MENTAL health patients are moving from expert care at Morisset Hospital into community homes with untrained staff, clinicians say, sparking fears that lives may be at risk.
The shift is described as ‘‘beyond dangerous’’ with the ‘‘very real potential’’ of the patients, their staff or community members being harmed, because the support workers providing their 24-hour care have little or no mental health training.
Information supplied to the Newcastle Herald says the former long-term patients have received funding packages under the National Disability Insurance Scheme of up to $500,000 each per year, compared to the average cost of packages in the Hunter of less than $60,000 per year.
Through the scheme, community managed organisations provide care under individualised plans approved and funded by the national scheme. However, the Herald understands that the transition of mental health clients has not been smooth. The ‘‘complex and difficult’’ clients have been re-admitted to hospital for months at a time since their release, one clinician said.
‘‘These clients display a range of behaviours, some aggressive, suicidal, self-harming, and all with staff who are not trained or equipped to deal with these situations,’’ he said.
One client, said to be one of the most dangerous with a long history of aggression and violence towards staff, has been awarded an NDIS package and is being cared for by an organisation ‘‘not affiliated with mental health and with no training’’.
A second clinician said that some support workers providing 24-hour care may have a few weeks training in mental health, but no hands-on training.
‘‘It’s a crazy system,’’ he said.
‘‘The more difficult clients get handed to the least experienced staff.’’
Hunter New England Health (HNEH) has confirmed that a number of long-term mental health patients have been discharged from Morisset Hospital and are now accessing disability supports at home through the NDIS.
HNEH director of rural and regional health services Susan Heyman said they continue to receive support from community mental health teams, but otherwise their care was up to the service providers nominated in their NDIS packages.
‘‘The NDIA is responsible for contracting the disability care providers and overseeing the quality of disability services they provide,’’ she said.
The National Disability Insurance Agency has refused to go into any detail.
In an emailed statement, the agency said there was a ‘‘Quality Assurance and Safeguards Working Arrangement’’ in place to cover the operation of the NDIS in the Hunter.
‘‘Under the Arrangement, service providers must comply with all relevant legislation, policies and guidelines that provide safeguards to users.
‘‘This includes a requirement for service providers to engage workers that are suitable to be involved in providing supports and services to people with disability.”
The document makes no reference to any standard minimum training requirements for support staff working with people with mental illness.
It does reference a policy specifying that people with intellectual disabilities should be cared for by practitioners with tertiary qualifications.
Consumer advocate Allison Kokany, a representative of National Mental Health Consumer and Carer Forum who has worked at Morisset Hospital, said she would be ‘‘horrified’’ if untrained staff were caring for former in-patients.
‘‘If someone doesn’t understand their needs, that’s when disasters happen, otherwise we would have hospitals where no one was trained because it wasn’t needed. They need the right skills, knowledge, experience and training to work with people with severe mental illness. Someone could be damaged.’’
Mental Health Australia director of policies and projects Josh Fear said that despite the promise the NDIS holds, there were a range of concerns about how it was being implemented.
‘‘The scheme is being rolled out 12 months ahead of the original schedule, and even today governments have still not have made some important decisions about the key features of the scheme,’’ Mr Fear said.
‘‘The ambitious implementation timetable means that the National Disability Insurance Agency is rushing to get the scheme happening in trial sites before it is rolled out nationally.’’
Many questions remained unanswered despite being put to the government ‘‘many times’’, he said.
Jenna Batemen, chief executive officer of the Mental Health Coordinating Council, agreed.
‘‘How is the NDIS showing us that the people providing services are qualified,’’ she said. ‘‘Organisations could start employing people who might have done the mental health first aid course and then say it’s enough. In England, we saw a real de-skilling of the workforce. If they just let the market control it, it does lead to a de-skilling of the workforce.
‘‘The NDIA has raised these issues, but they haven’t been answered. What are they doing about this potential?’’
Mental health services at Morisset include the 130-bed Morisset Hospital, the 30-bed medium-secure level Kestrel Unit with forensic and civilian clients, and cottages housing another 47 people.