Mental health Unit gap in our LGA still unmet: Calls for a return of manly's east wing

Photo of NB Hospital by Cabrils.

In October 2018, Manly Hospital was closed by the coalition government and all patients and services were to be relocated to the new Northern Beaches Hospital (NBH). 

Manly’s East Wing Mental Health Unit, which had admitted teenagers for care as public patients, was not incorporated into the NBH model though. 

The Northern Beaches Hospital’s entire mental health service currently provides 61 beds across 4 specialised wards:

  • A 20-bed ward for private health care admissions (Northern Beaches Clinic)
  • A 20-bed ward for public health care admissions
  • A 15-bed ward for the care of older people (65-years and over)
  • A 6-bed ward for short stay crisis mental health admissions.

According to a release on February 14 2024 from the AIHW (Australian Institute of Health and Welfare) 1 in 5 adults and 1 in 7 young people experienced a mental health disorder in the previous 12 months, 4.7 million people (18% of Australians) filled a mental health-related prescription in 2021–22 and almost $12.2 billion was spent on mental health services in 2021–22, around 7% of the total government expenditure.

NSW statistics in the same release record in 2021-2022 there were:

  • 2,168 public specialised mental health beds (32 per 100,000 population), providing 786, 986 patient days of service (97 per 1000 population)- (PON is querying ‘where?’). 
  • 96 residential mental health beds service beds (1 per 100,000 population), providing 28, 889 days of patient service.
  • 11, 181 full time equivalent staff (138 per 100, 000 population), including FTE consumer workers and 4 FTE carer workers. 
  • 1,912 supported housing places (24 per 100,000 population).

The Northern Beaches Council Estimated Resident Population for 2022 is 263,298, indicating the gap created when Manly hospital was closed, along with Mona Vale Hospital, has not been filled. 

Likewise, the Northern Beaches sub-market has fallen short in accommodating for mental health issues with reports showing a 30 per cent increase in younger members of our communities mental health issues leading to the loss of life between 2017 and 2020.

In November 2023 plans for the $50 million private Northern Beaches Health Hub were approved by the Department of Planning. This will be an 8-storey facility with Levels 2 to 6 providing a total of 80 Private Patient Rooms with Ensuites, Group Treatment Room, Lounge and Dining and Winter Garden. This will cater for all ages.

While that is being built, and with the closure of  Drug and Alcohol Rehabilitation services through Kadesh on the Mona Vale Hospital campus to help with some aspects and impacts of health issues, the Brolga Unit, a 12 bed Adolescent Mental Health Inpatient Unit based at Hornsby Hospital, is all that is available, and out of our area. 

Northern Sydney Local Health District (NSLHD) Child Youth Mental Health Service (CYMHS) provides services to the population living within NSLHD. Northern Sydney Local Health District (NSLHD) covers an area of 900 square kilometres. In 2021 the estimated population was 985,708 residents, and over the decade to 2031, the overall population is projected to increase to 1,091,346.

The Northern Sydney Primary Health Network Needs Assessment 2019-2022 records:

According to the Second Australian Child and Adolescent Survey of Mental Health and Wellbeing, nationally, approximately 13.9% of children aged 4-17 years were reported as having a mental illness in the previous 12 months. The survey was based on responses by parents or carers for children aged 4-17 years with inclusion of self-reported responses for children aged 11 years and over when available. 

Applying the national estimates to the NSPHN population, approximately 21,000 children were estimated to have a mental illness in the previous 12 months. 

• Higher prevalence (16.3%) among males compared to females (11.5%). 

• 14.4% of children aged 12-17 years report having a mental illness in the past 12 months compared to 13.6% of children 4-11 years. 68 

Prevalence of severe mental illness among young people; 2.1% of children aged 4-17 years have a severe mental disorder. Quantitative evidence: Applying the national estimates to the NSPHN population, approximately 3,000 children were estimated to have severe mental illness. 

Prevalence based on social determinants of health; Higher prevalence of mental illness among children living in step, blended and single parent families. 

Quantitative evidence: 18.3% of children in step families, 20.2% in blended families and 22.4% in single parent families report having a mental illness in the past 12 months compared to 10.4% of children in original families. Potential need within Northern Beaches LGA which has a higher proportion of step, blended and single parent families compared to NSPHN.

A few days ago the Sydney Morning Herald reported (‘These hospital beds could have saved Josh. They were never built’ - February 21, 2024) funding announced on July 23, 2022 for beds at NBH has been shelved. Reports coming in are stating the money announced never even reached the NB hospital.

‘’Instead, Mental Health Minister Rose Jackson will on Thursday unveil an alternative plan, including a $500,000 safe haven at Brookvale Community Health Centre, a mental health first responder program, and a liaison service for young people with serious mental health, drug and alcohol issues across the Northern Sydney Local Health District.’’ the report states

Minister Jackson has made no such official announcement, as yet.

The $11.4 million for child and youth mental health services in the Northern Beaches included:

  • $7.5 million to establish four dedicated acute paediatric specialist mental health beds at Northern Beaches Hospital, which will provide for the establishment and operation of the beds.
  • $1.4 million to employ additional staff, including senior multi-disciplinary clinicians, to support Northern Beaches Child Youth Mental Health Service in the Brookvale Community Health Centre. 
  • $1.1 million to recruit additional staff, including peer workers and clinicians, to support and operate the Northern Beaches Youth Response Team service out of Mona Vale Community Health Centre seven days a week.
  • $1 million to develop a new youth drug and alcohol community treatment service in Northern Sydney Local Health District, including employing senior medical, nursing and allied health clinicians to operate the service.
  • $365,000 to provide a full-time child and youth psychiatrist at Northern Beaches Hospital.

See August 2021 PON Report: Old MP For Wakehurst Announces Funds For Specialist Mental Health Beds At Northern Beaches Hospital In 2022/23 Budget: New Wakehurst MP Asks As New Financial Year Begins - 'Where Are They?' 

The SMH report also stated no additional funding will be provided to the Northern Beaches Hospital under the changes, and the hospital will be subject to an audit from the NSW Audit Office this year.

However, the Public Finance and Audit Amendment (Northern Beaches Hospital) Bill 2019, 'An Act to amend the Public Finance and Audit Act 1983 to authorise the Auditor-General to conduct performance audits of the Northern Beaches Hospital’ introduced in May 2019, and which lapsed in February 2023, is indicative that referring the NBH to the NSW Audit Office, which already has a Program of Works into 2026, may not be quickly or easily done.

Mackellar MP, Dr. Sophie Scamps stated in her first community newsletter for 2024 (made available Feb. 22, 2024):

‘’The lack of adolescent mental health services on Sydney's Northern Beaches is a serious problem for our community. The Northern Beaches Hospital, as a public-private partnership facility, cannot be directed by the State Government to provide the adolescent mental health beds that were funded more than 2 years ago. I have been working with the NSW mental health minister Rose Jackson to resolve this impasse so that the funds may be redirected to improving community based adolescent mental health services here on the Beaches. I am hopeful for a resolution soon.’’

Dr, Scamps has also spoken in Federal parliament on this matter: 

8th February, 2024- ‘’ The number of 12 to 17-year-olds presenting to hospital EDs with self-harm injuries increased by nearly 50 per cent for the year to July 2021, compared to the same period in 2019. Pittwater also has one of the highest rates of suicide for those between the ages of 15 and 24 of anywhere in greater Sydney. It is higher than in the eastern suburbs, the shire, the inner west, Parramatta or Penrith. The northern beaches area is particularly at risk, with data indicating a shortfall of up to 145 acute mental health beds. So nearly two years ago the northern beaches community was extremely relieved when, following a number of critical incidents, the then Liberal state government announced $11.5 million to improve acute adolescent mental health services that would be provided at the Northern Beaches Hospital. Over $7 million of that amount was earmarked for a new four-bed adolescent mental health ward. 

The problem is that now, nearly two years on, the Northern Beaches Hospital has still refused to implement or establish this four-bed adolescent mental health ward. Why? Because the Northern Beaches Hospital is a public/private hospital. It is the only one left in New South Wales after failed experiments in previous places. I know that Rose Jackson, the State Minister for Mental Health, has tried very hard to resolve this issue, but she has no power to direct a private hospital.’’

Warringah MP Zali Steggall OAM released a statement on February 22 2024:

‘’It's a sad truth, that we are in the midst of a mental health and suicide crisis on the northern beaches, particularly amongst our young people.

Whilst I welcome the NSW government announcement of the Brookvale Community Health Centre - a mental health first responder program, and a liaison service for young people with serious mental health, drug and alcohol issues across the Northern Sydney Local Health District, I am disappointed that the northern beaches community won’t have the four adolescent mental health beds originally promised.

Under the current circumstances, which saw public funds allocated without an outcome for the last 18 months, an audit of the Northern Beaches Hospital will be an important first step in determining how the hospital can better support the northern beaches community.

Young people and their families in the northern beaches who are dealing with mental health concerns deserve the appropriate support at the time they need it. I have been speaking with the NSW Minister Rose Jackson and NSW Health about the importance of this issue and the need to ensure all committed funding remains allocated to mental health services on the northern beaches as this would make an important difference in the treatment support of mental health in our area.

This is a start, but so much more needs to be done. To help determine how the remaining $4.5 million in funding can be allocated, I look forward to participating in an upcoming roundtable with NSW Health, Sophie Scamps MP and Michael Regan MP so that we can engage with key stakeholders in the community about how this investment can best support our mental health needs.’’

As the statistics climb higher in pointing out the obvious, and residents have been further alienated from vital services, are further expected to be private hospital clients whether they can afford it or not, they still have no one and nowhere to turn to to help save loved ones who will definitely be missed.

All the while the demolished Manly and Mona Vale Hospital campus sites sit empty - awaiting private investors to fill them up with ... - and while residents are still calling for these facilities to be restored.


_______________________


If you or someone you know needs someone to talk to, please call:

  • Lifeline on 13 11 14
  • Kids Helpline on 1800 551 800
  • MensLine Australia on 1300 789 978
  • Suicide Call Back Service on 1300 659 467
  • Beyond Blue on 1300 22 46 36
  • Headspace on 1800 650 890
  • QLife on 1800 184 527

Worth noting: Sub/non-Acute Admitted (all compensable categories) – fees for private patients in a public hospital (as at 2020):

  • Public Hospital $ 1,220 $ 1,230 $ 10 – increase: 0.8% 
  • Public Psychiatric Hospital $ 512 $ 516 $ 4 increase: 0.8%