The college of psychiatrists in Queensland says the state government needs to spend "hundreds of millions" of dollars to upgrade decades-old mental health wards, with a concerning number of patients dying by suicide inside public hospitals over the past six years.
Warning: This article contains references to mental health and suicide.
ABC News has confirmed 19 adult mental health inpatients have ended their own lives while in the care of mental health units across Queensland since 2018.
Such deaths are one of ten types of nationally reportable sentinel events – defined by the Australian Institute of Health and Welfare (AIHW) as "adverse patient safety events that are wholly preventable".
Three of the deaths occurred in the 60-bed unit at The Prince Charles Hospital (TPCH) in Brisbane over a 16-month period, with a further two patients surviving suicide attempts in the same time frame.
An external review triggered by Metro North Health bosses was publicly released last night.
It found two psychiatric wards at TPCH were beset with staff shortages, increasing demand and aging facilities that are "no longer fit for purpose".
"The inpatient facilities are ... not in keeping with contemporary guidelines for mental health facilities, not conducive to mental health recovery and wellbeing for consumers, and they pose a number of potential safety risks for both consumers and staff," the report said.
Speaking as president of the Queensland branch of the Royal Australian and New Zealand College of Psychiatrists, Professor Brett Emmerson said every death by suicide "is a tragedy".
"It's one of the reasons why we've been calling for the urgent refurbishment of the existing units," he said.
"Those two wards [at TPCH], along with the three wards at Royal Brisbane, one ward at Caboolture, the PA psych unit ... are all 25 or 30 years old."
"It is impossible to be able to provide contemporary mental health care in wards that have never been refurbished, they've just had a re-paint," he said.
Asked if new facilities were needed, Professor Emmerson said: "It'll be hundreds of millions [of dollars] to do it, but the answer is yes."
The experienced psychiatrist said community-based mental health services also required a major boost, with approximately 2,000 more healthcare staff needed across the state.
"If you have your community mental health services working better than they do now, you have less reason to admit people," he said.
Professor Emmerson said the state government's new payroll tax to help fund mental health services is not enough.
"There's so much evidence that mental health is still not a priority – it's not a priority to the state, it's not really a priority to the federal government," he said.
State Health Minister Shannon Fentiman said services across the country were seeing a rise in presentations and Queensland's mental health levy was helping tackle the issue.
"Every suicide has a tragic and life-altering impact on families and communities, and I send my deepest condolences to those affected," she said.
"Queensland has seen significantly fewer in-patient suicides than NSW and Victoria. But ideally, it would be zero."
"All hospital and health services are participating in the Zero Suicide in Health Care Initiative, aimed at improving suicide care across the state."
Ms Fentiman said the state government had invested in improving services for people in suicidal crisis before and after hospital, which included police and ambulance co-responders, crisis support spaces, universal aftercare, and crisis stabilisation units.
Urgent safety work underway
The Metro North Hospital and Health Service said $5 million had been committed for urgent safety improvements at the mental health unit of TPCH, and a majority of the review panel's 22 recommendations are already being addressed.
Metro North Health chief operating officer Jane Hancock said the service is providing "ongoing support" for the loved ones of those who died.
"People should not be scared to attend The Prince Charles Hospital if they need access to mental health care, we have put good remediation actions in place, we have increased nursing staffing within The Prince Charles Hospital mental health unit," Adjunct Professor Hancock said.
A new $14 million mental health Crisis Stabilisation Facility at TPCH is due to open on September 16 and will provide six short-stay beds and six lounge areas.
Ms Hancock said Metro North continued to "negotiate for increased resources" from the state government.
Ms Fentiman said the government had allocated $9.9 million to Metro North Health to support the implementation of the 22 recommendations.
She said this included funding for additional positions in community mental health over five years, $4.7 million over three years for new specialist older persons community mental health services and $6 million over three years to establish a homeless health outreach team in the Moreton Bay region.
The most recent data from the AIHW showed the Queensland community had the second worst rate of deaths by suicide per 10,000 people after the Northern Territory, with 773 individuals taking their lives in 2022.
Suicide rates are generally higher in regional and remote areas and among First Nations Australians.
