 Speaker 1: paramedics looking after them, and ultimately for the hospital staff 108 00:06:12,560 --> 00:06:13,600 Speaker 1: once they're inside. 109 00:06:14,320 --> 00:06:17,239 Speaker 2: Absolutely, it's not good for anybody and for our patients 110 00:06:17,240 --> 00:06:20,360 Speaker 2: in particular. We talk a lot in health about trauma 111 00:06:20,400 --> 00:06:23,640 Speaker 2: informed care and trauma informed practice, and what we want 112 00:06:23,680 --> 00:06:27,159 Speaker 2: to be able to do is to prevent any retraumatization 113 00:06:27,279 --> 00:06:31,400 Speaker 2: of people and being at the point where you're in 114 00:06:31,480 --> 00:06:36,360 Speaker 2: such crisis that you require ambulance transport into emergency department 115 00:06:36,800 --> 00:06:42,039 Speaker 2: when the likely chances are that there are preventable options 116 00:06:42,080 --> 00:06:45,400 Speaker 2: that could have been utilized much earlier had access been 117 00:06:45,440 --> 00:06:47,200 Speaker 2: available through the public health system. 118 00:06:47,920 --> 00:06:50,039 Speaker 1: Got a text here you'll be interested to comment on this, 119 00:06:50,120 --> 00:06:53,120 Speaker 1: and it goes to what you've been saying. Somebody in 120 00:06:53,560 --> 00:06:56,480 Speaker 1: the system saying, my unit within the government works with 121 00:06:56,600 --> 00:06:59,480 Speaker 1: highly complex and vulnerable people. We were designed to have 122 00:07:00,279 --> 00:07:04,000 Speaker 1: psychological and social work staff. We currently have one point 123 00:07:04,040 --> 00:07:08,080 Speaker 1: three psychologists and thirteen point three social workers. All our 124 00:07:08,120 --> 00:07:10,760 Speaker 1: staff do excellent work, but I'm concerned there's such a 125 00:07:10,840 --> 00:07:14,400 Speaker 1: reduced access to psychological services when they're needed. As I say, 126 00:07:14,440 --> 00:07:16,320 Speaker 1: that goes to the heart of what you've been saying. 127 00:07:17,160 --> 00:07:21,320 Speaker 2: It absolutely is, and really we can't replace psychologists with 128 00:07:21,800 --> 00:07:27,280 Speaker 2: other options. Psychologists there are there to provide specialize. They're 129 00:07:27,440 --> 00:07:31,320 Speaker 2: very highly trained. We have very complex training pathways and 130 00:07:31,360 --> 00:07:34,000 Speaker 2: the skills and the knowledge and the experience that psychologists 131 00:07:34,040 --> 00:07:40,160 Speaker 2: bring just simply can't be replaced, and the disparity between 132 00:07:40,480 --> 00:07:44,480 Speaker 2: psychology FT and others really speaks to this math exodus 133 00:07:44,480 --> 00:07:48,320 Speaker 2: of psychologists out of the public health system and is 134 00:07:48,320 --> 00:07:50,200 Speaker 2: an issue that needs to be addressed. There was a 135 00:07:50,200 --> 00:07:53,480 Speaker 2: ministery or around table that was held twelve months ago 136 00:07:53,640 --> 00:07:56,760 Speaker 2: with the promise of a psychology workforce plan. It is 137 00:07:56,880 --> 00:08:00,520 Speaker 2: yet to be delivered and the psychology workforce contend news 138 00:08:00,600 --> 00:08:04,400 Speaker 2: to be in crisis and South Australias simply don't have 139 00:08:04,520 --> 00:08:06,200 Speaker 2: access to the services that they need. 140 00:08:06,400 --> 00:08:07,800 Speaker 1: Was there a time as to when it was to 141 00:08:07,840 --> 00:08:09,720 Speaker 1: be delivered by there. 142 00:08:09,600 --> 00:08:12,400 Speaker 2: Was no time training offered, but a year down the 143 00:08:12,440 --> 00:08:16,320 Speaker 2: track there are no solutions and so people are continuing 144 00:08:16,320 --> 00:08:19,480 Speaker 2: to leave. A recent survey of psychologists from within SAY 145 00:08:19,560 --> 00:08:22,480 Speaker 2: Health tells us that eighty percent of psychologists are looking 146 00:08:22,480 --> 00:08:27,200 Speaker 2: elsewhere for work and if there's no meaningful change from 147 00:08:27,280 --> 00:08:31,520 Speaker 2: the industrial negotiations that will occur later this year, at 148 00:08:31,600 --> 00:08:34,600 Speaker 2: least eighty one percent le either resign or reduce their hours. 149 00:08:34,679 --> 00:08:36,760 Speaker 2: So you know, our vacancy rate is only going to 150 00:08:36,800 --> 00:08:41,000 Speaker 2: increase and people's opportunity to be able to access public 151 00:08:41,000 --> 00:08:42,760 Speaker 2: sector psychology will reduce even. 152 00:08:42,559 --> 00:08:45,880 Speaker 1: Further, and I imagine the Psychologists Association, Deborah, being hard 153 00:08:45,920 --> 00:08:49,160 Speaker 1: within SA Health and the Minister's office to get something done. 154 00:08:49,600 --> 00:08:53,720 Speaker 2: We absolutely are, we continue to be ready to be 155 00:08:53,840 --> 00:08:58,600 Speaker 2: collaborative and cooperative and engaging conversations. They are happening. The 156 00:08:58,679 --> 00:09:02,560 Speaker 2: reliance on the industrial pathways is probably a very narrow 157 00:09:02,679 --> 00:09:05,360 Speaker 2: view to take, but it seems to be the only 158 00:09:05,360 --> 00:09:06,800 Speaker 2: option that we have at this point in time. 159 00:09:06,920 --> 00:09:10,719 Speaker 1: Yeah, indeed, Deborah, appreciate your time. Thank you, Thank you 160 00:09:10,760 --> 00:09:15,040 Speaker 1: so much, Deborah m MacLean, President of the Essay Psychologists Association. 161 00:09:15,160 --> 00:09:18,679 Speaker 1: On the back of ambulances with mental health patients ramped 162 00:09:19,000 --> 00:09:21,640 Speaker 1: for hours up to twelve hours at the Royal Adelaide 163 00:09:21,720 --> 00:09:25,240 Speaker 1: Hospital a couple of nights ago, just totally unacceptable, isn't it? 164 00:09:25,600 --> 00:09:29,640 Speaker 1: First world health system? And these problems continue now. Okay, 165 00:09:29,720 --> 00:09:32,240 Speaker 1: the government's saying more beds coming on stream, and they've 166 00:09:32,280 --> 00:09:35,800 Speaker 1: been planned for well before the last dated election, but 167 00:09:35,960 --> 00:09:39,320 Speaker 1: it takes that long and it does obviously, can't click 168 00:09:39,360 --> 00:09:41,680 Speaker 1: your fingers. They don't appear. There's no genie in the bottle, 169 00:09:42,360 --> 00:09:46,080 Speaker 1: but billions. I keep saying this and coming back to 170 00:09:46,120 --> 00:09:49,440 Speaker 1: this point, billions upon billions upon billions, not just the 171 00:09:49,480 --> 00:09:51,840 Speaker 1: new hospital and the one to come in the women's 172 00:09:51,840 --> 00:09:56,720 Speaker 1: and children's, but that much being spent into our health system, 173 00:09:56,760 --> 00:10:00,440 Speaker 1: being poured into health year after year after year, and 174 00:10:00,880 --> 00:10:03,880 Speaker 1: we've got this terrible situation that has been with us 175 00:10:03,920 --> 00:10:08,360 Speaker 1: now for what ten or so years, just unreal, and 176 00:10:08,400 --> 00:10:10,360 Speaker 1: people with real needs being stuck in the back of 177 00:10:10,400 --> 00:10:12,240 Speaker 1: an ambulance. You can get to hospital, or you just 178 00:10:12,280 --> 00:10:14,280 Speaker 1: can't get in. It's crazy.