The killings Western Australia’s chief psychiatrist warned were committed by people who had received sub-standard mental health care were just “the tip of the iceberg we can see”, Dr Andrew Miller says.
The state’s chief psychiatrist Nathan Gibson released a report last week which found a spike in alleged murders committed by people suffering severe mental health issues could have been avoided if they had been adequately treated.
Dr Gibson pointed out that in a number of cases it had been clear that the mental state of the individuals involved had been deteriorating, and he was scathing of a health system that had not responded to repeated reviews and recommendations for achieving better mental health care for its citizens.
Dr Miller, president of the WA branch of the Australian Medical Association, said there would be "untold human suffering" that was not covered in this report.
He said it was astounding for there to be a government report “that essentially says that all the government reviews have amounted to nothing" and praised Dr Gibson for lifting the lid on the situation.
“This report has got executive failure written all over it,” Dr Miller said.
“Who else is in charge of the system?”
He said a culture of bullying, imtimidation, disengagement and burnout in the public health system meant there was an ongoing, smouldering war between physicians who were looking at the future of mental health service delivery and the bosses running the services.
Patients were not only failing to secure a bed in a hospital, but they were not even getting properly assessed.
The fact that mental health patients tried to get help through hospitals or other health providers but were not adequately assessed and instead fell victim to a fractured health care model was laid bare in Dr Gibson's new Targeted Review Report.
“And I don’t believe it’s the frontline staff’s fault,” Dr Miller said.
“We are at record levels for mental health patients being in emergency departments for more than 24 hours. There is a humanitarian disaster unfolding,” he said.
He said health executives marginalised the views of the clinicians, who worked under a top-heavy, bureaucratic, unresponsive structure.
"There are good individuals in these executives but I have to wonder about the leadership and the director generals need to take more responsibility," Dr Miller said.
"The Minister needs to take more responsibility and not just point the finger."
Dr Miller praised Dr Gibson's courage in criticising the lack of reaction by the government and health system to previous reviews and recommendations.
"I had to take my hat off – he called a spade a spade," Dr Miller said.
"He’s covered himself in dignity. He’s called out the review after review approach where findings are not effectively dealt with."
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