Mental Health Professionals know best (Yeah, right!) – Dave Macpherson Mental Health Blogger
The Faceless Health bureaucrats will see you now
Plastered on the wall outside the entrance to the Ward at Waikato Hospital’s Henry Bennett Centre (HBC) where our son was a patient is a large sign promoting the need for the service to ‘earn the trust of the family’, in order for the DHB to do their job effectively.
A laudable and sensible aim, you would think; but one that our family quickly realised was at best a box-ticking exercise, and for the senior clinicians our son Nicky saw, something they had no intention of taking any notice of.
The reason this is important comes down to two factors – firstly, as anyone with any lived experience in the area of mental illness easily observes, mental health and treatment for mental illness is an extremely inexact science, and family, whanau and others close to someone affected by mental illness often have as good an idea of what is needed to make their loved one well as do some of the perhaps overworked, and certainly disinterested ‘professionals’ appointed to ‘care’ for the patient. Often the family just want some support and a listening ear to help them with the strategies they already have in place, or to give them some ‘time-out’ from the relentless grind and stress involved in caring for a mentally unwell family member.
Similarly, most care and support of people with mental illness is undertaken by family and whanau members, who better understand the day-to-day effects of mental illness on both the person directly affected, and on those around them, than do ‘professionals’ who might meet the ‘patient’ for 30 minutes, once a week – or less.
For the overwhelming proportion of people affected by mental illness, full family/whanau involvement in their care and treatment plans is an absolute necessity, but is rarely practiced by mental health services around this country, especially inpatient services, and is actively scorned by many service staff, especially the more highly paid ones!
Some examples: this week, a guy I’ve been supporting as he and his daughter struggle to ensure some quality care is provided for his former wife, who is suffering some pretty severe problems, was excluded from a meeting between his wife and the most senior psychiatrist at Waikato DHB. It was the first meeting between the woman and this psychiatrist, and despite the guy having organised the consultation, and provided almost all the support for his wife over the last seven months, and his wife wanting him present, he was excluded.
The guy had also been excluded from an earlier consultation for his wife with a senior occupational therapist, again one that he arranged. So all of his insights into his wife’s issues and care were not available to this ‘know-it-all’ profession. It has taken seven months for the DHB to institute the care plan for his wife that the guy asked for right at the start. Incidentally, the same psychiatrist was involved in, and in overall charge of, our son’s care when he died.
Late last year, a friend of mine was supporting (as a client) a person who had come to him regarding an employment issue, but also had some severe mental health issues. The person with the employment issue had no family in the Waikato, so after consulting family in Whangarei, my friend went to the DHB mental health services with his client to attempt to arrange some care and treatment for him. Although his client was accepted as an in-patient, my fiend had a number of concerns about the (lack of) treatment plan for him, and attempted to advocate on his behalf at the HBC, only to be served a trespass order by management, barring him from visiting his client, even though he was this person’s only personal friend or family member in the area.
Other families have described to my family also being ‘trespassed’ from the HBC when they have got in arguments with staff about the care for their family members or friends.
When our eldest son went into the HBC ward that Nicky had disappeared from to search his belongings for clues as to Nicky’s whereabouts, HBC management called security guards to remove him (the same security guards who mounted no search for Nicky when he disappeared). A week earlier, while Nicky was still alive, one part of the HBC management reluctantly agreed to our family’s insistence that Nicky be only given ‘leave’ to go outside if escorted, while the very next day the American psychiatrist in charge of his ‘care’ unilaterally rescinded that agreement, without consultation or notification to our family, allowing Nicky unescorted leave – which he took, and died as a result of.
The link between these examples is the lack of genuine involvement of families in the care of mental health patients, the ‘we-know-best’ culture of the mental health profession, and how outcomes could have been different if families, whanau and friends had been listened to.
Dave Macpherson is the father of Nicky Stevens, who died while in the (compulsory) care of Waikato DHB’s Henry Bennett Centre, and is now an elected board member of the Waikato DHB. The opinions expressed are entirely his own and do not necessarily reflect the views of the Waikato DHB Board or its management.
“while the very next day the American psychiatrist in charge of his ‘care’ unilaterally rescinded that agreement, without consultation or notification to our family, allowing Nicky unescorted leave – which he took, and died as a result of.”
I struggle to understand how health professionals can make such arbitrary, unilateral decisions without consultation with other health professionals and with the family. The decision to allow Nicki out only with an escort should’ve been recorded on his case files.
If it wasn’t, that speaks of incompetance.
If it was, and the clinician over-ruled it, then he must be held to account and processes put in place throughout every DHB not to permit unilateral decision-making to take place.
We don’t let surgeons operate without consultation. I believe the mental health profession should operate in a similar manner, esp[ecially if a patient is “red flagged”.
Thank you, Dave for sharing this and informing us.
It was all recorded on various files, but the situation in mental health in this country is that the ‘lead clinician’ is in charge of the ‘case’, and even though HER boss told all staff ‘no unescorted leave’ for Nicky, she, after her very first, 30-minute meeting ever with Nicky, overruled that – and we knew nothing about it for several days – in fact my partner Jane was right in the middle of arguing with this arrogant psychiatrist about this, when Nicky was reported missing.
Mental Health in New Zealand is truly in crisis, it has been for many, many years, although a few years ago, that was under the last Labour led government, some humble progress was made to improve availability of some community mental health services.
The Nats are bean counters, do not believe this talk about their “investment approach”, there is much hype around it, but little truly effective action, and little funding.
I know of a case, where an abused woman, this goes back to 2008, was actually, due to language problems and due to grave mistakes made by the responsible health board staff, put into “care” of her abusive partner (as custodian or care-giver). Once the mistakes became obvious, even done through a court process, the mother of that young woman coming from overseas to try and get her daughter out of the mess, the services and the managers did all to close ranks and stonewall.
The matter was swept under the carpet. Misdiagnosis happened, negligence happened, appalling decisions were made, and only after years of desperate efforts did the mother of the abused migrant manage to get her daughter out of the arms of the abuser and away from the hopeless mental health services. They only offered the odd two to three day respite break to her, a psychiatrist to see for 15 minutes once a month, and a mixture of medication, that caused more side effects and harm than any good.
That is what many face, and beware those, who come from countries as migrants, where they do not speak English, and have insufficient knowledge of what goes on here, they run the risk of serious shit to happen. It happens to Kiwis, as we know, even those where honest family support is available, but denied access. So imagine how traumatic is must be for a person who has poor English and no friends or family around her.
It is time for a serious Royal Commission of sorts, to clean up the mess, and for getting a government committed to actually fund these necessary services, also more addiction treatment. In the meantime we continue filling our prisons with more people who go through the mill and get little or no help. What a disaster this country has become, for too many.
Well said, Mike!
At the recent inquest into my 15 year old sons death the “professionals” really showed their true colours. They were determined not to be held to account for any of their wrong doings. It took me 4 years to get to the inquest stage and during that time Whirinaki (CMDHB) had the chance to implement some new initiatives in order to change their horrendous incompetency. They came along to the inquest with a glossy pamphlet full of the wonders of the changes they had made. I had a QC working for me and he cornered them, he got them to admit that they hadn’t actually implemented any of the changes that this pamphlet was lauding, they were just hoping that the pamphlet itself would do the trick. And trick it was, I saw many “professionals” take the stand and lie, lie very unconvincingly too. The awful truth is that these same people have just changed agencies and are still out in the community pretending to help, I fully intend to name and shame as soon as I have the findings. We need to wake up to the fact that we have NO FUNCTIONING MENTAL HEALTH SERVICES in NZ. I see all these ads and instructions for where to go for help and I shudder to think of all the future victims of these useless agencies.
I have supported a number of friends and family members through serious mental health breakdowns and recoveries, in many different parts of the country. I think it’s worth noting that the quality of care is very uneven. In my experience, the Canterbury services treat their patients like livestock, while those in Wellington actually engage with patients as people, even while they are in the clutches of serious breakdowns, and do their best to help them get back to independence and stay there. Even within regions the care can be uneven. The mental hospital on the North Shore of Auckland is like something out of the 1980s, while the services at StarShip Hospital are leading edge and world class.
We can do so much better to support everyone’s mental health in this country. Firstly, we can address the many avoidable stresses that drive vulnerable people to break down; abusive work situations, sociopathic landlords, uncaring beauraucrats, and so on. Secondly, we can provide more training and resources for primary health care providers, so they can identify the early stages of mental illness and nip them in the bud before they become full-blown breakdowns. Thirdly, we can provide more outpatient services, supported housing, and respite care facilities, so people can maintain or restore their mental health before they get to the point of needing a stay in hospital. Finally, for those cases too severe for breakdown to be prevented by all of the above, we can provide world class mental health wards where our people can be cared for with compassion and respect for as long as they need, and helped back to independence as quickly as they can handle. The excellent Mother and Baby Unit at Starship Hospital is a model example of an effective inpatient service.
Dave I was in CHCH last week and quite by chance was playing my Reverie Harp at a friends house when her daughter and a young man arrived. He was really responding to the harp so I gave it to him to play which he did for close to an hour. He opened up about his mental unwellness journey this past 18 months both committed and in respite and stated if only this instrument had been available it would have made all the difference for him. He talked about being left alone for long periods of time with just a TV and how this was the worst thing for his unwell mind.
The young woman who I now think may be suffering depression also responded to the Reverie Harp sounds and commented how she felt herself ‘relaxing and clarity of mind restored’.
I truly believe this beautiful healing instrument has a role to play in mental unwellness recovery and prevention of suicide.
I am at present journeying for the next three years on what I am calling my ‘Leap of Faith, On A Wing & A Prayer Tour’ around NZ seeding Anam Cara Care a centre Reverie Harp Heart & Soul Healing into every Province finding people who are passionate about being involved in this new paradigm of holistic heart and soul care in every realm we as humans suffer from trauma, loss and grief.
I am constantly shown the amazing power of live Revrie Haro sounds, the gift of which is this beautiful instrument can be played by anyone. Immediately.
I will be at ‘Voices Sacred Earth Festival, in Albany 24th, 25th, 26th March where I am available to talk with anyone about the benefits to mental health of live Harp music, played intuitively so it ‘takes the mind’ out of the equation. Perhaps I can call in and visit overnight (I am towing my caravan) with yourself and Jane as I head North ? and we can discuss this further.
I am also playing and introducing Reverie Harp in Dunedin March 7th at the BBS Group Support meeting courtesy of Corinda.
I am also meeting with individuals bereaved by suicide along the way.
Namaste
Gwynna
Five times last year mental health patients were given electroshock therapy after they had explicitly withdrawn their consent, which is a human rights violation: http://vjmpublishing.nz/?p=641
The mainstream media ignores this, no investigation is planned, nothing. No-one cares at all. Sometimes it feels like the health system is actually trying to kill mental health patients, but they have to do it in subtle ways because eugenics isn’t allowed any more.
Fantastic post.