Guidelines for new emergency department mental health and alcohol and other drugs (AOD) hubs have been released.
The Department of Health and Human Services released the guidelines which include direction on the hubs’ eligibility criteria, the service model, patient journey, staffing, and safety and security.
The hubs will be established at Monash Health (Monash Medical Centre Clayton), Peninsula Health (Frankston), Western Health (Sunshine), Barwon Health (University Hospital Geelong) St Vincent’s Hospital, and Melbourne Health (Royal Melbourne Hospital). The hubs are the result of a $100.5 million investment by the Andrews Government in its 2018–19 Budget.
The hubs will be for patients who:
- are directed to present to ED triage by the area mental health service
- require urgent medical treatment and have an acute psychiatric comorbidity
- require urgent medical treatment and have an acute drug and alcohol comorbidity
- are mental health clients presenting with high acuity
- present with suicidal ideation or following self-harm or
- present with drug and alcohol dependence with the symptoms of acute intoxication or withdrawal.
The hubs will not be for patients who:
- have a high-risk medical instability or require acute or complex medical intervention/care beyond the service provision available within the hub
- have an organic disease or brain injury unless there is an acute coexisting mental disorder or AOD issue
- are currently exhibiting behaviours of concern, where a behaviour assessment room may be more appropriate
- are under 16 years of age.
The guidelines say the hubs will be an integrated service delivered by ED, mental health and AOD clinicians operating 24 hours a day, seven days a week.
Patients will be assessed by ED triage before being streamed to the hub for appropriate tests and treatment.
For patients who have both physical and mental health treatment needs, a senior ED clinician will decide if the ED or the hub is the best place for treatment.
The hubs will provide a non-admitted service in dedicated space within the ED, where patients will receive a comprehensive assessment followed by appropriate treatment which may include brief therapeutic interventions, peer support and referral.
Short stay units of four to six beds will be built within the ED for patients who need stabilization and intensive support for up to 24 hours or more.
The ED will be responsible for the clinical and operational management of the hubs, with ED clinical leads providing oversight over care.