Mental health with Dave McPherson: Some lessons we ought to be learning from the USA….
A few days ago, a hard-working local mental health campaigner sent me an article from the Boston Globe, the leading mainstream media outlet in the liberal-leaning New England part of the USA. Its Spotlight investigative team is running a series of articles on the state of mental health care in Massachusetts state, and it lead off with this:
“One by one, nearly all the state psychiatric hospitals were boarded up or bulldozed, but Massachusetts leaders broke their promise to replace them with something better — or much of anything at all. The failed mental health care system has led to a public safety crisis, including scores of murders by disturbed people, police shootings, and embattled institutions from courts to hospitals confronting a tidal wave of mentally ill people.”
The scenario sounded bloody familiar to me, so I read on about a litany of violence and deaths involving people suffering from mental illness, their families, other families, inadequate community and inpatient services and a bureaucacy and medical profession with their collective heads in the sand (or in even darker places).
The series summary concluded with the sentence:
“The result is a system that’s defined more by its gaps and gross inadequacies than by its successes — severely underfunded, largely uncoordinated, often unreliable, and, at times, startlingly unsafe.”
Thinking about the recent terrible Bremner case, my own son’s death while in the ‘care’ of Waikato DHB, the death of Sam Fischer while in Wellington Hospital, the closure of beds and wards in the Waitemata DHB’s mental health facility, and a host of other horror stories from this country, and especially from affected families and whanau, it isn’t hard to see our mental health care decision-makers have doomed this country to repeat those mistakes.
To help this process along, local authorities persist in importing failed and/or dodgy ‘mental health professionals’ from the USA to impart their ‘knowledge’ and to practice on desperate locals – two of these characters had lead responsibility for our son’s care at key times, and many others have been snapped up by DHB’s around the country.
In the USA, moves to close Victorian era and other old-style ‘mental hospitals’ gained pace during the 1970’s and 80’s after some well-publicized ‘One Flew Over the Cuckoo’s Nest’-type institutional horror stories, but instead of being fully replaced by community-based care facilities and services, integrated with each other, the replacements became a series of privatised, and pseudo-community services, starved of funding, lacking integration, and unavailable to many sectors and areas.
Mental health bureaucrats and ‘professionals’ in NZ have collectively followed the same path, and even those seeing the problems the community sees every day are slow to voice concerns, timid in their approach, and usually supremely arrogant in thinking only they have the ability to make any changes.
More reasons for a full-scale, community-led review – and complete overhaul – of our mental health services.
Dave McPherson is TDBs mental health blogger and a Waikato DHB Member-elect. He ran for office after his son was killed by the mental health system in NZ.
I feel for you Dave.
The only obstacle you need to overcome, goes by the name, Jonathan Coleman and as you rightly point out he is
” usually supremely arrogant in thinking only he has the ability to make any changes”.
Yet he will go into hiding and a statement that he is unavailable for comment is all us common folk hear whenever there is a mental health event.Then occasionally the common folk will hear the tired line…”under this government we have put more into health than any other government” In other words Coleman has not got a clue that it is fact he, whom is responsible for the gross underfunding, understaffing and neglect of mental health services. As you say Dave, supremely arrogant.
Just to emphasize the supremely arrogant attitudes National ministers take, todays piece on David Bain.
So Canadian judge Ian Binnie QC report was flawed and discarded yet the Governments hand picked judge Justice Ian Callinan QC will not be challenged:
“Amy Adams replied to say there was no need to discard or peer-review the Callinan report, as Karam suggested, because it was a draft only.
She suggested Karam write directly to Callinan with any concerns.
When Callinan’s final report was released in August this year, a second document was released where he responded to Karam’s complaints.
He chose to “offer no comment” on many of the criticisms but noted where corrections were made to the draft report.”
Full story below.
http://www.nzherald.co.nz/politics/news/article.cfm?c_id=280&objectid=11750530
This man was declares as not insane, hence his conviction and sentence. But I bet, that man has had serious mental health issues also, with catastrophic results, as nobody acted upon it, or bothered to care. When you drive sick people to despair, they will possibly react in “insane” manners in a moment that at least is close to insanity:
http://www.stuff.co.nz/national/crime/77612963/russell-john-tully-went-from-nicest-bloke-to-killer
I am actually surprised we have not had more of such tragic incidents. I know from good sources that WINZ had intended to try a harsher approach, a bit the UK style, when going to get sick and disabled off benefits and into work.
Given some unexpected developments, where they were seriously challenged on a number of issues, they seem to have backed down a bit with their approach, trying it in a slightly less draconian manner. Nevertheless some “assessments” by their Designated Doctors still raise eyebrows.
Mental health in NZ is in crisis, I know enough about it, as people are not getting the treatment they need. WINZ has limits to the disability allowance at about 61 dollars per week, so how can you get proper treatment when it is not subsidised (many professionals charging close to 200 bucks a session)?
If you are on a benefit and experience a patch of poor mental health, you would think it would be your doctor who decides how long you should be excused for job search obligations. Think again. WINZ only accepts a 1 month medical certificate, and then another 1 month certificate, and only then do they accept a 3 month certificate. Who the hell do these bureaucrats think they are? They are not medically qualified, and they should have no role in deciding the duration of medical certificates, that’s the job of the person’s doctor.
As a result of this policy, a person suffering a crippling breakdown of mental health, has to make and attend a series of doctors appointments, and come up with about $40 per visit while living on the smell of an oily rag ($40 is about 1/4 of the average weekly benefit). Potentially they have to carry each certificate across town to a WINZ office, since they often won’t let them be faxed or scanned and emailed. If each certificate is not received and processed well in advance of the previous certificate expiring, the person’s benefit can be automatically canceled, leaving them with no money, while potentially in no state to cope with the consequences (eg eviction from housing).
Is it any wonder homelessness and violent incidents are at epidemic levels in this country? What makes me furious is that most of this could be prevented by a properly funded mental health care system, and a welfare system designed to actually support people, not punish them. One solution could be to have the IRD manage the payment of benefits and the repayment of debts caused by overpayment. Automated computer systems should have no power to cancel someone’s benefit, which should required due process involved at least two humans checking the person’s circumstances and ensuring they do have alternative sources of income.
” slow to voice concerns, timid in their approach” (and soaking up overloads, stress and frustration.)
It’s either that, or have your funding cut to ribbons.
Any ‘review and revision’ of the mental health sector must also take into account services to schools – right down to kindergarten and pre-school, AND the prison service which is, too often, the last resort.