Kalgoorlie Hospital staff were “close to tears” as they told a probe into mental health services they were using so much of a powerful horse sedative to chemically restrain young people that the supply “nearly ran out”.
A report on conditions at the hospital revealed repeated delays in transferring mental health patients from Kalgoorlie to Perth led to staff prescribing higher risk medication such as ketamine for sedation.
The November report by the Mental Health Advocacy Service found Kalgoorlie Hospital was “not a place of safety for some of these patients”, particularly young people and those vulnerable to running away.
Hospital staff told the MHAS that ketamine, an anaesthetic often used to sedate animals — mainly horses — as well as humans was often used on out-of-control patients.
On one occasion, ketamine was prescribed to a young person with an intellectual disability who was in the hospital alone.
“We knew that giving him so much ketamine was dangerous, but we had no option,” a staff member said in the report.
“We are not equipped for chemical restraint here, but we do it.”
Staff told the MHAS “everybody was very uncomfortable” with the ketamine dosage given to the patient and the length of time it was used on them.
“The hospital supply of ketamine nearly ran out,” the report said. “Staff were visibly upset when recalling this situation and close to tears. One staff member said, ‘I am waiting for the next young person to come through the doors with the same issues … nothing has changed’.”
WA Country Health Service Goldfields regional director Geraldine Ennis said that ketamine was only considered for use when a patient was not responding to other sedatives. She said its use had not increased at the hospital in recent months.
“Clinical staff who administer ketamine are highly trained, with dosages determined by patient weight and delivered in titrated amounts based on clinical need,” she said.
“In circumstances where Kalgoorlie Health Campus administers ketamine, patients are intensively monitored in a critical care environment.”
The MHAS investigation was prompted by separate incidents in August and September last year where involuntary patients absconded from the hospital, resulting in a suicide and an attempted suicide.
The report revealed that another patient was able to abscond a short time after these incidents, despite a security guard being present.
They were brought back with injuries and had to wait another two days for a Royal Flying Doctor Service flight to Perth.
The report raised concerns about a shortage of staff at the hospital, with staff saying having only two mental health nurses per shift was inadequate.
“When we say it is high priority we mean business,” one said. “We are saying that we can’t cope here.”
MHAS chief mental health advocate Debora Colvin said the service was seeking further information about actions taken to attract more clinicians, as the hospital had not had a permanent medical director of psychiatry since 2014.
“Although more staffing had been agreed to by hospital management, the issue of attracting staff, including a Clinical Director, remains crucial to the safety and welfare of mental health patients in Kalgoorlie,” she said.
She said the service was also working with the Royal Flying Doctor Service to ensure mental health patients were prioritised, as they were often forced to stay in Kalgoorlie in favour of patients classed as Category 1.
If you or someone you know is thinking of suicide, phone Lifeline on 13 11 14.