Dave Macpherson – Last minute election bribes won’t cut the mustard, Coleman

A week ago, outgoing Health Minister Jonathan Coleman announced what was claimed as “17 new mental health initiatives” (more on that later).

In the week following, a number of stories about mental health hit the mainstream and social media.

As well as giving the lie to any suggestion that the outgoing Government were finally getting on top of the mental health crisis, public reaction towards Coleman was pretty universally derisory. I mean, how credible is a promise to spend millions on mental health only six weeks out from an election, when you’ve had the demand – and opportunity – to start “fixing” things for six-nine years?

Certainly, the pay-equity campaigning mental health workers and supporters that ran Coleman and English out of Dunedin Hospital on Saturday didn’t believe the election bribe was either genuine or useful to them.

There was nothing in Coleman’s mental health election bribe for them. Worse was the Ministry of Health’s leaked letter to DHBs from early July, warning DHBs not to settle on pay equity payments, and if they had, to reverse them. That sort of stupid interference in industrial negotiations often leads to industrial action, shows bad faith on the part of the Government, and always leads to ill feeling.

Mainstream media have claimed that Unions asked for mental health workers to be excluded from the initial claim, but the PSA gave the lie to that in a media release late last week that said Coleman himself had ‘made it clear’ that the Government would not settle on the rest-home workers’ pay equity claim IF mental health staff were included.

So running Coleman out of the Hospital was the least the workers could do. Management at Waikato DHB have reported to its Board that there is a serious risk of further understaffing in the mental health area if the pay equity claim is not settled, and settled quickly; support staff numbers are haemmoraging.

Then came the terrible story out of Whangarei, where a mental health patient in community care, and supposedly under a regular regime of visits and observations, had been dead for 6 weeks before the body was found.

This sort of thing is not as uncommon as you’d like to think. Our family Facebook page published this story, and immediately received reports of other similar incidents with mental health patients in recent years. Our son was not seen by his ‘community treatment provider’ (Hauora Waikato) for over six weeks, despite being under a Compulsory Treatment Order, and shortly afterwards had to be hospitalised after an unsuccessful suicide attempt. He died two weeks later.

Almost all community care arrangements are DHB/Government-funded – many of them are a joke, are underfunded, employ untrained or inappropriate staff, with many of them being poorly supervised and lacking empathy. ‘Crisis Assessment Teams’ (CAT teams) are not available for much of the time they are needed, or in many of the places they are needed. DHBs are unable to effectively monitor the organisations they contract to do this work – in some cases they are unable to even get patient files when patients transfer between acute and community services.

The entire community mental health care sector is a mess, and forms a major part of the change requirement that the Government proposals barely touch on.

During the week, experienced psychotherapist Kyle MacDonald, sharply criticised another aspect of Coleman’s election rescue package – the plan to fund ‘resilience training’ of school students; how individual young people can learn to cope with depression and other bad periods in their lives.

MacDonald made an excellent point, that the whole premise of this approach was to individualise the problem: ‘if only little Johnny or Julie could learn to handle the issues in their lives a bit better, they would suffer such mental health problems (including this country’s record youth suicide levels)’.

His point was that issues like poverty, poor health, drugs, unemployment poor education, and a lack of resources to support young people are the major contributors to a lack of ‘community resilience’. Resilient communities breed resilient people – the support structures and networks are in place.

Essentially MacDonald is saying the Government’s response in this space was typical of the neo-liberal focus on the individual. His finishing comment was telling:

“Teaching resilience without addressing the massive social problems we’re increasingly facing is like teaching people to swim in response to rising sea levels. Because even the best swimmers get tired, and without higher ground to swim to we all drown.”

And the so-called ’17 new mental health initiatives’? They were just a minor explanation of the budget package from two months ago – nothing actually new, and it took them two months to write the press release!