For ‘devolution’, the reader can insert ‘corporatisation’, or ‘’dismemberment’, or a host of other descriptions of the cuts to community and public health services that new right philosophies are delivering.
On our whanau Facebook page (’Nicky Autumn Stevens’) in the last week, we have covered the closure of the Lifeline telephone counselling service, due in June next year; a trial addition to St John’s ambulance services where the ambos will become frontline mental health professionals; a story about suicides among the country’s armed forces; and more on the Coronial process relating to suicides.
Lifeline have been operating for about 50 years, and are widely recognised as a national early intervention/recognition service for people with a wide range of mental health problems – and have been particularly important for many in the suicide prevention area. The calls to Lifeline for help have increased by over 40% in the last year.
They lost out in the Government’s latest ‘contract round’ (read ‘how to use your mates to save money at the community’s expense’) to a series of call centres specialising in different types of mental illness. Imagine if you will, a young person with suicidal thoughts decides he/she wants to talk to someone, but they have to make a decision – in the state they are in – should I call the Depression hotline? Or the Schizophrenia centre; or Bi-Polar; or who do I call if I haven’t been diagnosed? Forget about calling anyone – its too confusing and I can’t find the right number anyway. What do you think might happen then?
This particular devolution is likely to go the same way as the aged-care sector has; all those local church and community trust-run rest homes being swallowed up by a small number of large, well-connected and highly profitrable corporates.
The Nelson-Marlborough St Johns Ambulance mental health trial is set to be rolled out around the country. On the surface it seems to be a good idea – training ambos in mental health recognition and support strategies. Many of their callouts are for people with mental illness issues; quite similar to the Police, who are facing 50-60,000 mental health-related callouts annually. The numbers of these for both services are growing alarmingly.
The failure of public mental health services, both institutional and community; witnessed by suicide and mental health statistics all moving in the wrong direction, is causing devolution of front line mental health services to St Johns and the Police, who are themselves embarking on more in-depth mental health recognition and support training for their trainees and existing staff.
New Zealand is one of the few countries that doesn’t record suicides among former armed forces members, but anecdotal evidence apparently shows a growing problem there, with armed forces leaders identifying both a lack of support for ex-service people suffering from mental illnesses and a slowness in the coronial process meaning it is hard to get accurate information.
This brings us to the coronial system itself, where many ‘suspected’ (i.e. well-know by all except the Govt agencies) suicides are not investigated for 4-5 years, or even longer. Recent legal changes – largely unchallenged in Parliament – have led to Coroner’s offices avoiding contentious and expensive hearings by employing legal firms to run desktop reviews of suicides – often, it seems, the same legal firms that represent DHBs and other health agencies which have actually been responsible for the treatment of mental health patients. Full hearings are not held, and answers for whanau & friends are often even fewer.
Dave Macpherson is TDBs blogger on mental health issues