Seth felt the the only way that he could get attention paid was to harm himself. (ABC News: Scott Ross)
It was a sunny winter’s day in late July, and Seth’s mental state was rapidly declining.
“It was there, bashing it in your head, saying kill yourself, and I knew I could,” he said.
Seth had experienced the ups and downs of severe depression for a decade, but that day, home alone, his thoughts were the darkest they’d ever been.
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“I was really afraid, that I was going to … attempt suicide.”
“I wanted to, but I didn’t want to. I have two young kids.”
Instead, Seth went outside and cut off the little finger on his right hand.
“I didn’t want to do it, in the end it was a choice between physically debilitating myself or completing suicide, there was no other [option] … so I did that.”
The pain that came next was excruciating.
Builders who were working across the road came to help him. He told them it was an accident and they called an ambulance.
When the paramedics arrived Seth told him what had happened.
Seth says he only got the help he needed after being admitted for the injury to his hand. (ABC News)
“I told the ambo pretty much straight away,” he said.
“I couldn’t find my finger and at the time I didn’t care about that.
“I just wanted to get in hospital to get some acute therapeutic hospital treatment.”
Seth was taken straight into the Royal Hobart Hospital.
He was admitted to the surgical ward where he was treated for his injury before being moved to the psychiatric unit, where he received the mental health treatment he desperately needed.
He thought being suicidal was not enough to get him through the door.
“I was in such a state and I was just afraid that if I was in the hospital and I was suicidal, I was only suicidal,” he said.
Self-harm after two previous visits to ED
Seth had reason to think he wouldn’t get the care he needed by fronting up to the Royal as a mental health patient.
In the weeks leading up to that day, he’d sought help at the hospital and said he had not received the care he needed.
On his first visit, he lasted 12 hours in the Emergency Department (ED).
“It’s bright, it’s noisy, it’s confusing, I was starting to lose it,” he said.
The sedatives he had been given started to wear off and he spent several hours trying to get the attention of the department’s busy nurses and doctors.
Seth waited a combined 20 hours over two visits in the emergency department before he took the radical step of cutting off a finger. (ABC News: Scott Ross)
“It was one o’clock in the morning and nothing had been done and I was just afraid I would be stuck there,” he said.
“I just needed sleep, so I got dressed and packed my stuff and simply walked out.”
The second time he attempted to get help at the Royal, was two days before he cut off his finger.
He was in a bad way.
He again sought help in ED but spent hours waiting.
“I was in a complete and utter panic to the point of not being able to move and being in a fetal ball on the concourse on the tiles of emergency, rocking and smacking my head against stuff,” he said.
Seth said he was handcuffed by police officers who were in the ED at the time, and remembered being shouted at to calm down.
“And then [I was] being tied to a bed … and injected with something,” he said.
When he woke up, he was seen by a junior clinician who asked him if he drank alcohol.
“I was still groggy from sedatives, and couldn’t really express myself,” Seth said.
“He said ‘you are a drug and alcohol patient’, gave me a piece of paper and discharged me.”
Psychiatric patients made beds while waiting to be seen at the Royal in September. (Supplied)
Seth believes that if he had been admitted to the psychiatric ward on those visits, he would not have made what he now describes as the irrational decision to cut off his finger.
“You can only get help if you’re in crisis, but only the right type of crisis,” he said.
“If it doesn’t look like you’re bleeding to death, coming into hospital you are shunted to the side.
“The only thing that I could think … the only way I could be recognised and have attention paid to me was to harm myself in such a way that I couldn’t just be fixed up in emergency.”
Seth has spoken out about his experience because he wants to see change.
“In the last few years I have known several people who have tried to access support … but it’s just not enough,” he said.
‘We know there is more to do in this space’
Tasmania has the lowest percentage of acute mental health beds in the country, at the same time as having one of the oldest, sickest and poorest populations.
The Royal has had ongoing problems with bed block, often causing ambulances to “ramp”. (ABC News)
Tasmania has 71 acute mental health beds statewide, including 33 at the Royal.
Up until 2013, the Royal had 42 beds but the number was reduced under both Labor and Liberal governments.
Doctors have been calling for the number of acute beds to be restored, arguing the reduction is leading to long wait times in the Royal’s emergency department.
“A lot of patients I think are suffering because of this reduction in bed numbers that we have now,” said Milford McArthur, the former chair of the Tasmanian Branch of the Royal Australian and New Zealand College of Psychiatrists.
Last month the ABC revealed that psychiatric patients had used towels and blankets for makeshift beds when they were forced to wait for long periods.
A State Government spokesman said it did not disclose the personal medical details of individual patients.
“We are aware of this patient and his concerns and he has met with the Minister’s office and the Chief Psychiatrist.
“We are focused on reducing suicide and improving our responses to suicide prevention, including key initiatives such as the Early Intervention Suicide Prevention Referral Service, the recently released Tasmanian Mental Health and Suicide Prevention Communications Charter, and ongoing additional resources for grassroots community organisations.
“We know there is more to do in this space which is why we are delivering our $95 million plan for a better mental health system.”
The Government has promised to open 25 mental health beds, but it remains unclear when they will open.