Abstract
Happenings in the far North West
Mosaic by local artist Judy Mengil symbolising a meeting place.
In May 2012, I was at the opening of Mabu Liyan (‘Good healing spirit’), a 13-bed + one ‘seclusion ready room’ mental health inpatient unit, on the Broome Hospital campus. This has to be one of, if not the most geographically and logistically isolated mental health inpatient units in Australia (perhaps the world?), as it is equidistant between Perth and Darwin, on the spectacular and almost unspoilt Pearl Coast in the Kimberley region. I have to say, opening Mabu Liyan is a highly commendable and ambitious response to a clarion call from the north-west population with whom I have lived for 10 years. For quite some time now they have been ‘over’ living at the spoke-end of a necessarily gargantuan hub-and-spoke inpatient model of care. As far as I can tell, the initial consumer and carer feedback has been refreshingly positive, and also at times humbling. No doubt, in part, this is due to every Indigenous patient admitted to the unit having been engaged by (if not immediately greeted by) an Indigenous member of staff.
Of course, when a unit such as this opens in a location on the edge of nowhere, there are bound to be a few ‘teething problems’. For instance, it has taken several months to gain authorization under the MH Act WA (1996)–- perhaps not an unusual journey, so I’m told, into learnt helplessness for clinicians and managers alike, as builders, subcontractors, project managers and architects wrestle to make the building fit for its final purpose, meeting the very clear safety requirements of the Office of the Chief Psychiatrist (WA). I can only sympathize with my metropolitan colleagues and peers, who have already seen their high-dependency bed stocks beginning to dwindle, as the inevitable ‘cost transfer’ accounting process begins.
As befits the iconic north-west region, this faraway mineral-rich land that keeps the Australian economic dream alive, there have already been some humorous moments. Such as the caller inquiring whether Christmas Island was in our newly acquired catchment area and, if so, could we take a patient please? It seems this caller, possibly based in Perth (2100 km to the south of Broome), was not acquainted with the commercial flight routing in this part of the world. Broome is not a major transport hub; it is at the end of a long spoke, as mentioned earlier. So is Christmas Island. The hub is, and will remain, Perth. So any patient would have to bypass at least seven rather larger and more established inpatient facilities en-route from Christmas to Broome.
Another patient was to wing their way to Broome from a town on the Pilbara coast (that is in our catchment area), a miserly 800 km to the south. They missed their scheduled direct Friday evening flight (flights are scheduled twice weekly to Broome), and Mabu Liyan staff then anxiously awaited the patient’s arrival, re-routed (you’ve already guessed it) via Perth. The patient never made it. It didn’t seem to matter how many times staff attended Broome airport arrival area, as each Perth flight came in (carriers will not confirm passenger details, even in such instances). Turns out the patient started to feel better during the journey, perhaps whilst overnighting with extended family in Perth, and decided they no longer favoured the proposed expedition to the far north. Some might see this as a ‘flight into health’; others might perceive a serendipitous good outcome.