Dave Macpherson: It will take more than $s to fix our broken mental health system

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Since the Government’s budget announcement of a large spending increase in the mental health area, it has followed up with specific initiatives, including the recent establishment of the new Suicide Prevention Office, and increased spending on Maori & Pacific suicide prevention and school counselling and mental health support.

That is all well and good – it is necessary and potentially very useful.

BUT, and here’s the rub, throwing money at the problem while keeping with the same culture in the mental health industry, and the same leadership in the profession, will risk all of the Government’s good intentions having either little effect, or having such a long lead time for real change that things like the horrific suicide statistics will not show the trend reversal that this Government needs to prove its got on top of the issue, and in reality is a better custodian of the mental health budget than the Canutes in the last, unlamented and uncaring National Government.

A selection of recent stories and local cases brought this problem home to me.

Late last month, Newshub published an article pointing out that in the most recent 12 months period, Wellington DHB’s Adolescent Inpatient Service had 35 cases of inpatients going sufficiently ‘missing’ to require missing persons reports to the Police – some of the patients going missing more than once. Anyone following what happened with my son, and the consequences of several other high profile cases where patients went ‘missing’ from mental health facilities, could be excused for wondering what the hell those in charge of this taxpayer-funded service had learnt from past mistakes – perhaps nothing, being my thought. Incidentally, there were 5 suicides in this facility during that period, although the relationship to the 35 ‘missing’ patients is not spelt out.

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Predictably, the manager in charge, one Nigel Fairley, immediately played the ‘excuses’ defence card, partly blaming a temporary facility, and partly blaming some of the patients themselves! This is par for the course with officials in the mental health system, who are pathologically incapable of saying, for instance, ‘sorry, we stuffed up. We will learn from our mistakes and improve our act.’ In fact, I believe the mental health profession has a compulsory training module in “how never to say sorry, or to admit mistakes’; probably funded by the medical insurance industry.

A couple of months ago I attended a portion of a Coroner’s Hearing into the 2015 death in Thames by police shooting of Vaughan Te Moananui; it was absolutely clear from the evidence we heard there that the Waikato DHB mental health ‘professionals’ (one a contractor) responsible for Vaughan’s care didn’t provide the support and care they were supposed to, and were trying to cover their backsides in the hearing. Now, while the death occurred 4 years ago, the mental health ‘professionals’ were giving evidence in 2019, but clearly with zero willingness on their part to accept any responsibility.

In the last three weeks my partner Jane has supported two families who have contacted us, at their wits end as to how to support seriously ill family members who were technically in the care of Waikato DHB’s mental health services. Not only in both cases were the patients previous inpatients at the Henry Bennett Centre, but there had been a clear lack of follow-up support and care for them, to the point where both became very ill again, with no pathway of help open to the families who were trying to help, and no information about where to go. Eventually the police helped in one case, and my partner was able to convince DHB management to sort out urgent better care for the other person.

Both cases screamed out to us that the mental health profession generally had not changed their ways from the period our son died while in their care, and that there was no evidence of any learning from past mistakes, other than perhaps at senior management level – a level that is rarely accessible by patients and families in need of urgent support. A clear lack of culture change and good leadership was obvious.

So, Jacinda, you need some new thinking influencing the mental health industry – from the top down, and via much better training, from the bottom up. Otherwise there will be more disasters and more shocking statistics that will reflect poorly on your Government, no matter how much money is pumped in.

 

Dave Macpherson – TDB mental health blogger & Former Waikato DHB Elected Member whose son died while in mental health care.

4 COMMENTS

  1. Thankyou for being such strong advocates and spokespeople for change in the mental health system.
    Just today I found out there is No support or help within the system. Other than emergency respite; allocated 72 hours, then back home, with no suppport or help.
    This is very hard to share, but it is important…..
    I have a history of multiple traumas and have PTSD and relatively rare dissociative identity disorder as a result of abuses, traumas, major losses, natural disasters, survivor of crimes and I will add the mental health system.
    Recently I have had multiple significant triggers, these have accumulated, some are ongoing.
    Due to these there have been mental health relapses. Serious ones.
    Mental health services have been aware and it was a battle of three months, to receive any ongoing supports. This was abruptly and irreversible harmed by a DHB pyschologist stating a month ago that all traumas experienced in this life were “karma…as in paying back past lives” and “when someone has gone through early abuse, thay may create situations of adult trauma”. I stopped seeing her Yet it had a life changing significant impact and furthering mental health deteriation. Trust was gone as it was already tentative trust within the mental health system given remote past harmful experiences with their “services”.
    Last week there was a period of dissociation and dissociative states that lasted 22 hours. There was a police search. When there is dissociation due to significant triggers, stress and distress there is a very high suicide risk in a dissociative state and “I” have no memory or little memory. Managed to somehow get home although wet and disorientated (evidence at being at the beach-drowning attempt and loss of memory and where had 22 hours gone). Police were very kind (as they have always been-there have been other dissociative state episodes during this time), are aware of PTSD and DID. They are very aware trust in mental health services is limited to nil. They took a photo in the event I need to be found, as they are aware high likelihood of this happening again.
    I chose to go into respite the next day; into the mental health ward.
    There I was told by the psychiatrist that a case manager would be reinstated, the community support worker hours could be increased, at some stage have a group meeting with that pyschologist and would be supported to voice concerns, impact of toxic comments and where to from here, so to speak as well as an appointment with a psychiatrist next week.
    All this week waiting for a phone call re what I felt were positive hopeful and supportive plans even though trust was shattered.
    Today I find out there is to be No case manager at all, No community support at all. None. The community team Dismissed what the hospital stated that needed to and suggested to be done.
    Their answer (the community mental health team)….
    They can not lower risk level. As in suicide attempts or completed suicide while in a trauma based dissociated state.
    (And personal judgement) quite likely, DID is relatively rare therefore do not “know” how to help.
    Left with no human compassion, isolated, no supports, harmed by mental health and at risk of suicide while dissociated and dissociated state.
    Heart is broken, mind has fragmented further and soul is shattered….and complete self blame for abuses, traumas, major losses, natural disasters, survivor of crimes (even though two offenders were sent to jail a and for one crime I have permanent name suppression).
    Have been numb tonight (shock no doubt as to the mental health system Again)and all stress, distress, triggers and I do not know what each moment may bring. I do not know who to trust anymore.

    • Please share, you have my permission. If only to be heard/read. The mental health system is Not trauma informed compassionate care based (quite the opposite with its medical based indifferent treated like a hospital number based, saving dollars). I have no idea how “my (our) story” will end; I (we) cant go through any more traumas or harms; this much I (we) know….
      BUT Most Importantly This needs to change for Others. Please. No other person should ever go through what has happened in my (our-dissociative identity disorder) situation.

    • Incredibly sorry to hear of your trials, and especially your recent dismissive treatment by the MH system. Unfortunately, this sort of story is all too common. Those making decisions on MH need to read stories like this, and to start putting themselves in the shoes of those going through these traumas.

      • Thankyou kindly for replying. I have no hope yet what would be a blessing if at all possible (I do not have funds available; living on $100 per week after power and rent)….
        I have had my daughter taken from me, robbed and assaulted, attempted manslaughter, sexual violations and other atrocities, traumas and again including mental health systems harms.
        As I say I have no hope and isolated (including christmas day alone; if still here-not a threat just a truth at this time) But considering it is this time of year it would be a blessing that all people in pyschiatric units across the country received a christmas card with a special message; one that resonates in hope, empathy, being heard, kindness and compassion etc. Many of the people in wards are isolated and to be in there on christmas day-new year will be very very hard for them.
        I am alone, isolated and do not want others being alone.

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