Challenge on Auckland mental health services
On Tuesday this week I used Question Time in the House to ask Health Minister David Cunliffe about Auckland Hospital’s psychiatric acute unit Te Whetu Tawera, as I had just heard that Selwyn Wallace, the man whose body was found floating under Wynyard Wharf in mid-August, had been released from the unit just prior to his death.
In the light of this tragedy - and in the wake of other recent deaths of patients associated with the unit - I sought to press the Government on the issue of the adequacy of Te Whetu Tarewa and of support and rehabilitation servcices once people are released. The response from Minister Cunliffe was as assured and dismissive as the one I had received from his associate Jim Anderton a month earlier on the same issue.
Cunliffe:
I am satisfied that following an independent review earlier this year, Auckland DHB has begun making extensive changes to its adult mental health services to improve the safety and wellbeing of patients…… included appointing a new head of psychiatry, changes to nursing accountabilities and rosters, and new reporting mechanisms.
Anderton:
Some failings within the Auckland system have already been acknowledged, but I am satisfied that by and large NZ’s services – both physical and mental health services – are improving.
What neither of these Ministers seem to understand, or at least to publicly acknowledge, is the depth of the structural failings with the Auckland DHB’s provision of mental health services. The acute unit is constantly at crisis point because of pressure on beds and staffing. There are reports of violence and sexual offending within the unit. Deaths of patients associated with the unit are ongoing. Alongside this, there appears to be only one major rehabilitation unit in the district - Buchanan Clinic - for which there are long waiting lists if one is lucky enough to get in at all. Good, safe accommodation and adequate health support are not necessarily accessed by all who are sent out into the world to fend for themselves.
I believe there are major structural and resourcing issues here that will not be addressed by alterations in the designation of nursing staff, new rosters and changes in reporting mechanisms. The Green Party would like to be part of a Government which actually sees mental health as deserving of attention and resourcing equivalent with physical health, not as its poor cousin.
I am not out to bag mental health staff in either the hospitals or the community – they are struggling with the situation daily, and know the realities better than any of us as they try to do the best job they can. But the people who deserve the best this country can afford to offer if we are to call ourselves a decent society – people with and recovering from mental illness - deserve a much fairer go than they are getting at the moment.
September 4th, 2008 at 10:56 am
Don’t forget the three unexplained 2008 deaths in the Christchurch Te Whare Manaaki Forensic Unit - Hillmorton Hospital.
Talk about another whitewash and I can assure you it’s a scary place for a sane person.
September 4th, 2008 at 11:11 am
Oh the temptation!
September 4th, 2008 at 11:20 am
Go on take the bait BB?
September 4th, 2008 at 12:29 pm
Now, come on BB. It’s not often d4j comes here and says something sensible. For once he has, so let’s not ridicule him.
This problem has been going on for years.
I don’t know much about Te Whare Manaaki in Christchurch (tell us more d4j, but with Te Whetu Tarewa there have been whitewash reports that attempt to blame it all on “poor clinical judgment and practice”.
But nothing changes, and the deaths and abuse of and by patients continues. There is clearly something seriously wrong structurally here. It is all to do with resourcing. There are so many people with serious mental health problems queued up for admission to acute units, and so few beds for them, that the pressure on staff to inappropriately discharge so they can admit someone they consider to be more ill is enormous.
And then, in the Auckland DHB at least, there is minimal, if any, support care provided to people who are considered to be sufficiently recovered to discharge from Te Whetu Tawera that it is no surprise many are simply unable to cope in the community.
September 4th, 2008 at 3:29 pm
Real beef with me BB. Man I can’t wait to find out what sad loser continually attacks my credibility. [*moderated*]
I agree Toad that the acute shortage of Mental Health workers and facilities is tragic. They tell me youth with addiction issues have to wait 6 months before they can see anybody in the Mental Health community teams. The mental health service is a shambolic mess but Labour has not addressed the underlining causes of the problem
September 4th, 2008 at 6:05 pm
d4j, this is an issue that I agree completely with you on. And the Labour Government is to blame.
Not that National did much better before that, or Labour under the Rogernomes before them, I recall.
It was all just a neo-liberal fantasy that if Government deinstitutionalises almost everyone with mental health diagnoses (apart from those who pose blatantly obvious threats of violence to either themselves or someone else), the “community” will somehow cope.
Well, the “community” doesn’t cope, and for the most part cannot cope, because we are not resourced to cope. In the ten minute walk between my train and my work, I see almost every morning a guy with obvious mental health problems.
He’s usually drinking beer (at 7am), and curses and offensively or aggressively gestures to everyone who walks past him and shouts incoherently at us.
He is another mental health statistic waiting to happen. One day he will get tipped over the edge, and his offensive and violent disposition will likely manifest itself in him perpetrating a crime of considerable violence.
I would love to be able to help him, and be able to get him referred to somewhere that he will get some effective treatment, care and support.
But there is nowhere for people like him, so I choose to ignore and to avoid him, because building up some false hope that the system could actually help him might be the thing that tips him over the edge into serious violence or self-harm. And I don’t want to feel I am the person to blame for that.
So I do nothing, and the reason I do nothing, is that the mental health system stinks.
Blame Labour. Blame National. I don’t care who you blame, but the Green Party isn’t part of this abandonment of some of the most vulnerable members of our society, and is very angry about it.
I’m sure Sue Bradford, despite what you may think of her on other issues d4j, is genuinely committed to a country that could do much better for those with mental illness.
September 4th, 2008 at 6:23 pm
What is rather disturbing Toad, is the fact that many suffering acute mental illness are convicted and incarcerated into the hands of the Department of Corrections, who are totally untrained to help these prisoners, or should I say patients. And, people wonder recidivist rates are still far too high. Duh , where are the treatment centers like Queen Mary Hospital !!??
September 4th, 2008 at 8:39 pm
Agreed, d4j. There are many people in prison who should not be there. The test of “criminal insanoty” is set at too high a bar.
And prison provides minimal, if any, rehabilitation or treatment for anyone who does have a mental illness. Just lock them up for a while, then move them out the door to “community support” with a $350 “Steps to Freedom” grant, and leave them to fend for themselves.
Is anyone surprised that many are back inside within a few months?
FFS, it was the same incompetent theory of “rehabilitation in prison” that saw the psychopathic Graeme Burton released without any rehabilitation that would mitigate against him murdering again.
Which he then did!.
September 10th, 2008 at 4:18 pm
The Mental Health system in Christchurch is absolutly appalling.
I was a inpatient by my choice from mid Jan to near the end of Feb 2008, in between the three suicides. I am not surprised at the suicides. My heart goes out to the families. My qualification is in Social Services. In Feb Pysch Services advised my GP to give me a certian medication after my GP tried to get me admitted as I am hypersensitve to medications, hence I get side effects. Later that night after taking the meds I was rushed into CPH and then transfered from CPH to Hillmorton Hospital. I was there for over 4 weeks and I have never seen such an appalling, worrying and dangerous environment. I dont mean because of the patients either. I understand the review was a whitewash. I would love to see a copy of this report. Upon discharging myself from Hillmorton I filed an official complaint and I have never heard back from them. Talk about pushing the problem under the carpet.