Dave Macpherson – The Mental Health Inquiry – get involved

By   /   May 9, 2018  /   8 Comments

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Three months after taking office, the Labour/NZ First/Green Government announced an Inquiry into this country’s Mental Health services – after the previous National Government insisted for three years it was ‘on top of’ the issue, including New Zealand’s world record level of youth suicides, nationwide staffing crises in the sector, and fast-growing lack of confidence in the service from most communities.

Three months after taking office, the Labour/NZ First/Green Government announced an Inquiry into this country’s Mental Health services – after the previous National Government insisted for three years it was ‘on top of’ the issue, including New Zealand’s world record level of youth suicides, nationwide staffing crises in the sector, and fast-growing lack of confidence in the service from most communities.

National’s former Health Minister, the ‘Emperor With No Clothes’ (otherwise known as Jonathan Coleman) is a gone-burger, with Labour’s David Clarke replacing him and pretty quickly swinging into action on the this and many other lingering health disasters from the previous nine or more years.

While the proof of the pudding will be in the eating, and in particular will lie in the willingness of the new Government to fund the changes in the Mental Health sector that the Inquiry will certainly recommend, we are urging anyone at all with thoughts about a better way forward for Mental Health to participate in the Inquiry. There are several ways of doing this, spelled out on the Inquiry website here, so please get onto it!

There are a set of standard questions that the Inquiry Panel is asking (but you are not restricted to only commenting on those):

What is currently working well?

Our response to this is: not much! Other than the fact that growing numbers of people: communities, families and ‘patients’, are demanding change and are mutually supporting each other; plus the fact that some of the smarter politicians have recognised that significant change, not tinkering, is needed. There are the odd community-based services, and even some institutional services, that do good work, and there are many individuals working in the field that have great ideas and empathy, but all have been hamstrung by poor leadership and a poor mental health sector culture.

 

What isn’t working well?

Clearly, the culture I mention above is a major issue – no matter how many resources you throw at a problem like this, if the whole system isn’t headed in the right direction, you won’t get to the desired destination. Right now clinicians, especially psychiatrists as a profession, act as though they have all the answers, and patients, families and communities are at best annoying, box-ticking exercises. There is little wholistic about mental health services provided – with growing numbers of ‘patients’ being pushed out of residential care situations with no care or support plans in place, and many communities without even basic community care arrangements, let alone residential care facilities. Lack of sector accountability for mistakes, leading to an inability to improve or change, is another issue – which breeds the growing lack of community confidence in the mental health profession and leadership.

The current ‘model of care’ is essentially the ‘pill and pillow’ approach – drug them and if they are really in a bad way, lock them up as well (but only until you need the bed for someone else). It’s essentially the 1960’s American approach graphically shown in ‘One Flew Over the Cuckoo’s Nest’, with general hospital-based residential facilities instead of isolated Waikeria and Lake Alice-style ‘mental hospitals’. There is lip service at best to traditional Maori and Pasifika methods of supporting whanau members in trouble, and a lack of attention even to more modern American and European models where people’s whole lives are part of the ‘treatment’ process, with particular attention to the restorative role of art, music, physical activity, employment and housing. The significant link between poverty and mental ill-health is quietly spoken about, but never addressed.

There is zero support available from the official mental health services, and only available in the community from a scattered handful of hard-working individuals and small organisations – at the moment, you’re ‘on your own’ once you’re out of the hospital doors, or the worst has happened and your family member has died; little care, and no accountability.

Inquiry respondents then have the opportunity to say What could be done better?; and we call for a strong emphasis on prevention, education and awareness raising in the community, building resilience in the community, primary mental health care services in schools, universities, GP medical clinics and a wide range of community organisations. There is also the need for effectively-supported, independent advocacy services that are not dependent on DHB or Ministry contracts, and for the experience of families and whanau impacted by mental illness and suicide to be incorporated into these.

I welcome readers to take part in the Inquiry, and to use these comments as an introduction to the Inquiry documents if you wish.

Dave Macpherson is TDB’s mental health blogger. He became a Waikato DHB member after his son died from mental health incompetence.

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8 Comments

  1. Jack Ramaka says:

    We did have a functioning mental health service 35-40 years ago it might not have been perfect but at least we had a mental health service ?

  2. Jack Ramaka says:

    We did have a functioning mental health service 35-40 years ago it might not have been perfect but at least we had a mental health service ?

  3. Marc says:

    This whole inquiry is doomed to fail to bring needed solutions, given the man put in charge, one Ron Paterson, former HDC, then Ombudsman, who resigned much earlier than when his time was up. He faced serious challenges, as he covered for his former HDC Office and did not want to investigate issues at the HDC:

    https://nzsocialjusticeblog2013.wordpress.com/2016/03/28/how-the-hdc-throws-out-valid-complaints-and-protects-code-breaching-health-professionals-a-true-story/

    https://nzsocialjusticeblog2013.wordpress.com/2015/10/04/how-the-n-z-health-and-disability-commissioner-let-off-a-biased-designated-doctor/

    http://nzsocialjusticeblog2013.wordpress.com/2014/05/27/health-and-disability-commissioner-can-we-trust-in-hdc-independence/

    Some stuff he was doing before, refusing to investigate a senior Advisor within MSD, who deleted his emails, wholesale, with correspondence with senior outside advisors, who influenced government policy:
    https://nzsocialjusticeblog2013.files.wordpress.com/2015/08/ombudsman-complaint-o-i-a-to-msd-dr-bratt-publ-int-prov-dec-compl-hilit-22-05-15.pdf

    https://nzsocialjusticeblog2013.files.wordpress.com/2015/08/ombudsman-complaint-3xxxxx-msd-o-i-a-fr-16-01-14-bratt-presentations-anon-ltr-13-06-15.pdf

    https://nzsocialjusticeblog2013.files.wordpress.com/2015/08/ombudsman-complaint-msd-o-i-a-rqst-16-01-14-dr-bratt-presentation-info-hilit-dec-23-06-15.pdf

    https://nzsocialjusticeblog2013.files.wordpress.com/2015/08/ombudsman-complaint-abt-dr-bratt-deleting-emails-refusal-to-investigate-r-paterson-17-08-15.pdf

    https://nzsocialjusticeblog2013.files.wordpress.com/2015/08/ombudsman-complaint-dr-bratt-deleted-emails-refusal-to-investigate-r-paterson-hilit-17-08-15.pdf

    Ron Paterson is a legal expert and careerist, he has protected government, DHBs and other agencies again and again from serious and valid challenges and claims, and done stuff all to improve things. He is rather concerned with protecting doctors, psychiatrists and government agencies from challenges, so he is by his track record, not fit to do the job he has been given.

    He is two faced, will deliver some ambiguous report, and after all, nothing much will change. It will be hand wringing BS and talk and he will enjoy another big pay out, for his ‘services’ which are ultimately for himself.

    I despair how Kiwis fall for all this BS again, again and yet again, are you so ignorant or gullible?

    • Marc says:

      I have access to ample info, showing the NZ government, at least the last one, is or was CORRUPT, and that MSD and other agencies have covered up wrongdoings on a massive scale. A new email received by a highly reliable source today confirms this, even makes it look much worse, so one guy like Ron Paterson, having been presented equally condemning info before, he should know.

      He is not honest, he is part of the problem, and he should never have been appointed to this role, it shows how inept or even complicit Labour are in this whole cover up game.

      It looks more like a show, a cover up, a look good exercise, than a real and honest inquiry.

    • Dave Macpherson says:

      I agree with your comments about Ron Paterson- but you miss a good part of the point about this Inquiry; the fact that it as fought for by ordinary people & industry workers, against the wishes of the previous Govt, is telling. It gives an opportunity for those who’ve been harmed by the industry to speak out, and support others who are doing so. The recommendations of the Inquiry will be less important than the fact that a large group have been organised, in a sector where it is notoriously difficult to do that.

  4. LOLBAGZ says:

    If you’re looking for sanity, sorry but you dialed the wrong universe

  5. Anker says:

    Dave you may want to check out the service delivery model of Professor Ian Falloon an ex pat NZder.

    In the Uk in 1984 he implemented his model in rural UK. A cornerstone of his approach was integrating families into the treatment team. Mental health nurses were based at GP practices and all patients were routinely screened to determine if the had the early signs of mental illness. Mental health professionals would then visit families and patients in their homes providing treatment and care. This service got some impressive results. Worth looking in to