In a plaintive cry a few days ago from health minister Jonathan Coleman in response to another hammering from the community and – this time – from unions representing mental health workers, on the occasion of the closure of a chunk of Waitemata DHB’s mental health facilities, we were told that the Government has responded well to mental health needs in the country by increasing the budget allocation from $1.1B in 2008 to $1.4B this year.
Simple math tells us that this is about a 2.5% increase per year, but measured against record official* suicide levels, mental health facilities turning patients away, mental health wards closing due to staff shortages, high staff turnover in community mental health services and growing public unease about the state of this sector, current public expenditure on mental health is clearly not cutting the mustard.
During the same period, we’ve seen the growth of private mental health services and facilities, charging huge fees affordable to only a few; after Capri’s latest round of TV advertising, my partner contacted them to find out the cost of basic 4-6 week treatment course for a patient – there was no change from $30,000 – and the parent of another person told me recently they had forked out $40,000 for a 6-week treatment course for their son at another private provider. Soon, I’m sure, BUPA and Radius will be getting into this game!
In 2015, the Ministry of Health floated for the Government the concept of privatisation of mental health services, where assessed patients would be effectively granted cash to ‘purchase’ services – a budget would be attached to their mental unwellness, and used to fund the services they accessed. Quite how such a cockamamie idea would work in practice was never discussed, but various pseudo-community mental health services were audibly salivating at the prospect of competing in this particular marketplace.
Although this concept doesn’t yet seem to have been progressed, you can see where the Government and its ideological bedmates are heading. They are keen to abandon the public service model of healthcare, and promote the private corporate model in its place, with aged care and soon mental health being among the first testing grounds.
One of the dangers of this move is that there will be well-meaning groups in the community, as well as some iwi health providers, who will be easily convinced (see charter schools) that a privatised mental healthcare model will enable them to get out from under the heavily bureaucratic, professionally-dominated public funding model currently in place, and they will jump at the chance for a greater degree of independence. In return, the Government will jump at the chance to present some token community-based ‘successes’ to counter the criticism they will receive for a much larger chunk of Vote Health going to their corporate mates.
*many suicides are not recorded as that – as no official determination is made or, as in our son’s case, has yet to be made – so his is classed as death by suspected drowning, 18 months after it happened.
Dave Macpherson is The Daily Blog’s mental health blogger after losing his son to mental health incompetence. He is also a candidate for the Waikato DHB.
Band aid politics Dave they are playing.
Yes agree CLEANGREEN band aid politics in all areas of policy not just mental health. But also making money of the sick is sick it is unethical but the gnats have shown NZers they have no ethics or principles its all about the money money money and f… the people.
Last thing we need is privatization of our mental health systems let alone general health .
Try seeing a professional counsellor, a psychologist or psychotherapist in the community. The state funded or subsidised “Community Mental Health Centre” do usually only focus on the extreme end of those needing attention and treatment, and mostly they simply dish out medication, or briefly put people into a respite home.
Those needing medium to longer term treatment are condemned to ring around or look around for specialists who usually charge at least $150 a session, some $200 or more.
WINZ only pay up to $ 61 a week maximum in Disability Allowance. So how would anybody get access to treatment, unless it is covered by treatment centres and services that are subsidised.
Dave mentions Capri, they have now decided that they have to close. Yes, they already charged heaps, who the hell can afford that though.
There are long waiting lists for treatment in addiction treatment centres and elsewhere, Coleman lives on Planet Key, as we know, he does not care, he simply leaves it to the actuaries to look after health, those that count the beans and they are also bound by what is prioritised by DHBs, whose hands are again tied by what the government offers in funding.
So nothing changes much, and all this talk is endless BS.
I know of various providers that once were subsidised but now have to charge fees. People who have cash can pay, others have to beg at WINZ, but as mentioned above, they only pay so much, so perhaps the clients have to go begging in the streets, which will then motivate Councils to bring in bylaws to ban forms of begging, and to round up those deemed a nuisance or homeless, to put them in some temporary shelters.
We are moving backwards, I fear, not ahead.
But “hey”, the government has this on offer:
‘Work to Wellness’, work will set you free, yes it is “therapeutic”:
https://national.org.nz/news/2016-08-31-helping-those-with-health-conditions-into-work
But then, we had this before, did we not?
http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10893823
After that came this:
http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=11514141
Not much was discussed about this in public, though.
I wonder why?
They sweep their failed trials under the carpet, and do not even offer the “evaluation” they earlier promised.
And like they conduct these welfare experiments, based on their ideology that the market is best at solving all problems, they do the same in health, including mental health treatment programs.
We never really learn about the collateral damage, apart from some individual tragic stories, but then the lawyers are called, and all controversial stuff gets swiftly denied.
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