What are communities worth?



Jacaranda House is a purpose built mental health out-patient clinic on Kennedy Road in Napier that has been operating successfully for around 20 years.  In 2015 The Hawke’s Bay District Health Board will close this essential facility and sell the property.

This decision isn’t because Jacaranda House is failing, or that demand has dropped to such an extent that it’s no longer justifiable (if only…).  In fact, quite the opposite; the clinic sees approximately 60 to 70 patients per week.  The patients on its books are in the ‘severe to enduring’ category.  The ‘mild to moderate’ tend to go to their GP and get a referral to counselling services, so the people who will be affected are the most vulnerable in our community.

The DHB has given the usual excuse around rationalisation of services: that new facilities in Hastings will provide a better quality, and more intensive rehabilittion.  Amazingly, the DHB’s offer of help to the Napier patients who may not have access to transport is to provide a free bus to Hastings.  As if these patients are like kids going on an outing or a sports team that needs a lift to the park.

The head of the DHB’s Mental Health services, surely must know that many of these Napier people struggle to make the trip to Jacaranda House as it is, let alone travel on a bus to Hastings. To suggest this is any kind of ‘solution’ is absurd.

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So why the move from ‘community-based’ mental health care, back to the institutional model of the past that I thought medical practitioners were so against? Money.  Pure and simple.  The DHB is spending millions refurbishing its on-site mental health unit at Hawke’s Bay hospital in Hastings.  In fact the head of the Mental Health Services proudly stated that “The development of the mental health unit is the most significant spend in health care in Hawke’s Bay since the amalgamation of the Napier and Hastings Hospitals in 1999.”

Anyone who has ever been to the Hawke’s Bay Hospital’s mental health unit will know that this redevelopment is years overdue, however, why should this affect community-based services?  Quite simply, the DHB has forgotten that community care must actually be about communities.  To crow about how much money the DHB is spending on new mental health unit misses the point.  This isn’t some destination where “if you build it they will come”, rather mental health provision must be a combination of community delivery and hospital services; not one or the other.

Any society should be judged by how it treats its most vulnerable, and Jacaranda House is one of the important threads that holds Napier’s community together.  If one starts pulling these threads, civilised society slowly begins to unravel.  This is what is happening in Napier, and across many provincial towns and cities.

Jacaranda House is a special and successful place staffed by wonderful, caring people.  If it closes, many of those who require the services offered by Jacaranda House will have nowhere to go. When mental health patients do not receive the level of care they require, then the patients, their families, and our communities all suffer.

We are told these decisions are to create financial efficiencies but at some point it has to stop being about money and start being about what is right for our people and their communities.  We simply can’t keep hollowing out services and cutting costs and expect to maintain a civilized society where those who need help have access to the appropriate care and facilities.

So, this begs the question; how much are communities worth?  The DHB believes it can shut down a fantastic facility that provides a very important service for up to 70 Napier people a week and the cost is acceptable.  Well, it’s not acceptable.  Our city’s health and wellbeing is worth a hell of a lot more than that.  Amalgamation of mental health services in Hastings is not the answer to better community outcomes.




  1. In which financial year will the *free* bus become user pays ‘because of declining patronage’?

    Do any of those comfortable people so recently appointed to the health board have public email addresses so they can be vigorously applied to? If not – why not?

    Has anyone at the DHB put a price on the costs of fear and panic and missed treatment for their unfortunate clients? (Let’s NOT call them ‘patients’: it implies helpless and impotent, in too many cases.)

  2. Mental health outpatient care in Auckland also leaves to be desired. There used to be 5 fully funded free sessions available with counselors and psychologists at Procare Psychological Services, but a year or two ago, they were forced to start charging for those sessions, and to cut the “subsidised” ones from 5 to 4. And that is only once every 6 months, I believe, so any person, who now needs some treatment, has to go to WINZ or pay themselves, the fees that are charged.

    Once the “subsidised” sessions are used up, full charges of over $ 150 per session apply.

    And for the community mental health services, they have endless waiting lists, and mostly they just prescribe medication, and send people off again.

    I must say that mental health care in New Zealand is still very poor and often appalling. At the same time the need for such care and treatment seems greater than ever, with more persons having anxiety, depression, addiction and other illnesses, than ever before.

    Also CADS (Community Alcohol and Drug Services) have had funding cut or capped, while demand for services has increases substantially. I hear similar news from various other health service providers.

    So where is all this “additional care” that the government claims they are offering, while putting welfare beneficiaries with mental health and other issues under immense pressure now, to prove they cannot work, even when the doctors certify this again and again, that they are too ill to work?

    Tony Ryall is a lying and cunning Minister, and it is times he packs his bags, with the rest of his colleagues, especially that overbearing, bullying Paula Whats-her-name Beneshit!

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