My name is Dr Joe Garside. I am employed by Sydney West Area Health Service as a senior career medical officer practicing psychiatry. For several years I have worked exclusively in a community setting. With the help of a full time clinical nurse consultant I am currently providing regular homeless outreach psychiatry services to homeless people with mental illnesses in the greater Parramatta area. This involves visiting 5 homeless centres and a weekly clinic at a drop in meals centre run by Parramatta mission. I also teach medicine at Sydney University and in 2009 I was employed by Sydney University as a lecturer in Psychological Medicine.
The international medical literature gives varying figures for the load of serious mental illness in the homeless population ranging from around 10 to 70 percent. There is uniform agreement the rate of substance abuse in this population is 80 to 90 percent. My own experience is the mentally ill homeless population also has a high rate of incarceration and intellectual impairment.
Apart from prescribing psychotropic medications the other needs of this group is access to quality general medical care and strong advocacy dealing with organisations such as public housing and social security. This group is also denied access to specialist psychological services.
An initiative that would be useful in area I work is funding for a full time social worker and sessional work by an interested general practitioner and clinical psychologist as well as easy access to a neuro psychologist. This is likely to cost around $200000 a year. These services are unlikely to ever be funded by the local area health service. Financially these services would be best managed through a local NGA such as Parramatta Mission to stop the funding being swallowed by he area health service.
I hope to attend some of the work shops.
Dr Joe Garside MBBS
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