Strain of drug use: Peel Health Campus' ability to handle meth addicts in ED questioned

Over the past three weeks, the Mandurah Mail has highlighted the devastating impact meth has on individuals and the community as part of our Falling Through the Cracks series.

Falling Through the Cracks - Week one coverage:

In the four months from January to April this year, 210 code blacks were activated by Peel hospital staff, equating to almost two every day.

Code blacks are incidents or threats of violence that pose a personal risk to staff, patients or visitors within a hospital.

The issue was in the spotlight on June 21, at a Stop the Violence summit assembled by WA Health Minister Roger Cook after pressure from unions to address aggression in hospitals.

The state's first urgent-care clinic treating patients affected by drugs or alcohol opened mid-2018 at Royal Perth Hospital, which was modelled on similar units in the eastern states.

Naomi McCrae, secretary at the Health Services Union of WA, which represents more than 20,000 allied health professionals across the state, said a similar clinic was needed at Peel Health Campus.

"If we know there are particular hospitals that have large numbers of certain patients, such as meth users in the Peel region, you would think that the focus of that hospital would be on a structured way to minimise and alleviate the risks that come with dealing with those patients," she said.

"It also needs to be properly managed, so there is not only a chance for those people to recover, but it can be done so there is no risk to staff or other patients."

Australian Medical Association WA spokesman Dr David Mountain said there had been a sizable increase in meth-related violence in recent years.

"It drives a lot of the severe violence and agitation we see," he said.

"All hospitals have had increases in the amount of code blacks and need for restraints and sedation in their departments as well."

Falling Through the Cracks - Week two coverage:

Dr Mountain said medical staff could not be guaranteed safety on the job.

"People have had to take time off work, left our profession or left emergency medicine due to the injuries and trauma involved in being attacked," he said.

Dr Mountain said he could not think of a more triggering environment for patients affected by meth - even jail was better, he said.

"It's calmer at times, the lights go out, you get fed and there's routine to it," he said.

"(An ED) doesn't have daylight, the lights are on the whole time so it's hard for people to get to sleep and we are not really set up to deliver people's routine care.

"Somebody who is already agitated or who has major issues going on is not going to cope well being in a crowded, noisy, well-lit emergency department for 12 to 24 hours."

The current ED set-up also drained Mandurah police resources, according to WA Police Union president Harry Arnott, with officers regularly spending long stints at the campus.

"At times there have been four to six hours with limited police cars available to task in the Mandurah area, because they are tied up on these jobs," he said.

In 2018, the state government committed $5 million to redesign the Peel emergency department.

A further $25 million was injected by the federal government, which will include a mental health in-patient facility. But, there has been no mention of creating a clinic for drug-affected patients.

Federal Health Minister Greg Hunt said the state government would ultimately decide the building design.

Falling Through the Cracks - Week three coverage:

Canning MP Andrew Hastie said it was important the upgrades were coordinated.

"The upgrades funded by the federal government are expected to begin in 2020-21, with the state and federal health departments currently working through the details," he said.

Mr Hastie said he recently met with stakeholders to discuss the needs of the Peel region, including in relation to drug-affected patients, and would be able to comment further in upcoming months.

WA Health Minister Roger Cook said the $5 million ED redevelopment should be completed by next August.

"The redesign of the Peel ED will help facilitate earlier senior medical review and will provide better separation of patients and enhanced privacy," he said.

Mr Cook said new software would be introduced to the hospital around the same time, which included a "meth flag", where staff can indicate whether a patient may be affected by drugs.

A Peel Health Campus spokeswoman said the hospital had "rigorous" procedures managing patients affected by drugs and alcohol, with security and hospital staff trained in violence de-escalation.

"Security personnel have a visible presence in the ED and are on standby to assist in other areas at all times," she said.

"The hospital has an excellent relationship with the local police, who attend quickly if needed."

Contact the meth helpline on 1800 874 878.