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.
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.