00:02Everybody would be aware, particularly after the COVID, people have become more aware that
00:07children and adolescents have been experiencing more and more the mental health difficulty.
00:11So the need, the demand has gone up, but I don't think we have kept pace with the staff
00:17establishment for the need to be met.
00:20And over the course of time, the training pipeline and everything hasn't kind of quite
00:25kept up to meet the needs.
00:27And why is the situation particularly acute in Western Australia?
00:33It may be to do with the regional rural areas and the amount of population versus, you know,
00:41the growth of population versus geographically where they are might be a thing to play there.
00:49But equally, it's kind of across the board everywhere.
00:53It's a redistribution issue as much as also an issue with the numbers.
00:58As you know, it's about 230 as per the projections that it's short.
01:05We're not behind in other states either.
01:08Okay.
01:09So how long are young people having to wait to see a psychiatrist?
01:12And what impact is that having on them?
01:15There are two main things that's happening.
01:18The system that's available and the staff that are available, particularly in the public system,
01:24are only able to see the kids when they are reaching a crisis point.
01:28Because 85% of the work goes on to really acute presentations, which means that we are not doing the
01:37other end where early identification, early intervention,
01:41and supporting them as and when those things are emerging.
01:44Because of the shortage and the difficulty in getting to one, you almost get there by the time it's really
01:52the complexities and comorbidities have set in.
01:54So that's one impact that we are not able to provide them the help earlier in their journey.
02:01And the second is that because of the more of the problems that are happening at that acute severe end
02:07into the adolescent age group,
02:09there have been, rightly so, a lot of investment in the youth age group.
02:15And so much of those younger age group kids are not having the ability to be looked after and seen
02:23by the professionals and the systems that are available to us now.
02:27So that's twofold.
02:28One, we are not giving the care for the younger ones as much as we would like to.
02:34And two, we are not able to provide as much of that early interventions and support because most of the
02:39time and energy is spent on looking after that very acute end.
02:44So what's the answer then?
02:45It takes time to train psychiatrists.
02:48Is there an alternative strategy to fill the gap?
02:53It's probably an analogy to see that not everybody who has got a chest pain needs to see a cardiologist,
03:00right?
03:00So here we are talking about those who really have got that level of severity that is needing a child
03:08psychiatrist.
03:08So we need a roadmap that makes sense because currently everyone is queuing up maybe in the wrong queue because
03:15there is no roadmap or an ability for anyone to say for a cancer, if you have a breast lump,
03:21I would say people know what the next steps are.
03:24And my friend would know, my neighbour would know, my family would know, my GP would know.
03:28But for mental health conditions, we don't have got that level of a roadmap and a continuum of care mapped
03:34out.
03:35So that right from the primary care, things that have been looked after in the primary care, so GPs, and
03:40then picking them up into the secondary levels and then into the tertiary level.
03:44So everybody who has got mild or the severe, no one has got that ability to say, this is your
03:51right place, this is the right contact, this is the place you need to go.
03:54So people are probably also spending time sitting in the long wait list, which is probably the wrong one for
04:02them.
04:02We really need a roadmap and also from care workers to other mental health professionals to child psychiatrists, everyone joining
04:13hands and paediatricians and everyone who's looking after children to join hands and have that mapping of services and the
04:21right matching agreed upon for each of your geographical area.
04:26That's probably what's going to be really needed.
04:28If you just increase the numbers, we will never be able to kind of, you know, match the numbers, while
04:33numbers are important.
04:35It's also equally important how we share that work, how we do that continuum of care is also equally important
04:40to solve the problem.
04:42Professor Valsama, Eepan, thank you so much for your time today.
04:47Professor Valsama, Eepan, thank you.
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