Carers Victoria response to the low availability of public psychiatric beds

To the Editor

It was great to see the carer voice strongly represented in Victoria’s low availability of public psychiatric beds and the impact on patients, carers and staff (Allison et al., 2017; Carers Victoria, 2016).

Carers Victoria knows that the mental health and well-being of carers of people with a mental illness are poor. Being able to gather evidence on the effect of hospital admissions on carer and caring family well-being would be significantly useful. Such data would improve understandings of how carer concerns change, reduce or increase over time and at different stages, for example, when the person they support is admitted, treated or discharged from hospital. This could inform the targeting of carer supports.

Carer distress can be caused by a range of factors which would need clarification if it contributed to a consumer’s admission. Carers may fear self-harm or suicide by a person they support or harm to a family member by the person. Alternatively, distress may be caused by significant care responsibilities over a sustained period. Support may also be provided by a carer to more than one person and subsequent distress can then be cumulative. Therefore, gathering evidence on the impact to carers from acute bed shortages for people experiencing severe mental illness should consider carer well-being data, based on a range of carer concerns.

It is also important to consider care planning and advance planning undertaken by caring families. Strategies to identify illness onset, and minimise harm, which are mutually agreed to by families and consumers (and supported by the work of other community mental health practitioners and service providers) can be compromised in the long term by a lack of acute bed access. When working well, care relationships support consumer independence. If people in a care relationship have negotiated issues of emergency planning, and a consumer has made choices and decisions, to access particular supports at particular times with the assistance of their carer, then it is important that our hospital system honours those choices.