An Experience in the Australian Mental Health System

Words By Lilith Zaharias

Last night I found myself staring down the barrel of a suicide attempt. I spent several minutes hovering over my medicine drawer before, with sudden resolve, I dug out every single box of painkillers and other medication that I had accumulated over several years of being Not Good™ with discomfort.

Thanks in large part to the timely interruption of a dear friend I didn’t go through with it. I found myself broken down in my well worn armchair, dully considering, between bouts of ugly-crying, whether to call an ambulance.

I knew deep down that I needed help. What was more difficult was deciding whether I was “worth” an ambulance – I was after all not in immediate danger and calling an ambulance feels like an extreme step. However, despite living in the affluent and urban Northern Beaches, hospital isn’t exactly an accessible proposition; I don’t drive, and public transport access to our new hospital from anywhere outside the Dee Why to Chatswood corridor is a nightmare at the best of times, and flat out impossible at 3am. Designed as a replacement for both Mona Vale and Manly hospitals, which had the misfortune of being in prime real estate locations, the Northern Beaches Hospital is perched in the middle of nowhere, surrounded on three sides by empty bush as far as the eye can see.

So I found myself picking up my phone and dialing 000. I began, for the first of what has so far been ten times, to describe what I was going through and why I needed help. The ambulance arrived in a matter of minutes, barely enough time for me to have found a jacket and put some essentials in a bag.

Making conversation in the ambulance, I commented on how much further the new hospital was than the old hospital at Mona Vale, and was informed that even when the old hospital had been operational, it had never had a mental health unit, and would have been completely unable to help me. It was quite a shock to discover that our health system is so underfunded that a major metropolitan hospital might completely lack a major and critical facility. Given how easy it had been to get to Mona Vale hospital by bus, I would very likely have taken myself there completely unaware that I would need to be somewhere completely different had this occurred only a few months previously.

On arrival, I was taken into a relatively modern but quite dirty assessment room. There were scraps of plastic and a few flecks of dried blood on the floor near the bed. This room, it turned out, was where I would spend the next 11 hours.

My room did turn out to be quite close to a nurses’ station, which allowed me to pick up one quite interesting piece of information, when I heard a couple of nurses bemoan how short their breaks had to be. It seems that, whereas at Mona Vale and Manly hospitals staff numbers allowed nurses to comfortably take one and a half hour breaks, providing sufficient time to nap and restore energy, shortages at the Northern Beaches Hospital mean they are unable to take any longer than half hour breaks. If night shift nurses had been relying on naps during breaks to maintain their concentration, a loss of this time could have potentially life threatening results. I found it hard to imagine how replacing two hospitals with one could end up with greater staff shortage.

The next six hours were uneventful, interrupted only by the doctor who had first examined me stopping by and looking surprised and confused that the mental health team had yet to see me. After finally managing to slip into what might have passed for sleep, I was woken up by a kind nurse from the mental health unit. Despite being well meaning, it was clear he had absolutely no clue what it meant to be transgender or how to deal with the fact that I am. Given that he works in mental health, this seems like something he should have been trained in. But then again, I’d say most members of society are undereducated when it comes to queer issues, so I guess it isn’t surprising.

Waiting around, I again got the opportunity to overhear an interesting conversation. A patient next door was told she would receive far superior facilities in the ward if she was on private health insurance and willing to pay a $50 per day copayment. It was explained she would get a better room, more food options, and more attentive care. It sounded like nothing so much as an advertisement.

I would be faced with a similar sales pitch once admitted to the mental health ward – whilst I wasn’t told I’ll need to make a copayment, I have now been informed that the private mental health ward is, effectively, superior in every way.

This is not something I’ve heard or experienced in any other hospital. Whilst I have at times been asked to use private health insurance, on other occasions this was justified on the basis that it could take pressure off the resources of the public system. Never have I been promised better care in a public hospital just because my family could afford to pay for the privilege. To me this is an horrific indictment on the state of our healthcare system.

I’ve finished writing this from the public mental health ward. I’ve yet to decide the most ethical response to the offer of private care. Whatever the outcome, I’m convinced this system needs urgent, radical change.