Shortage of acute beds in Tasmania a ‘crisis’, mental health expert says

The Royal Australian and New Zealand College of Psychiatrists (RANZCP) and the Australian Medical Association (AMA) have both called for more acute beds in Tasmania due to the state’s ageing population and high rates of substance abuse.

According to the Productivity Commission’s 2018 Report on Government Services, Tasmania had 53.7 beds per 100,000 people in 2015-16, but only 34.2 per cent of those were acute, though it is not clear if those figures include the 10 beds that were removed over the course of the Royal Hobart Hospital (RHH) redevelopment.

The percentage of acute beds is the lowest in the country, with 82.2 per cent of beds in Queensland classified as acute and 66.2 per cent in New South Wales, though each state classifies acute and community-based beds differently.

The RANZCP’s Tasmanian chairman, Milford McArthur, said the state had a higher demand for mental health services than other states, which is not supported by enough acute beds.

“There’s often 10 patients sitting in casualty, needing admission and it’s certainly a crisis situation from our point of view,” said Dr McArthur

“In Tasmania, we are the oldest, most disadvantaged population with a high need of mental health care and also a high substance abuse rate so we probably need more acute mental health beds than some of the mainland places, but in fact we have less.”

So how many beds does Tasmania have?

In figures confirmed by the State Government, Tasmania has 71 acute mental health beds statewide, including 33 at the RHH, one of which is in the de-escalation room.

The RHH had 42 beds up until 2013, when the bed numbers were reduced under both Labor and Liberal governments.

Dr Frank Nicklason


“We certainly seemed to manage okay with the 42 beds. We rarely had patients waiting in casualty overnight,” Dr McArthur said.

On Sunday night, a number of psychiatric patients waiting for beds at the RHH made makeshift beds out of towels and slept on the floor of the Emergency Department (ED) until about 2:00am.

Many of the patients had waited days for beds on wards.

AMA spokesman on mental health, Frank Nicklason, said those numbers did not ease on Monday, and it is taking a toll on hospital staff.

“I had a very distressed call from a very experienced clinician on Monday who was working in the Emergency Department, and they had 10 or 12 patients in the department with serious mental illness and those patients would be requiring admission,” he said.

Acute care not the only problem: Mental Health Council

While a lot of the focus has been on acute beds, Mental Health Council of Tasmania chief executive Connie Digolis said it did not paint a comprehensive picture.

Sign outside Peacock Centre construction site in Hobart


“I think what we’re seeing at the moment is a demand that appears to be directed towards our acute services and that’s what we would argue is what we need to change because we need to be looking at how to take the pressure off our acute services,” Ms Digolis said.

Health Minister Michael Ferguson said the State Government is investing $95 million into a better mental health system and echoed the council’s call for community-based care.

“All acute bed capacity reductions in previous years [Labor and Liberal] have been on professional advice to shift resources into the community and to meet projected occupancy levels, however the Government is committed to ongoing consultation and investment in Tasmania’s mental health system and facilities,” he said.

“Over the past four years, we have provided millions of dollars in additional funding, boosting support for child and adolescent mental health and opening more community-based mental health beds.”

In a key state election promise, the Liberals pledged an additional 25 beds in Hobart, 15 at the Peacock Centre and 10 at Mistral Place, but in Parliament on Tuesday Mr Ferguson was unable to say when they will open.

Dr McArthur said there are more beds needed to cover the short-term increase in demand.

“These are acutely unwell patients at high risk and the patients want admission, and their families and their friends want them to be admitted, and that great cannot be easily diverted to less intense care facilities,” he said.

“Community resourcing is really important and that will be our saviour in the long-term, but that takes years to implement and it’s certainly not in place at the moment.”

Feature image credit: ABC News, David Neale

This article was published as part of my paid employment with the ABC. It was published on 19/9/2018, and is available here: 

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