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Patient safety works ongoing in public mental health units

Mental Health Inpatient Safety Works Remain Incomplete Two Years After WA Suicide Risk Audit

In a stark revelation highlighting ongoing challenges within Western Australia's mental health system, critical safety upgrades to inpatient facilities have yet to be fully implemented, more than two years after a comprehensive audit exposed significant suicide risks. The audit, conducted by the state's health department, identified numerous vulnerabilities in mental health wards that could contribute to self-harm and suicidal incidents among vulnerable patients. Despite promises of swift action, progress has been sluggish, raising alarms among healthcare professionals, patient advocates, and families affected by the system's shortcomings. This delay underscores broader systemic issues in mental health care, including funding constraints, bureaucratic hurdles, and competing priorities within the public health sector.

The audit in question was initiated in response to a series of tragic incidents in WA's mental health facilities, where patients had taken their own lives or attempted suicide due to inadequate safeguards. Released in mid-2022, the report painted a concerning picture of inpatient environments riddled with "ligature points" – fixtures like door handles, shower fittings, and window mechanisms that could be used for self-harm. It also highlighted insufficient staffing levels, poor monitoring protocols, and outdated infrastructure that failed to meet modern safety standards. The audit recommended a raft of immediate and long-term fixes, including the removal or modification of high-risk ligature points, installation of anti-ligature hardware, enhanced surveillance systems, and better training for staff to identify and mitigate suicide risks. At the time, health officials pledged to prioritize these changes, with an initial timeline suggesting completion within 12 to 18 months. However, as of the latest updates, many of these essential works remain unfinished, leaving patients exposed to the same dangers that prompted the audit.

One of the most glaring examples of these delays involves major hospitals in Perth and regional areas, where wards designed for acute mental health care have not undergone the necessary retrofitting. For instance, facilities like Graylands Hospital, a key psychiatric center, were flagged for urgent upgrades, yet reports indicate that only partial modifications have been made. Sources within the health department have attributed the slowdown to a combination of factors: supply chain disruptions exacerbated by the global pandemic, budget reallocations to address other healthcare crises such as COVID-19 recovery, and the complexity of retrofitting older buildings without disrupting ongoing patient care. Critics argue that these excuses mask a deeper lack of political will and insufficient funding allocation. The state government's mental health budget, while increased in recent years, has been criticized for focusing more on community-based services rather than inpatient infrastructure, leaving hospital wards under-resourced.

The human cost of these delays cannot be overstated. Since the audit's release, there have been multiple reported incidents of self-harm and suicides in WA's mental health units, some of which might have been preventable with the recommended safety measures in place. Families of affected individuals have shared heartbreaking stories, emphasizing how the system's failures compound the trauma of mental illness. One anonymous parent recounted the loss of their son in a ward where a known ligature point had been identified but not addressed, stating, "We trusted the system to keep him safe, but it failed him at every turn." Mental health advocates, including organizations like the Mental Health Advocacy Service and the Australian Medical Association's WA branch, have voiced frustration over the lack of progress. They point out that inpatient safety is not just about physical modifications but also about creating therapeutic environments that promote recovery rather than exacerbate distress.

Experts in the field have weighed in on the broader implications of these delays. Dr. Elena Ramirez, a psychiatrist with over two decades of experience in public mental health, explained that unaddressed ligature risks create a constant undercurrent of anxiety for both patients and staff. "In an environment where trust is paramount, knowing that basic safety isn't assured erodes the therapeutic alliance," she noted. Furthermore, the audit's findings align with national trends in Australia, where mental health inpatient suicides have been a persistent issue. According to data from similar reviews in other states, such as Victoria and New South Wales, delays in implementing audit recommendations often lead to increased incident rates, higher staff burnout, and greater strain on emergency services. In WA, this is particularly acute given the state's vast geography, where regional facilities face even greater challenges in accessing resources for upgrades.

Government responses to the ongoing concerns have been mixed. Health Minister Amber-Jade Sanderson has acknowledged the delays, attributing them to "unforeseen challenges" while emphasizing that some progress has been made. In a recent statement, she highlighted that over 60% of the audit's recommendations have been actioned, including staff training programs and interim risk mitigation strategies like increased patrols and temporary barriers. However, opposition figures, including Shadow Health Minister Libby Mettam, have slammed the government for complacency. "Two years on, and we're still hearing excuses instead of seeing results," Mettam said. "This isn't just about buildings; it's about lives." Calls for an independent review of the implementation process have grown louder, with suggestions that external oversight could accelerate the works and ensure accountability.

Beyond the immediate safety concerns, the situation reflects deeper systemic flaws in WA's mental health framework. The state has seen a surge in mental health presentations post-pandemic, with emergency departments overwhelmed and inpatient beds in short supply. The audit's revelations come amid a national inquiry into mental health services, which has exposed similar issues across Australia. Advocates argue that true reform requires not only completing the physical upgrades but also investing in preventive care, such as early intervention programs and community support networks to reduce the need for inpatient admissions. Without these, the cycle of crisis management persists, placing undue pressure on already strained facilities.

Looking ahead, there is cautious optimism that renewed focus could spur action. Recent budget announcements include additional funding for mental health infrastructure, potentially earmarking resources specifically for the outstanding audit recommendations. Health department insiders indicate that tenders for major works are in progress, with completion targeted for late 2025. However, skepticism remains, as previous deadlines have slipped. Patient rights groups are pushing for transparency, demanding regular public updates on progress and independent audits to verify claims.

In conclusion, the incomplete safety works two years after the WA health suicide risk audit represent a critical failure in protecting some of the state's most vulnerable citizens. This delay not only perpetuates risks but also erodes public confidence in the mental health system. As WA grapples with rising mental health needs, addressing these shortcomings is imperative. Swift, decisive action is needed to ensure that inpatient facilities become safe havens for healing, rather than sites of preventable tragedy. The stories of those lost and the pleas of advocates serve as a poignant reminder that behind every statistic is a human life, deserving of the utmost care and protection. Until these works are completed, the audit's warnings will continue to echo through the halls of WA's mental health wards, a testament to promises unfulfilled.

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Read the Full The West Australian Article at:
[ https://thewest.com.au/news/health/mental-health-inpatient-safety-works-yet-to-be-completed-two-years-on-from-wa-health-suicide-risk-audit-c-19325596 ]