Psychiatrists are warning of inadequate youth mental health services in NSW, burned out clinicians and a system that’s failing parents, after one Sydney mother went public after relinquishing custody of her 13 year old daughter in a last bid to get her the help she needs. Despite state government assurances that services have not been cut, Hills District mother Marion has spoken out about her first hand experience, while senior clinical figures have also disputed government claims that no cuts have been made. Marion spoke to Linda Mottram on 702 ABC Sydney about her struggle to keep 13-year-old Charlotte alive and to prevent her self-harming. “I’ve had to relinquish my custody to FACS (Department of Family and Community Services) – I didn’t have any other choice,” Marion said. “To get the care for Charlotte, I had to face the facts that I couldn’t keep her safe anymore. I had to choose between keeping my other children safe and making sure Charlotte gets the help that she needs, because unfortunately, every door has been closed to me.”
For any parent, it would be unthinkable – willingly handing the custody of your child over to Family and Community Services. It has been for Marion too, mother to 13 year old Charlotte, but after two years of self-harm and suicide attempts, Marion felt she had no choice. How did a mother of three from the Hills district of Sydney get to this point, with all the talk of increased support and services for mental health, how did a young girl slip through the cracks? Marion and Charlotte’s story started when the ‘popular girls’ at school started bullying then-11 year old Charlotte. “I started noticing things when she was in year 5, after she got bullied at school,” Marion said. “By the end of year 5, she had shown a lot of anxiety going to school… and by year 6, she started to self-harm as well. I noticed cuts in late year 5 and early year 6, and when I had asked her about the cuts, she said she did it with the scissors from her pencil case in the girls’ toilets because that was the only way she could deal with the pain.” Charlotte began seeing a psychologist, but her mother said it didn’t seem to help. By the middle of Year 6, Marion decided to remove Charlotte from the school and enrol her in one with a more ‘holistic’ approach, including a nurse on staff that could help with Charlotte’s other health needs. But despite feeling welcomed by the new school, anxiety soon set in again. Since then, things have rapidly deteriorated. “How much she self-harms depends on how much I can contain her at home, lock up every possible thing that she can self-harm with, and being with her every minute and every second of her time at home.” Last week Charlotte was admitted to the Psychiatric Unit at the Westmead Children’s Hospital for the third time. “On Friday, due to her instinct to hurt herself so badly, she actually locked me in the garage,” Marion explained. “Then, when my two other children decided to help, she unfortunately hurt them. When I did get finally released from the garage, she hurt herself quite deeply after that and I had to take her to emergency and she needed stitches. And then she had to be admitted to the psychiatric unit.”
Over the past two years, Charlotte has been referred to a number of other specialist services, including Redbank House at Westmead Hospital. Due to resources and the complexity of Charlotte’s needs, however, they were not able to accommodate the teenager. Marion said that funding cuts had reduced the number of available places at Redbank House, meaning Charlotte was still on the waiting list. After two years of asking for help and pleading for services for Charlotte, Marion reached the end of her tether. “I have tried every possibility to get resources in the area to help me, but unfortunately on Monday I’ve actually had to relinquish custody to FACS in order to get her the help that she needs. Unfortunately, it had to come to that.”Handing her child over appeared to be the only option after Marion’s earlier attempts to get help from FACS were rebuffed. We even had a meeting with the department of community services in January with three staff specialists, asking FACS to help us as a family and to help Charlotte and her acute condition… but what I was told, and the doctors were told, is that there is little they can do and that we need to manage it the best we can.” In fact, Marion was told that because Charlotte was not a ‘child in danger’, they could not help. “I do not understand why a 13 year old needs to go through all of this … I cannot fathom why, as a mother, I have to make this choice to protect my child who I gave birth to and who I never intended to give up for any reason. I think that is something that you should never have to do.”
Replying to a request for an interview, a spokesman for the Minister for Mental Health Jay Rowell released a statement via email. “There has been no reduction to the operating budget for Redbank House, however due to staff shortages over the past six months the facility has been operating at a reduced capacity. The Western Sydney Local Health District is actively recruiting to fill these positions and restore full service.” The spokesman pointed to investments the state government was making in mental health and added in a further email that there had been no reduction in service delivery beyond that necessitated due to temporary staff shortages. The views from senior psychologists and psychiatrists are different though. Psychiatrist Dr Gary Galambos, NSW Chair of Royal Australia/NZ College of Psychiatrists, said that his colleagues had long complained that the system had been restructured to the point of deep demoralisation among clinicians, who were forced to ring patients and delay their appointments. “My colleagues are extremely concerned about the losses of services in inpatient child and adolescent services in western Sydney,” Dr Galambos said. “The bed numbers (at Redbank) went from 17 down to, my understanding is, eight at present and out of those eight only four are acute beds. That’s clearly a cutback. I don’t see what else you could call it. It might be argued that it’s temporary but unfortunately my colleagues regularly experience prolonged periods where positions aren’t filled and then the remaining clinicians are so overburdened that you end up getting a domino effect where those clinicians get burnt out and so it’s too difficult to work in a system where the demand is so much higher than the supply and patients are suffering.” For Marion, it’s now an agonising wait to hear from the department about the future of her daughters’ care. “I have had to keep myself going,” Marion said. “I’m a working mother, and I deal with my pain at night. That’s what I need to do for Charlotte. I need to be there for her. And I need to get the best care for her, and be her advocate through all of this. She still needs me. And that’s why I’m talking to you – going through this, I did not realise how little was available for our children. I tried everything, and I was told there was nothing else I could do.”
This article first appeared ABC, 26 February 2015.