Where do you go when you don’t feel safe inside your own head?

Whether it’s you or a loved one, the experience of mental breakdown is distressing for everyone. It’s painful, exhausting and takes time to recover from. It’s not easy to know what to do; what to say, who to talk to, or where to go to ease the overwhelming feeling of being trapped in an unsafe place.

‘Suicide is the leading cause of death for Australians aged 15 to 49 years. We lose more people to suicide than die on our roads each year. It affects all ages, genders and ethnicities.’ ⁱ

Having somewhere to go that will be welcoming, safe and equipped with people who understand what you’re going through isn’t always possible. A lot of people experiencing difficulties might not even know where to find such a place.

Gaining access to services and overcoming barriers to reaching out, even when services are available, is a challenge for people suffering poor mental health. Navigating the layers of bureaucracy needed to access free services through a GP takes determination, even for people who have an advocate to help them. Often people who need support don’t access it. This trend is especially acute for people in rural and remote areas of Australia where additional barriers such as distance to services and culture can prevent people reaching out.ⁱⁱ

Suicide and intentional self harm injury in rural and remote areas is considerably higher than in metropolitan areas, with age-standardised suicide rates tending to increase in alignment with higher levels of remoteness.ⁱⁱⁱ

In 2021 10.3% of people from the Bega Valley reported having a mental health condition (including depression or anxiety). This was higher than the state and national rates of 8%      for NSW and 8.8% for Australia^iv.

While demand for mental health services in the Bega Valley is higher than average, the region has an effective and committed network of mental health organisations delivering a range of services to people from different age groups, backgrounds and needs.^v However, when it comes to safe places where people suffering mental distress can go to stay overnight or for an extended period, the provision is limited.

Bega Valley resident Wendy Wait knows what it’s like to have a loved one in need of long term mental health and specialist care, and has experienced the limitations of the current mental health services available at the South East Regional Hospital (SERH), Bega.

Wendy describes her experiences of being with her son when he was admitted into high and low dependency wards at SERH, Bega as exhausting, dehumanising and involving a great deal of waiting. Even after hours of waiting to be assessed there was still always a possibility that they would be told there were no beds available and on occasions her son was sent home with a referral to the community mental health team.

‘What people experiencing a mental health crisis require’, says Wendy ‘is often a quiet, space to de-escalate or to sleep and feel safe.’  Her experiences of visiting her son in mental health wards has mostly been calming and peaceful, but not always. Wendy’s son stayed briefly in a city mental health hospital which she describes as being ‘aggressive, noisy and an unhealthy place to be.’

Wendy’s son says that spending time in hospital has been beneficial for him in gaining access to mental health specialists and community health services, particularly psychiatrists – getting an appointment for a private psychiatrist is challenging and often incredibly costly.

For Wendy’s son, arrival at hospital will usually involve a wait before being assessed by a doctor or a registrar. If assessed as being ‘unwell, or at risk’, (and there are beds available), he would be admitted to the mental health ward where he would often have his own room,   be seen by a psychiatrist, then medicated and observed and supported as required.

From there on, his time in hospital would be spent waiting and filling in the days between visits from psychiatrists and sometimes an occupational therapist if requested. Her son says the mental health ward wards offer a low stimulus environment, but there are spaces for activities and mental health nurses who check in with how you are going. The staff are very supportive, although, from Wendy’s son’s experience there is currently no permanent psychologist* on the psychiatric wards at SERH which can cause delays in treatment.

Another factor which concerns Wendy is that the transition out of hospital care isn’t always  a gradual one, and with limited beds available, the transition may happen more suddenly than is ideal, or even safe.

Wendy says every time she went to visit her son in hospital she would walk through an empty 7 bed ward that only ever seemed to be used for staff use and storage. This is the sub-acute ward.

In NSW, a Sub-Acute Mental Health Unit (SAMHU) provides short-term residential care for people who are becoming too unwell to be at home and who need a more structured and supported recovery. SAMHU’s serve as a transition point, either preventing hospitalization or supporting patients after a hospital stay. The units focus on recovery and integration back into the community using a combination of group and individual therapies.^vi

The original plan for the hospital was to have 3 stages of mental health inpatient care – high dependency, low dependency and sub-acute wards, but ever since the opening of the new SERH Bega in 2016, the sub-acute ward has never been in use.

Wendy spoke to various people at the hospital about this empty ward, and was told again      and again that the reason the subacute ward remained unopen was due to lack of staffing    and funding. After discussing the matter with MP Dr Michael Holland, Wendy started a    petition in December 2024 to inform the public of this unused, much needed facility and     to ultimately get the sub-acute ward opened.

Wendy’s petition reached 768 signatures on the 16th April 2025 and will now be delivered  by Dr Michael Holland to be presented in the Legislative Assembly to NSW Minister for Mental Health Rose Jackson for a response.

Wendy is keen to keep this important issue alive and encourages people to write to local MP’s Dr. Michael Holland and Kristy McBain to ask what their plans are for the currently under-utilised sub-acute mental health ward at SERH Bega. She says we can all help by continuing to ask questions about the status of this sub-acute ward and to keep the discussion active and ongoing.

The sub-acute mental health ward at SERH would be an amazing asset to the Far South Coast, as it was no doubt intended to be. Wendy stresses that the hospital staff are great and are doing the best they can to provide care for the increasing numbers of people experiencing mental health problems, but clearly they are understaffed and limited in the services they can provide.

There is no denying that people living in regional areas face extra barriers to seeking mental health support and more appealing options for support like a sub acute mental health ward, may help to bring more people to the service where they can get the specialist help and  support that they need. The SERH Bega is currently the only long term mental health service available from the Victoria border, inland to Cooma and up to Wollongong.

The Bega Valley Data Collective’s Living Well in the Bega Valley initiative can help highlight key issues facing the community, such as mental health. By creating a platform in the community for people’s voices to be heard, we can better understand what supports individuals need to enhance their wellbeing, and provide data to back that up.             Through Living Well in the Bega Valley, we can help advocate for issues such as the lack    of a sub-acute ward in the area, to help ensure a better future for our community.

Background Information: Far South Coast mother urges people to sign petition to open unused mental health care facility in Bega hospital, About Regional 6 February 2025 by Marion Williams

Image credits: Suicide deaths by sex and remoteness areas, Australia, 2001 to 2023, AIHW

Mental Health reported condition as a % of the population in the Bega Valley compared to Capital Region, NSW and Australia, 2021, Bega Valley Data Collective

Special thanks to Wendy Wait and her son

Note:

If you need mental health support, you can visit a GP and access 10 free sessions with a psychologist. The Community Mental Health Team is another way to gain access to specialist mental health support, however they tend to be for short term acute cases rather than ongoing, long term support. Head Space and Grand Pacific Health also have a range  of excellent mental health services, including a peer-support program which can be helpful.

Safe Haven located at 17 Bega Street, is an excellent resource that everybody should know about and is open everyday. There is no need to disclose any personal information or to have any specific issues to discuss. It is simply a safe place to go.

If you need to talk to someone for immediate support 24/7 call Lifeline.

If you don’t feel safe and need somewhere to go where you will be looked after overnight, you can call an ambulance. Once you’re in the ambulance you’ll be taken to emergency department at the SERH Bega, where you will be cared for and kept safe until a specialist can see you.

i Department of Health and Aged Care, 7 August 2024, Suicide in Australia, available at https://www.health.gov.au/topics/mental-health-and-suicide-prevention/suicide-in-australia  accessed 2 May 2025