Opinion: Mental health service in crisis - still

It’s the small stories that get to you.

1 NEWS Columnist Dita DeBoni Source: 1 NEWS

Like the one told to me by a psychiatric nurse recently, about how budget cuts had led to the closure of a small community centre that took in people with mental health issues during the day, giving them somewhere to go to chat to others, play games, pass the time. Relieve some of the stress on their already overburdened families.

Although it sounds melodramatic, it’s absolutely true: the nurse was crying as she described the devastation of the families that relied on that very threadbare service to improve the quality of their lives.

This week we are once more reminded that the mental health system is in crisis, with the update by Kirsty Johnson in the Herald on autistic man, Ashley Peacock, who has been locked in an isolated mental health unit for five years; a place so isolated his long-suffering parents have never been inside.

This is a heart-breaking story, and certainly not an isolated case.

The care of psychotic patients is, of course, extremely complicated. But the key part of the story is identified by psychologists working in the system themselves: Ashley, and people like him with "complex needs" do not have services – or not enough services – in enough places around the country that will allow them and their families decent quality of life.

Kirsty’s story today suggests the Ombudsman’s office, which monitors how many patients are kept in long term seclusion, doesn’t know how many are dealt with this way.

It also notes that the Ombudsman has suggested to the Ministry of Health it build some secure, individualised units for patients with high and complex needs considered candidates for seclusion – but they have not been built.

Combined with an already huge number of stories detailing budget shortfalls for mental health funding – particularly in Christchurch, but across the country – and story after story about underpaid, overworked mental health workers, it all points to a system in crisis. A system in crisis, for people in crisis.

And again, it’s the little things that add to the whole.

The Government has just revealed it’ll slash government funds for the country’s budgeting service by $3 million (despite denying it two weeks ago). Relationships Aotearoa has been scrapped.

Fourteen other social service providers have also lost their funding in the last round, the cuts hitting regional services particularly hard.

These services may be small but they all work to keep families and lives together. They are all part of the mental health picture.

It’s interesting to compare these stories of families struggling to get help for their children with a recent story in the Listener, in which Health Minister Jonathan Coleman big-notes his successes in the health portfolio.

His metric of success is that more people have had elective surgery, people are living longer, and specialist appointments have gone up. He bemoans the fact that more young medical graduates aren’t looking at careers managing DHBs – “Because they are great jobs. If you are running a major DHB you might be on $500,000 - $600,000.”

Apart from regurgitating industry lines about obesity, there’s little that seems to light his fire about the health portfolio apart from how fast it will get him into the “top 5” in Cabinet.

There is not one mention of mental health in this entire expose of his inner workings. In any case, he’s apparently now passed the responsibility for fronting questions about mental health to Sam Lotu-Iiga, the minister recently relieved of the Corrections portfolio.

There’s a telling line in Dr Coleman’s interview, where he says he has no desire to be the Opposition spokesperson “because it’s hard to be credible once you’ve done it”.

It’s hard to be credible while you’re doing it too, if you are a person, like Dr Coleman, who is happy to sit back and say nothing do nothing while an entire system designed for the most vulnerable people in our society collapses around your ankles.