A MENTAL health nurse seemed like an like an impossibility for me. I have realised for some time that many of my patients had serious mental health issues and that the public system was failing them systemically.
Kings Cross is a magnet to the homeless and the mad. They feel comfortable here; there has always been a tolerance of outrageous behaviour on the streets. Many of my patients lived rough in parks or cars or couch surfing in other people’s flats.When the mental health nurse initiative was announced, I searched far and wide to employ somebody to assist me.
Alan was in charge of community mental health triage at a local teaching hospital. He was disillusioned and looking for something different, having worked on the streets in Liverpool and London in the UK. The fit was seamless from the first patient.
I would invite him into the consultation with the patient’s approval, and then he would lead them to his cubbyhole in my tiny practice and work miracles. Alan would liaise with the housing department, getting homeless schizophrenics a place to live much faster than I ever imagined.
He would facilitate care plans and personally escort broken-toothed dental disasters 200 metres to the local dentist to make sure the first appointment was firmly in place.
He would ride his motor scooter on home visits to Woolloomooloo, where children at risk were subsisting with benzodiazepine-dependent mothers.
Now we case manage several hard-end mentally unwell patients who had fallen through the cracks of the underresourced public system. They trust Alan implicitly, and with his assistance their management has become much easier.
To give you a taste of some of our new patients, one is a highly deluded man who believes he was a boy soldier. He performs the most amazing impromptu bird impressions in the middle of a consultation and claims to have fought in the Vietnam war, Bosnian conflict, first Gulf war and even the cold war. ASIO is very concerned about him as he keeps ringing the organisation for the money it owes him for his heroic undercover operations.
Alan has performed miracles for him, applying for and succeeding in getting him priority housing and a pension he should have had years ago; getting his teeth sorted out; even getting in touch with his family to reassure them he’s okay. They had not heard from him for years and imagined he had died.
On occasions Alan will walk a dishevelled unwashed patient to the Wayside Chapel for a shower and a change of clothing. They return smiling and clean for a consultation.
In the last few months, we have been deluged with referrals from Mission Australia and the Salvation Army. Word has passed around that the homeless receive a timely and efficient service. We now have a waiting list.
These patients are the most thankful and compliant group. To see them emerge from hopelessness has been an uplifting experience for all of us in the practice.
One such patient is a deluded homeless Korean man sent to us by the Salvation Army who lives off scraps in Chinatown, sleeps outside churches in the city, and tells me about “Hella Sharon”, an imaginary woman who visits him in a car every night and uses him for sex.We are attempting to repatriate him with the assistance of his sister in Seoul. It has been a slow process to get him to trust Alan, but he is making headway.
I had never realised how much mental illness was a part of general practice until Alan came to work with me. Now I cannot imagine working without a full-time mental health nurse. My practice has become much more fulfilling since he joined me.
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