The public image of the mental health sector is clearly giving the Government and medical establishment headaches, given the work recently produced by the Auditor-General’s office looking at the problems of the services provided to acute mental health patients – those requiring ‘inpatient’ care, usually at DHB facilities.
In the 3 years from 2011-2014, almost 20,000 people used these services; given the rate or growth, we imagine the figures for the most recent 3 years will be somewhat north of 25,000; the sort of statistic that gives the lie to the claims by Government and health bureaucrats that they are ‘on top’ of the problem.
The fact that one of their own, the official bean-counting agency known for dry accountancy and not for in-depth social analysis, has been given the job of assessing just how bad things are in this high-profile part of the mental health sector, shows just how damaging community claims of a broken system are.
Despite Jonathan ‘Canute’ Coleman and his flunky Director of Mental Health, John ‘The Emperor is Wearing Clothes’ Crawshaw, continuing to repeat the mantra that the mental health system isn’t broken and a few tweaks powered by a couple of million extra bucks will keep it on track, their own cuzzies in the Office of the Auditor General (OAG) have been able to easily spot the signs of collapse.
Not enough beds for acute mental health patients, patients being discharged too early from these units with in many cases little or no ongoing support or accommodation plans are some of the findings of the OAG. Of course, a quick scour of the social media pages reporting on mental health issues could have told them the same story – these issues have been reported on for some years – but when faced with unpleasant facts like this, the first refuge of bureaucrats is to set up a review to enable delays take the heat out the issue.
Only this time, the fire in the kitchen was too strong and too obvious, and the ‘review’ by the OAG had no choice but to admit it was consuming the joint and, perhaps inadvertently, notify all that there was nothing in place to stop it.
Interestingly, they added that families and communities concerned with the welfare of their loved ones and friends and whanau needed to be consulted a lot more.
My family’s Facebook page in memory of our son, ‘Nicky Autumn Stevens’ has received quite a few comments backing up this story over the last 2 years. Only two weeks ago, at a Waikato DHB meeting, management reported that occupancy of the DHB’s only acute mental health facility was running at over 100%, with patients at times sleeping on portable beds in corridors and in normally private meeting rooms.
This particular facility was built 15 years ago, and in that time the local population has increased by 50%, with mental health issues in the community increasing even more quickly – but no change to the facility throughout that time shows a DHB and a Mental Health service asleep at the wheel.
Answers to the problem lie in several areas: a root and branch, full-scale independent Mental Health Inquiry is urgently needed to look at the overall issue of, and solutions to, the mental health crisis; the culture of shooting patients full of drugs without a holistic approach to healing is needed; more acute facilities are needed urgently; more nursing, support and medical staff trained in New Zealand are needed urgently; families, whanau and communities need to be listened to and given status in a new system; more community facilities and services that support people with mental health issues both before and after acute treatment are urgently needed; poverty, which strongly links to poor mental health, needs to be addressed – the list could go on for ages.
These answers will not be found by Coleman and a bunch of time-serving, hui-hopping bureaucrats sitting on their chuffs in Wellington. The community must continue to pile pressure on them and their paymasters until the issues start getting seriously addressed.
Dave Macpherson is TDB’s mental health blogger. He became a Waikato DHB member after his son died from mental health incompetence.