The Butterfly Effect: Poor access to non-acute psychiatric beds and the emergency department congestion crisis in WA

Australia has a largely dehospitalised mental health system, where the vast majority of non-acute beds in stand-alone psychiatric hospitals have been closed.

Thus, Australia has considerably fewer psychiatric beds per capita than most other high-income countries, and is over-reliant on ever-shorter admissions to acute hospitals for most patients (Allison et al., 2020a). Extremely limited access to non-acute beds is leading to mental health access block, emergency department (ED) crowding, and delays in the transfer of care (TOC) from ambulances to EDs for both mental health and non-mental health patients. Patients are experiencing protracted periods in the confined space of an ambulance, without ready access to food, water or toilets, with heightened risks of clinical deterioration.