One quarter of mental health beds at Albury Wodonga Health were occupied by young people last year, the Victorian Royal Commission into Mental Health found.
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Service gaps for youth was a major theme of the final, 3000-page report released yesterday.
Albury Wodonga Health - with Goulburn Valley Health - was identified as having the state's highest proportion of clients aged 18-25 in adult mental health beds. That estimate, of 20 per cent in 2019-2020, compared to between 13 and 16 per cent at nine other hospitals, including Ballarat and Bendigo.
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Commissioners also pointed out that "young people with the most complex support needs at Albury Wodonga Health received on average 1.7 days of treatment across an average of 105.6 days with the service".
"In comparison, at Goulburn Valley Health consumers received an average of seven days of treatment across an average of 237.8 days with that service," the report said. "These figures speak to a system providing on average very modest amounts of treatment to those who are able to get services."
Box Hill is our closest inpatient facility for youth, and Eastern Health submitted it "often accommodates" adolescents from Albury-Wodonga and surrounds.
"The development of purpose-built child and family mental health community facilities is required," it stated.
Thirteen new youth mental health and well-being services were among the Royal Commission's 65 recommendations.
Problems with funding
An Albury mental health worker has told the Royal Commission scrutinising his industry that it is "besieged" by problems around funding, systemic priorities and workforce gaps.
Clinical Nurse Consultant Gary Croton was a witness last year, speaking to his work with the Hume Border Victorian Dual Diagnosis Initiative.
His expertise was called upon, having worked continuously in mental health and alcohol and other drugs settings for 45 years.
Mr Croton said he has been the Victorian Dual Diagnosis Initiative's sole worker in this region since a service at Wangaratta was subsumed by the new VDDI in 2002.
"In 2012, auspice of the service was transferred to AWH, and AWH now assumes responsibility for all regional clinical mental health services," he said.
"The opinions and views expressed in my evidence are my own.
"Services are, too often, pressured, inadequately-resourced environments where there are multiple, often-competing demands," he said.
"These conditions are the antithesis of those needed.
"The Hume Border's approach, in this context, has been to recognise that mental health substance use capacity building is a long term endeavour, and that it is most effective to work from a strengths-focused, systems approach."
He said limitations of the Hume Border VDDI included that it was a sole-worker service and a cross-border one.
But he also said creation of the VDDI was a landmark change and Victoria had made significant investment.
"There are multiple everyday examples of Victorian mental health and/or AOD (alcohol and other drug) workers providing successful treatment," he said.
"An example is the Integrated Primary Mental Health Service (IPMHS) of Northeast Victoria.
"Wherever people come into the system they should be welcomed and engaged as they are."
Mr Croton said a yet-to-be-published document out of the United States "proposes crisis hubs as places for people in crisis to go to, that are an alternative to Emergency Departments".
"The document states that the avoidance of unnecessary ED visits should be measured as a system-wide quality metric," he said.
"The proposed Crisis Hubs would be one element in an ideal mental health substance use crisis system.
Mr Croton also wrote in his 40-page submission that Victoria's psychiatry workforce is "heavily concentrated" in metropolitan areas and more access through telehealth for rural patients should be facilitated.
He referenced Murray PHN's latest needs assessment which showed difficulties in navigating the system and limited outreach.
That needs assessment, submitted separately to the Royal Commission, shows Benalla has the highest rate of registered mental health clients in the Murray PHN region (26.3 persons per 1000), ranking it fourth in the entire state of Victoria.
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Wangaratta, Indigo and Wodonga are all significantly higher than the Victorian average and ranked within the top 10 LGAs in the state for registered mental health clients.