Dave Macpherson: Mental Health staffing shortage PLUS culture deficit
Mental health workforce shortage statistics published this week demonstrate a staffing deficit that will surprise no-one except Health Minister Jonathan Coleman. But what they don’t show is the major culture change needed within that workforce that will also be needed to make a real difference to the effectiveness of this country’s mental health system.
Yesterday, on my family’s Facebook page in memory of our son, was placed the following comment, responding to the fourth story in as many months of a suiciding Palmerston North mental health patient:
“if someone is truly intent on ending their life they will succeed regardless of all the safety plans put in place”.
Over the last 2 years, as we raised issues concerning suicide and mental health, we’ve received a small but steady stream of almost identical comments from people identifying as mental health sector workers, to the point where it seems likely that this attitude is part of the psychiatric and nursing training given to staff working in this field.
15 months ago, one particular such obnoxious comment was received from a Waikato DHB Henry Bennett Centre mental health nurse, telling us to ‘get over’ our son’s death, suggesting it was inevitable. Wisely, the Director of the service at Waikato DHB instructed that person to apologise to us, and promised she would be educated. However, we are well aware, from the continuing comments like yesterday’s, that the attitude is pervasive around the sector, and in some parts of the community.
My family is concerned that you would still have many of the current problems with poor/inadequate treatment, no matter how many mental health sector staff positions are filled – while such attitudes are widespread.
We know many mental health staff work hard, and try to do their best in difficult circumstances, but much of that good work is undone every time one of their colleagues admits defeat before they even start.
I’m not aware of any mental illness that is automatically a 100% death sentence – treatment (not necessarily chemical), empathy, proper care and support, involving of family, whanau and friends; these are all factors that can help a person mitigate the effect of mental illness, and in many cases recover from it.
Our son Nicky Stevens was diagnosed with acute schizophrenia, but for the majority of the time he ‘carried’ that diagnosis, he was communicative, involved, active, passionate and clearly collected a wide circle of friends. When his psychosis became severe, he needed people physically around him to keep an eye on him, and mainly just to talk with him. Being left alone caused the most problems, but we thought a secure ward, with 24/7 care, at the largest public hospital in the Southern Hemisphere could surely manage to keep enough of an eye on him to keep him from damage.
Nicky lived with this situation for some years, and we were aware of several other family members of friends who had got through the worst of their similar illness and were able to live productive and happy lives.
What we didn’t take enough account of was a collection of mental health staff who effectively had attitudes like the ones expressed above, psychiatrists who thought (and probably still think) they knew better than his family and friends, and an incompetently-managed facility where ‘public service’ was not the kaupapa. Having our son involved in that particular part of the mental health service, under the ‘care’ of people who thought like this, was the worst thing that could have happened.
It angers us immensely whenever we hear this sort of comment, as we know that other people will die, or be damaged, as a result of this attitude, that culture, in our mental health services.
That is one major reason why we know that more staffing alone will not be enough, and we therefore support the call for a full-scale, independent review of mental health services, where the culture and ethos of these services can be exposed, dissected and re-assembled into something that supports our communities and meets the needs of the hundreds of thousands suffering from mental illness.
Dave Macpherson is TDB’s mental health blogger. He became a Waikato DHB member after his son died from mental health incompetence.
The Mental Health System in NZ has gone backwards in the last 30 years in my opinion ?
I tried to talk about suicide with Wairarapa locals after Chelsea Brunton’s funeral – I was met with the same comment. When they’ve decided to do it there is no stopping them. That was in the community, I said that’s not true, that people aren’t getting help they need, but the woman wouldn’t believe me.
Made me really sad, cause I am often suicidal, only reason I don’t do it is because I know mental health and government want that – getting rid of the weakest they are persecuting with their advancing of rich and persecution of poor for profit.
I know suicidal people put in Arohata by police for begging for mental health care in Wairarapa.
After my protests last week several people came up to me and said they had also had health ‘professionals’ tell them to do a good job if they suicide, cause nobody like cleaning up the mess if they failed. In my case Dr Cherry told me if I did attempt suicide to do a good job as doctors didn’t like cleaning up the mess.
Wairarapa now No. 1 in New Zealand for suicide and still ACC and mental health refuse me all care and tell community, police etc that ‘lots of people have tried to help me, I just don’t want it”.
I don’t want abusive, degrading, unprofessional care FOR SURE, I want care I am entitled to under law, that I have won two ACC reviews to have reinstated. I want professional treatment and rehabilitation models applied – not be experimented on with drugs. I want a safe stable home to live in and the care I need to I can get back to work, even though my life is now destroyed and I have absolutely no hope for the future.
At 52, after losing my home and not working for over a decade, only suffering, poverty and fear to look forward to rest of my life. Of course I wish I was dead, so do most people I know who live in the darklands of this neo-liberal hell hole.
Thanks for sharing this JR, this is the sort of culture that is part of the problem.
Time for Johnathon Coleman to go!!!!
He has turned his back on the aged also with taking away any dental assistance for urgent repairs if the teeth are causing extreme pain!!!!
So the aged can’t bite or eat to live!!!!!!
So Coleman has assigned the aged to die!!!!!
Because without the ability to eat now the aged now cannot afford to pay the VERY VERY EXPENSIVE DENTAL WORK WE FACE NOW.
Damn Johnathon Coleman to hell, – as he is so damn cruel!!!!
The whole health system is fucked. A friend had a fall on Friday night and broke their arm, still awaiting surgery on the injury, now scheduled for Thursday, almost a week after the incident and I suppose, no guarantee that date will not change as it has already, twice, to draw out to Thursday.
Hi Dave. Can you provide a link to the Mental health workforce shortage statistics. I am very eager to see the stats.
Regards
Bert
Hi Bert – try this:http://www.radionz.co.nz/national/programmes/ninetonoon/audio/201849671/figures-reveal-under-staffing-of-mental-health-sector
It was a Radio NZ official info request, which they built a programme around on Monday morning this week (9-Noon show).
Dave
Thanks Dave. A quote from the link…
“Nurses Organisation mental health section chair Gina Soanes said nurses continually told her they were under pressure.
“There’s the expectations that they are always on doing overtime and things like that and the turnover puts a lot of pressure on them. People want to do the best for the work and their patients, but the pressure is too much for them sometimes,” she said.”
Why are there financial pressures on DHB’s to the point that unfilled positions are still listed as vacant. So if there are 27 or so unfilled mental health nurse positions at roughly $60,000, over 1.2 million, is this a way the DHB’s can show a savings for Coleman? I can see why staff are overwhelmed and under pressure to the point of resignation.
Sadly, hardly surprising your son didn’t get the required experienced attention he so sorely needed Dave.
Meanwhile, there is a spare $5 million for our rich yachting. Priorities?
Agreed Samwise and at a time when it was sadly needed, we spent 27 plus million wasted on an unnecessary bloody flag referendum.
Probably to busy sniffing coca cola cans ?
It is all about the New Global Agenda which has been going on since WW2
with the Global Elite creating world chaos so more controls can be put in place, let them out of the Institutions and start procreating and upsetting the gene pool, meanwhile the elite can have their selective breeding programs with the beautiful people and A Listers.
There is a Method in the Madness, Douglas was one of the architects along with overseas interests, Harold Titter was the man imported from offshore to implement the changes, I can remember my father who worked in Mental Health being extremely angry with Titter, probably because he had an Uncle Jack who was the Gardener at the Avondale Mental Institution in Pt Chevalier ? Just guessing somewhat ?
NZ has the highest score on an APEC ‘Integration Index’ for mental health (released last year). This measured implementation of ‘effective mental health policies’, including ‘services and programs available to assist people living with mental illness integrate more successfully into society.’
Pretty scary huh.
Thanks for the post Bomber and Dave,
Like police, rest home workers and various other jobs there are those that put their all into a job and take each case on its individual merits, use compassion, empathy and understanding and apply patience and love to their work.
There are those that lazily make assumptions based on ego, lack of empathy, lack of patience. I suggest to some extent we are all capable of both.
The latter is more likely to happen in a poor, underfunded, undersupported, overstressed work environment.
I go back to a couple of things Mike King says.
1/ we live in a very critical/ judgemental society
2/ We need more than just money, we need to do a stock take
3/ Medication should be a last resort, not first line of defence. No one ever became mentally ill or depressed due to a lack of SSRI’s.
I’m not an expert in this field but I’ve seen 3 people go through it, 2 struggled with side effects from SSRI’s and the third is a long story one of you is already privy to involving a very young girl from an excellent home who is now institutionalised but still to this day hasn’t had any counselling, no CBT, no psychotherapy. Like it’s a dark art no longer practiced.