Children with autism are languishing in mental health wards for "months", leaving others stuck on emergency departments for days waiting for an admission, according to Western Australia's chief mental health advocate.
- Ms Colvin has written to the State Government calling for urgent action
- She says one child had to wait up to five days to access urgent mental health care
- The Government says hospital discharge delays are due to the transition to the NDIS
Debora Colvin penned a letter to three Government ministers in November after becoming increasingly concerned about the number of young people waiting days in hospital emergency departments for admission to one of the state's two youth mental health units, while adolescents with autism were stuck on these wards "with nowhere else to go".
She said on the day she sent her letter there were four teenagers who had been waiting days for an admission to a mental health ward.
One had been waiting for five days, two for three days and another for just over two days.
The only two youth mental health wards in West Australia authorised to take 16 and 17-year-olds have 12 and 14 beds, respectively.
Ms Colvin said these wards could be traumatising and were not always appropriate for young people with autism, but that they were being admitted after desperate parents took their children to hospital emergency departments.
"They will just get so desperate that they will take their child to an ED and just say 'you've got to help me'," she said.
"In many cases these mental health wards — which are acute, locked wards — can be quite traumatising."
She said it was an incredibly frustrating situation.
"Urgent action is needed to find accommodation and providers to help these children with complex and dual diagnosis needs who will keep coming.
"At the very least there needs to be transitional accommodation arrangements."
State Government blames NDIS for delays
The State Government has told the ABC it did not agree young people with autism were spending extended periods on youth mental health wards.
A spokeswoman conceded hospital discharge delays had emerged as a significant issue during the transition to the Australia-wide National Disability Insurance Scheme (NDIS).
It said 40 patients with a primary or secondary diagnosis of autism were discharged from the two acute youth mental health units in the 13-month period between October 2018 and October 2019.
In this period, the average length of stay was 13 days at the Fiona Stanley Hospital Youth Unit and 23 days at the East Metropolitan Youth Unit.
Over the same period, there were 27 patients aged 16 or 17, with a primary or secondary diagnosis of autism, with mental-health-related admissions cared for on non-mental health wards.
'A situation that is escalating'
Autism Association of WA chief executive Joan McKenna Kerr said anecdotal evidence showed instances of young people with autism presenting at hospital emergency departments had increased.
"We have a situation that is escalating," she said.
"We need to get to the bottom of why it is occurring and we need preventative strategies in place.
"It is not a good situation for families and it is a terrible situation for children."
Ms McKenna Kerr agreed the process of transferring services from the state to the NDIS may be contributing to the problem.
"NDIS does not as yet have a response that is nimble enough to respond to families and kids that are in crisis," she said.
"In the old state system, you had a local area coordinator — we don't have local area coordination to the same extent anymore."
Ms McKenna Kerr said more dedicated emergency respite beds were also needed.
NDIA defends support on offer
The NDIS supports more than 7,200 West Australians with autism as their primary disability.
A National Disability Insurance Agency (NDIA) spokesman said the NDIS provided a range of disability-related supports for its participants, including respite support for participants when required.
"When people are in acute settings such as hospital, they are likely to be receiving clinical treatment," the spokesman said.
"When an NDIS participant is ready to be discharged from hospital, the NDIA works with family, carers and the health system to ensure they have the right disability-related supports in place, including finding appropriate accommodation if required."
In June 2019, the Disability Reform Council (DRC) agreed on the Hospital Discharge Delay Action Plan (HDDAP), aimed at ensuring the timely discharge of NDIS participants from public hospitals.
Health liaison officers are being introduced nationally to improve communication between health systems and the NDIS to support more timely discharge from hospital.
In a statement, a State Government spokeswoman said the Department of Communities had several programs and strategies for young people with complex support needs.
"The coordination and streamlining of services to this cohort of individuals can be complex and challenging," she said.
"WA Government agencies are involved in the development and implementation of the national HDDAP."
The spokeswoman said a safe discharge from hospital required "bricks and mortar" facilities, an approved plan with funded supports, and suitably trained and experienced service providers.
"The significant increase in the number of NDIS-funded individuals with complex supports requirements has substantially increased demand for specialised services," the statement said.
If you or someone you know needs help, call:
- Emergency on 000 (or 112 from a mobile phone)
- Lifeline on 13 11 14
- Kids Helpline on 1800 551 800
- MensLine Australia on 1300 789 978
- Suicide Call Back Service on 1300 659 467
- Beyond Blue on 1300 22 46 36
- Headspace on 1800 650 890