PSYCHIATRIST Alan England is the first to admit it’s a battle to maintain staff in public mental health services.
He says mental health isn’t seen as attractive for potential clinicians when other career options exist in areas such as emergency or general medicine.
Nor is the discipline held in high esteem by some in the medical or wider communities.
“We struggle to attract people and the negative press impacts upon them,” he said.
Dr England, clinical director of mental health, drug and alcohol for Murrumbidgee Local Health District’s Albury sector, showed The Border Mail through Nolan House, whose doors are closed to most Border residents.
“It’s a relatively nice place, but we don’t go around choosing our customers,” he said.
“Our patients are a heterogeneous group because mental illness does not discriminate.
“We have fabulous nurses who come to work here every day, who put up with a lot, including the terrible stress of dealing with those who want to kill themselves.
“We have to support them and retain our staff.”
Nolan House is “frequently bursting at the seams”, even though most mental health patients are deemed suitable for outpatient clinics.
“We’re in the unenviable position of determining those among our patients require containment and we undertake very thorough assessments to do so,” he said.
“We would prefer people to be managed within the community but there are those at high risk and there is no guarantee of their safety.
“For them, this is a safe haven until they are through their crisis and they can be managed at home.”
We find Nolan House quiet and ordered — staff busy in an office or with patients seated at tables talking or keeping to themselves.
It’s not unlike other health and care facilities, except perhaps there’s more security for the safety of patients and staff.
In a courtyard some patients enjoy the sun and others a cigarette and it’s quiet as they watch while we photograph Dr England and his colleague Jennifer Manwaring.
I notice one woman knitting and ask her about the garment she tells me she is making it for her granddaughter.
Dr England says a social function is held around a barbecue weekly for patients and staff.
He says that if the Border gains a headspace centre for young people with mental illness, it will complement public and private facilities for children and adolescents.
“It would be a wonderful addition, providing for the co-ordination of existing services and assessments,” he said.
“It might allow for the identification of cases earlier.
“With a specific group like young people whatever services you provide need to be appealing, accessible and approachable.”
Dr England said even young people identified at a headspace centre as acutely suicidal would be referred to Nolan House for inpatient care.
“Those at the serious end of the spectrum always end up with us,” he said.
He says wider recognition of mental health services, via campaigns such as The Border Mail’s Ending the Suicide Silence series will often see an inundation of requests for help.
“There are never quiet times,” he said.
“Our position is that there should be more discussion; this is not something that should be swept under the carpet.
“When it is out in the open and talked about, the resources available are open to review.
“I have lived here for 20 years and the impact on the community from deaths via suicide is enormous.
“There is an outpouring of grief because of the broad range of people affected.”