Refocus, reset, resolve: The ED mental health crisis is not an “epidemic” | AMA (WA)


Refocus, reset, resolve: The ED mental health crisis is not an “epidemic”

Thursday August 19, 2021

Dr Martin Chapman

Mental health presentations in Western Australian emergency departments have increased significantly over the last decade.
According to current AIHW data (May 2021), WA was previously the lowest amongst the states but has now risen. WA now has the highest annual increase (5.2 per cent) of any state (national total is 1.2%).

Also, whilst others are “flattening the curve”, our State is still rising.

Ultimately the data shows the direction of the WA MH system has not worked for consumers and supporters over the last decade.


ED mental health presentations

A system viewpoint offers an insight into WA system function (see infographic below). Not all mental health patients are the same. The WA Auditor General (2019) in a four-year patient journey study found that 10 per cent of patients account for 50 per cent of ED presentations and 90 per cent of acute bed use.

A small group, these patients rotate constantly in the acute system and often get trapped. This has created the impression of an ‘epidemic’ – but it is the same group presenting repeatedly.

A key direction is to refocus state mental health services on the high-user group and those with Severe Mental Illness (SMI). Properly planned, designed and integrated clinical, psychosocial and accommodation services for the 10 per cent high-user group has the potential to free up 50 per cent of ED capacity and 90 per cent of acute beds.

It appears a suite of new Sustainable Health Review (SHR) inspired services are being designed to address these issues. This gives hope that the WA system will be able to help these patients, reduce ED pressure and open acute services for other consumers and supporters.


Dr Martin Chapman


Dr Martin Chapman
Consultant Psychiatrist