The tsunami of demand

For me one of the themes of the sessions I have been to is a sense of defending ourselves against being overwhelmed by demand. Vikram's session on big ideas included big numbers about unmet demand and I went to a session this afternoon on the pointy end of mental health care in the emergency departments of Australia and New Zealand. A familiar story was told of rising numbers of people presenting to emergency departments with mental health problems linked to increased demands for shorter length of stays. This has now got to the point that what is valued in clinicians is cr

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eating empty beds rather providing good quality care. However there are some potential answers also being talked about at the Congress - there have been two sessions on e-therapies today (The Lowdown/The Journal and SPARX) which probably have a role at being part of the fence at the top of the cliff rather than (the literal) ambulance at the bottom of the cliff. Jim Crow's keynote this morning also described lessons from other countries in Asia where families and consumers have found ways of empowering themselves to provide some of the psychological and social support often missing in the ways that we practice psychiatry in New Zealand and Australia. So to cope with the tsumani of demand as psychiatrists we probably need to step back from "the next patient" identify what we uniquely do and start helping others do the rest.