Young patients receiving critical psychiatric care at a mental health ward in Sydney, Australia have been sent home to make space for “suspected” Covid-19 patients.
A distressed staff member from the USpace ward at St Vincent’s Private Hospital said health workers and patients were told on September 12th that they had until the end of the week to clear out in compliance with a “surge action response” public health order to make way for Covid-19 patients.
The staff member said mental health workers were being reassigned to other duties, and were distressed as their speciality was children’s mental health, and they feared for their patients.
A psychiatrist with the hospital and former USpace director, Associate Professor Elizabeth Scott, said she received notice late on Sunday 12th September that the ward would be claimed for Covid patients. She has had to break the news to a number of her patients and their families.
“It’s unplanned, it’s abrupt and it seems to me like a very crisis-driven plan rather than a well thought-out initiative,” Scott said.
“Last year when there was Covid surge planning, it was certainly on the cards that New South Wales Health would take over some of the facilities including USpace, but we had more notice then.
“But the situation is different this year. Over the last year we have seen a dramatic increase in youth mental health presentations to emergency departments, and these are people with a range of serious mental health disorders. State and federal governments have said that youth mental health is a priority, and that more support, services and funding is needed.”
The short notice was making it difficult to put tele-health and other at-home support services in place, and to arrange how these would be funded, Scott said.
She said she believed the twenty-bed ward was chosen by the health department because it contained single rooms with their own bathrooms, and because it was located in a separate part of the hospital away from other patients, making separation of Covid patients easier.
“Support for our mental health patients requires quality infrastructure, support and planning,” Scott said. “Providing a different model of care at this point for an inpatient unit will be difficult.”
David Faktor, a spokesperson for St Vincent’s Private Hospital, confirmed that as part of the pandemic response the hospital “will be temporarily utilising USpace to serve as a suspected Covid ward”.
“The USpace layout provides the St Vincent’s campus with the best available accommodation configuration in terms of protecting this patient cohort’s safety and minimising risk of cross-infection,” he said.
He said USpace was a “vital” service for young adults, but that “we also need to ensure we maximise our pandemic response for the community to ensure all segments including this vulnerable population have access to the care they need”.
“Over the past year, USpace has developed comprehensive virtual care programs to be able to manage appropriate patients remotely within the community,” he said. “Where a patient is not appropriate for such care, they will be referred to another service in consultation with their treating care team.”
The official website for USpace includes testimonials from patients including one who said the service “saved my life”. It was Australia’s first private young adult mental health unit providing specialist care for people aged 16 to 25 years, and treats young patients with a range of conditions including mood and anxiety disorders, PTSD, ADHD, borderline personality disorder and substance use.
The ward will now be closed until at least November.
The ward cares for complex cases, including people for whom little understood underlying health conditions, may be driving their mental health symptoms.
Kaitlin Mountain has been a patient at the ward on-and-off since she was 16, and said the impact of the closure on youth there would be “catastrophic”. Mountain, now 30, has subacute autoimmune encephalitis, an inflammatory brain disease which in her case led to serious psychiatric disturbances.
“For a young person that struggles to contend with their own thoughts, to be told that they will finally be treated in this environment at USpace is a relief,” she said. “They have a set routine, and it has now been pulled from underneath them.
“It’s not like just because it’s a private hospital they have money or somewhere to go. When I was in there, there was nowhere in the public system with the space and expertise to treat me. I had to take money from my pension to pay for my private health insurance, and was surviving on about $15 a day. Many patients are from a low socioeconomic background.”
Psychiatrist and co-director of health and policy at the University of Sydney’s Brain and Mind Centre, Prof Ian Hickie, said the service USpace provides was “critical”.
“What the pandemic has shown is the pressure on certain groups of people has not been equal, and one of the group’s most adversely affected has been young people and their mental health,” he said. “This is an area in which we already do not have sufficient resources. We now as a consequence of the pandemic are seeing the closure one of those very few resources.”
Hickie said he was concerned the dire situation young people were finding themselves in was being seen as less critical than Covid-19, and it is disturbing how authorities can conclude this when the Covid-19 situation throughout not just Sydney, but the whole state of New South Wales is hardly overwhelming the healthcare system.
New South Wales has a population of 8.2 million, and as of the 24th September 2021 just 1,186 people have been admitted to hospital, equating to 0.01% of the population. Two-hundred-thirty-two of these admissions have resulted in admission to intensive care, with 110 requiring ventilation. The state of New South Wales is able to cope with 1,550 patients requiring intensive care.
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