Victoria’s mental health industry is in dire straits as conditions worsen and labor shortages continue

In the busy emergency department where mental health nurse Kim Gallaher works, people at their lowest point in life can wait up to 12 hours to be seen.

They have reached a point where they desperately need help, and they need it now.

But once they’re finally seen, sometimes all she can do is send them away. There are often not enough beds available to accommodate people overnight and waiting lists for outpatient services are long.

“The abuse they went through, the neglect they went through, the racism they went through — we see all of their trauma, they tell us about all of their worst experiences,” she said.

“And we have to listen, because we care and we want to do something different.

“And then we have to say ‘I’m sorry, I don’t have the services for [help] you’, and that’s what attracts me – that’s what makes me angry.”

It’s no secret that Victoria’s public health system is currently under strain, but mental health is facing its own crisis.

Despite the 2019 Royal Commission into Victoria’s mental health system and billions of dollars in investment over the past year, the sector is in dire straits.

Kim and other mental health workers said ABC patients were still falling through the cracks, often with dire consequences.

Kim says the hardest part of her job is meeting people who desperately need services she can’t refer them to.(ABC News: Darryl Torpy)

What causes the crisis?

The main problem is the major shortage of workers, with hundreds of vacancies across the state and no one to fill them. Those who remain face burnout.

“[The Victorian government] basically said they were going to implement all the recommendations of the royal commission,” Ms Gallaher said.

“It’s a huge undertaking – and yes, we’re about to do it – but without staff it doesn’t work.”

The government’s ambitious program to implement the recommendations, some by the end of this year, has led to many workers quitting frontline work and moving into non-clinical roles.

One worker said it comes at a time when acute wards are busier than ever with “incredibly sick” people.

Those left on the front lines tend to be junior employees, filling roles once reserved for those with more experience.

A man wearing a blue jacket stands with his arms crossed in an office with a serious expression.
Paul Healey says jobs are advertised but there is no one to fill them.(Provided: Health and Community Services Union)

Health and Community Services Union secretary Paul Healey said new vacancies were increasingly being advertised online following the royal commission.

“Over 3,000 new positions are coming into mental health, which is really exciting, really needed,” he said.

“But without the workforce there, it’s not okay.”

The reasons for the shortage are many, but include the recent halt in immigration, the lack of healthcare workers willing to pursue careers in mental health, and departures due to burnout.

Workers also say pay is an issue.

To add salt to the wounds of the remaining frontline workers, Ms. Gallaher said, mental health workers in the public health system have not increased since April 2019.

Their four-year Enterprise Bargaining Agreement (EBA) was due to start in 2020 but was only approved by the Fair Work Commission on Friday after being signed off by the government last year.

A masked nurse adjusts her blue plastic glove in an operating room.
Mental health workers in the public health system have waited for a pay rise throughout the pandemic.(Rawpixel: Chanikarn Thongsupa)

It also means that their salary increases of around 10%, to be expected over four years, have not yet taken effect.

Meanwhile, general nurses have had their salary increases implemented in 2020.

“We take care of the patients, but who defends us? Who takes care of [mental health] nurses so that we don’t leave, that we don’t go there: “I can find a much easier job elsewhere and earn the same amount of money”?” asked Ms. Gallaher.

“Why should I stay? And there are a lot of people [thinking that].”

Staffing issues could lead to increased use of force

Victorian Mental Illness Awareness Council chief executive Craig Wallace said the staff shortage was having a profound impact on service users and patients.

He said understaffing was leading to increased use of force and restraint in Victorian hospitals.

A man standing in front of a staircase looks at the camera.
Victorian Mental Illness Awareness Council CEO Craig Wallace is concerned about the impact of staff shortages on patients and consumers.(ABC News: Jessica Longbottom)

A recent report by the organization found 7,500 cases of staff restraining patients and locking them in a room alone in 2020-21.

That’s an increase over the past four years, although the government has agreed to end the practice by 2031.

“And of course we are very concerned about how [the worker shortage] could lead to the use of restrictive interventions.

Another mental health industry insider, who did not want to be named, said Victoria lags far behind other states in recruiting and retaining frontline staff despite all of the sector’s planned reforms.

They said the federal government should also invest more money in the system to increase the number of employees.

Kim Gallaher in a blue blouse with her bag and water bottle.
Despite the challenges, Kim plans to continue her career.(ABC News: Darryl Torpy)

In a statement, Mental Health Minister James Merlino said the government was committed to strengthening the mental health workforce.

‘Without the care of our dedicated mental health professionals, the new beds, inpatient facilities and community mental health services we are busy building will not get Victorians the support they need – it’ is why this year’s budget provided the biggest investment in our mental health workforce in the history of this state,” said Merlino.

Despite the pressure she is under, Ms. Gallaher does not plan to leave the front line.

“I’m not there yet, and I’m glad I’m not there yet,” she said.

“I like what I do and I want to improve the services.”

She said she just hoped the government’s plan to get others to join her worked.

Michael A. Bynum