EVERY month, approximately 2000 seriously ill people are seen by public mental health services in Albury.
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Some will be admitted to Nolan House, the acute inpatient facility adjoining Albury Hospital; more than half will be treated within the community via attendance at outpatient clinics operated by the community mental health team.
Dr Alan England is the clinical director of mental health, drug and alcohol with the Albury sector of the Murrumbidgee Local Health District.
He says most of the 2000 patients who seek help each month will recover from their mental illness and move on.
But when patients take their own lives, it affects those caring for them.
“This is a small community, and it is different working in mental health here than it would be in the city,” Dr England said.
“When there is tragedy, it is often someone we know and it seriously impacts on ourselves, our friends and our families.
“I see our nurses cry when something like this happens.
“Our staff are often devastated by these tragedies; they ask themselves ‘Where did I go wrong?’, ‘What else could I have done?’
“Working in mental health carries a stigma; anything to do with those in mental health is put behind walls and that kind of stigma is pervasive.”
Dr England’s colleague, Jennifer Manwaring, team manager of community mental health, drug and alcohol in Albury, says even when there is tragedy, staff continue to go to work each day to support those in need.
“When someone dies it has a huge impact on the individual case manager and the team as a whole,” she said.
“They are not robots, they are human beings.”
Ms Manwaring says media reporting is often not reflective of the fact most of those with mental illness are managed within the community, outside of the 24-bed Nolan House facility.
But she says criticism of services is taken seriously and complaints are seen as an opportunity to improve service delivery.
“There is an analysis when things go wrong, an examination of the files of those patients from when they enter the service through every instance of contact,” she said.
However, Dr England says when things go wrong, it shouldn’t be seen as a reflection on the quality of the existing services.
“If you look at the referrals we get, the outcomes we achieve, they are not just statistics, but a quality of life for our patients,” he said.
“Clearly people want more mental health resources but if the public perception is that we are not doing a good job, then why would people come here?
“The perception that we need other services because the ones we have are hopeless is an outcome no one wants.
“We want to send a clear message that people should seek help and they should talk about it if they are suicidal.
“If people are talking about it, if it is out in the open and people are more cognisant of its impact on the community, there is more informed debate about the quality of services and where there are gaps. The more services that can be provided the better.”
Dr England says the “effective, dedicated group of people” working in mental health bore a weight of work and responsibility often unknown within the wider community.
He said the nation’s ageing population would see that burden get worse rather than better as people grew older and became more isolated and socially disenfranchised.
“This is building up over a long period of time; to counter these issues you have to stop the social dislocation, stop the domestic violence and the drug and alcohol abuse,” he said.
“You are dealing with a really prickly problem.”
Dr England draws a clear connection between those involved in drug and alcohol abuse and the development of mental health problems, but says psycho-social stress caused by issues such as family breakdown is also responsible.
“Between the ages of 16 and 85, the lifetime prevalence for people developing a significant mental health disorder is now one in two,” he said.
“Anxiety disorders are very prevalent; they may account for up to 20 per cent of those in society with mental illness.
“We have a role in advocacy as well; for the disenfranchised, for people who are vulnerable, one of our roles is to be advocates for them.”
