Emergency department–focused mental health policies for people with severe mental illness

Private psychiatric hospital care in Australia: a descriptive analysis of casemix and outcomes

“…As in the PPHDRAS data, the average length of stay in private hospitals is longer (39%) than in the public sector, but this may be due to acute bed shortages in the public sector (Table 2). 9…”

“…As in the PPHDRAS data, the average length of stay in private hospitals is longer (39%) than in the public sector, but this may be due to acute bed shortages in the public sector (Table 2). 9 The AIHW only reports relative proportions of diagnostic groups treated respectively by public or private hospital separations. Private hospitals provide 77.6% of all separations for recurrent depressive disorders, 67.2% for mental and behavioural disorders due to use of alcohol, 57.2% for dissociative disorders, 52.0% for obsessive-compulsive disorders, 48.8% for depressive episodes, 48.2% of eating disorders, 44.4% for persistent mood disorders, and 44.2% for other anxiety disorders.…”

The productivity commission report on mental health: Recommendations with negative consequences for clinical care in public and private sectors

“…However, no mention is made of the more pressing concern of similar shortfalls in acute beds. In fact, communitybased and residential services cannot replace acute and non-acute bedbased services, these services are complementary, and accordingly, require commensurate funding for acute and non-acute beds as well (Allison et al, 2020).…”

Re-balancing Victorian psychiatric services: Will increasing the supply of community services impact upon hospital demand?

“…However, this indirect approach is challenging to implement in already low-bedded countries like Australia, where only essential acute admissions occur. Moreover, in high-income countries, higher levels of community care are associated with greater hospital capacity, partly because better case-finding by community services reduces the treatment gap, bringing more people into mental health treatment systems (Allison et al, 2020).…”

“…The data trends presented in Tables 1 and 2 raise questions about whether further substantial increases in primary and secondary mental health services will reduce the acuity of mental illness in the population and thereby lower hospital demand. Hence, even if the recommendations of the Productivity Commission and Victorian Royal Commission were fully implemented, a communitycare-centred approach, without sufficient complementary acute hospital beds, will likely prove ineffective (Allison et al, 2020). In fact, based on previous data over the last decade, increased community services might be associated with increased hospital use, rather than the reverse, related to a reduction in the treatment gap.…”