In 2014-2015, NSW Police and Ambulance transported 60% of mental health consumers who called Triple Zero in HNELHD. Of the ones who were transported, 46% of the patients were not admitted to the Psychiatric Emergency Care Centre or Emergency Department at Calvary Mater Newcastle hospital. People who are not admitted appropriately are often left to find their own way home, which could be hard for people that are not local and are transported without money, a phone or family present in the area. In some rare cases the ED will pay for a taxi, but its is not common practice among hospitals.
Another wrong practice that was conducted was to admit patients who did not need to be admitted. This proved to be a drain on both time and resources on police and ambulance staff. Ambulance staff spend about four hours to care for one person. This time was spent waiting at the scene for the ambulance to transport the consumer, which can be considerable as mental health consumers are considered a low priority for emergency transport. The travel time of an hour each way needs to accounted in as well, including time taken at hospitals waiting to complete handover which is often 20 mins to two hours. This led to a number of associated risks, including a lack of medical emergency services in areas serviced by only one police car or ambulance.
For mental health patients, the time and the process of waiting for the police and the ambulance being transported back home again was a traumatic process which impacted negatively on their already stressed state of wellbeing. It was also an unnecessary expense for NSW police, Ambulance NSW and the Hospital.
The Telehealth project tries to tie in the gaps and make the process easier for the consumer and cost effective for the police and ambulance involved. The aim of the project; “To reduce unnecessary transportation of mental health consumers to Calvary Mater Newcastle Hospital, by 50% within 12 months.”.
Benefits of the project?
- Help NSW Police and Ambulance NSW deliver a high quality and efficient service.
- Improves access options for mental health patients
- Delivers specialists, evidence-based mental health information and recommendations to police and ambulance staff.
- Reduces unnecessary admissions of Mental Health Consumers to hospital
- Increases awareness among service providers of mental health care.
How is the project implemented?
There were two sets of checklists created which was in consultation with emergency services, community mental health team and the consumer unit manager. The checklists identify whether consumer requires a telehealth triage or if they need to go to the hospital.
10 iPads were provided to participating police and ambulance staff, allowing them to complete the checklist on site. The project officer rode along with both the services to understand training needs and set up devices based on first hand experience of the requirements of the staff on scene. Face to face training was provided for all the staff with ongoing meetings to make sure new staff understand the process.
If the consumer required a telehealth Triage, police or ambulance staff were able police or ambulance staff were able to connect to the Mental Health Contact Centre located at James Fletcher Hospital in Newcastle, using the iPad.
The Mental Health Contact Centre then conducted a triage directly with the consumer and provided recommendations on safe and timely interventions to police or ambulance staff. These included:
- transport to hospital
- an appointment with a community mental health service
- an appointment with the consumer’s general practitioner.
The project has been implemented in standard business hours.
Dates: September 2015 – December 2018
- Ambulance NSW, Nelson Bay Peninsula
- Calvary Mater Newcastle Hospital, HNELHD
- NSW Police, Port Stephens Local Area Command
- Centre for Healthcare Redesign
- NSW Police
- Ambulance NSW
- Senior mental health consumer advocates in HNELHD
Project Leads: Jay Jones (Project Coordinator) & Leanne (Beth) Gow (Project Officer) at Mental Health Services, Hunter New England Local Health District
Don’t miss Jay Jones the Project Coordinator at Mental Health Services Hunter New England Local Health District at the Mental Health Access & Quality in Emergency Departments, who will unpack the results of the Telehealth Pilot project.