Note: This article includes content that may be distressing for some readers.

The mental health care dilemma in New South Wales has once again captured public attention following the escape of two patients from the same hospital, who were subsequently alleged to have been involved in separate tragic incidents resulting in three fatalities.

These events have rekindled scrutiny over the state’s mental health system, coming on the heels of the Bondi stabbing inquest. This inquiry revealed how Joel Cauchi, the perpetrator, was overlooked by mental health services.

One of the individuals, aged 31, was an involuntary patient at Sydney’s Cumberland Hospital, the country’s largest mental health institution. He is accused of stealing a vehicle and crashing it in Sydney’s southwest, leading to the deaths of two women, aged 60 and 84.

The second patient, a 25-year-old, managed to escape from the same facility during a transfer to another hospital. He is alleged to have stabbed three individuals in Merrylands, resulting in one fatality.

Both men are currently facing legal proceedings. Meanwhile, the Western Sydney Local Health District has expressed its commitment to enhancing the safety of patients, staff, and the public. A formal review of their security measures is underway.

NSW Premier Chris Minns said there’ll be an urgent government review into security protocols at Cumberland Hospital.

“We need to keep the public safe in the circumstances where someone has a psychiatric episode and is a danger to themselves or members of the public.”

Mental health system too focused on waiting for a crisis before initiating treatment, say advocates

NSW Nurses and Midwives’ Association Cumberland delegate Nick Howson said the system is broken, and nurses at the hospital are struggling with systematic failure.

“The reality of it is you can see the outcome of what happens when there’s not enough people around to provide the care that we’re supposed to provide,” he said.

“We’re doing what we can with very little resources behind it, you can’t blame an individual hospital or an individual health district because they are hamstrung by the funding from the government.”

Calls for more funding

Last year, dozens of public hospital psychiatrists resigned in protest over a lack of funding

The Chair of New South Wales Royal Australian and New Zealand College of Psychiatrists RANZCP says a recent temporary pay rise is insufficient to address a lack of community care, housing and hospital beds.

Dr Ian Korbel says funding for mental health has always been an issue.

“We’ve seen that since the de-institutionalisations that happened in the late 80s to early 90s. The money that was saved from closing those old institutions just didn’t move to the community care where they needed to be.”

“So it means the patients are ending up in hospital more than they should. We have over 50,000 people in NSW who have severe mental illness who are not accessing care — this is neglect by the state of its most vulnerable patients,” Korbel said.

Chief executive of mental health consumer group BEING Giancarlo De Vera said a greater focus must also be given to community support to prevent people being left in positions where they are held for treatment against their will.

“These levels of funding are just insufficient. We need more mental health outreach in the community. We need more supported housing for people who have serious mental illness both short-term and long-term.”

“To a degree we need more beds as well. We’re looking at some of the lowest levels of beds in the western world. We’re down to less than 30 beds per 100,000 people in NSW, where the average is about 60,” De Vera said.

Push for a coordinated national approach

SANE Australia’s chief clinical officer Dr Rahul Khanna said the funding comes down to the state and federal governments.

“We’ve seen that failure across a national really, and part of it comes down to funding responsibilities between state and federal governments ending up with a really fragmented system, that’s really hard to understand and hard to access.”

Correction: an earlier version of this article incorrectly stated Dr Pramudie Gunaratne as the current NSW chair of Royal Australian and New Zealand College of Psychiatrists. Dr Ian Korbel is the current chair.

Readers seeking mental health support can call Lifeline crisis support on 13 11 14, or Beyond Blue on 1300 22 4636.

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