Concerns are growing about the number of mentally
unwell people spending repeated time in prison and then
falling through the cracks when they return to the community,
sometimes with tragic results. Bruce Munro looks at the
statistics and talks to those affected and those calling for
Prisons are New Zealand's largest mental-health institutions.
The streets are our second largest.
It can be difficult for people with mental illness,
particularly if they have been in prison, to find their
place in society again. Photo by Jane Dawber.
Once upon a time we locked up everyone who was not
"normal" and "good".
They were the "mad", the "bad", the "sick" and the
"disabled". And we had a different place for each of them -
asylums, prisons, hospitals and infirmaries.
But then we closed most of our mental hospitals and sent the
vast majority of the residents on their way. The cracks in
care yawned wide, people with mental illness got into trouble
or did terrible things, and we often put them in the only
place left - prison.
Today, mental illness is rife among the more than 8600 men
and women in our country's 19 prisons. More than half have
lifetime psychotic, mood or anxiety disorders. Twenty percent
are "thinking a lot about suicide", and nearly 60% have mild
to severe personality disorders. The vast majority of
prisoners with mental illness have the added complication of
long-term substance abuse.
Rev David Brown
And when they have done their time, we send them out
Vincent [surname withheld] was released from prison for the
eighth time earlier this year.
Of Ngati Porou descent but raised by a Pakeha family in
Otago, he has been incarcerated for 17 of his 39 years. That
does not include two years in Cherry Farm psychiatric
hospital, north of Dunedin, where he was diagnosed with
paranoid schizophrenia at the age of 15.
Nor the year spent at Dunedin's Wakari psychiatric hospital
after Cherry Farm was closed in 1992. Nor a year at
Hillmorton Hospital in Christchurch ...
With nowhere to live when he was released from Milburn's
Otago Corrections Facility in February, Vincent slept under
bridges and in Dunedin car parks for about a month and
a-half, until he got into trouble again.
"There were meds in prison, but I stopped taking them," he
"I suppose I was fighting the system. I was angry, not
sleeping, not taking my meds.
"I thought I could be well but I wasn't ... I came out a
Dr Warwick Brunton
After several weeks living rough, and in an agitated
state, Vincent wanted to be admitted to Wakari Hospital but was
told there was no room. He was given some medication and told
to come back the next day. He took all the pills at once and
then, sometime after 5pm, entered the yard behind the South
Community Mental Health premises and used rocks and a chair to
do $50,000 worth of damage to vehicles parked there.
"Whenever I do my crime, I've always showed remorse and done
my time," he said.
"I'm just really pleased those cars weren't people that day."
The judge ordered Vincent to pay $3000 reparation and gave
him a six-month home detention sentence so he could continue
a community drug treatment programme.
Since then he has been living in a boarding house off High
St, in Dunedin, with about 13 other tenants who are former
prisoners, former mental-health patients or both.
In the late 1800s this part of town was known as the Devil's
Half-Acre, a notorious triangle formed by Princes, Maclaggan
and Maitland Sts where slumming, sweated labour, prostitution
and drugs were commonplace.
More than a century later its legacy continues in the form of
sometimes squalid rental properties housing dozens of
ex-inmates and former psychiatric patients.
It is where community worker Carol Frost witnesses poverty
and despair on a daily basis.
Cherry Farm in 1957. Photo from ODT files.
"It gets you down. The hopelessness of it is
soul-destroying," she said.
"We see the same people over and over, and try to help them.
"If they have family support it's difficult but not
But if you have no-one to support you and make sure you take
your medication and pay your rent, you deteriorate.
"If you are living in a dive and all the people around you
are drunks and drug addicts, what chance do you have?
" It was a catch-22 situation, she said. They find it hard to
get accommodation, and at least the landlords give them a
roof over their heads. Some of the houses are run down, but
if they were spruced up their present tenants would have
nowhere to stay.
New Zealand "threw out the baby with the bathwater" when it
closed most of its mental hospitals during the 1990s, Mrs
She lists the problems her clients face. There is not enough
support and care in the community for people with mental
illness, Wakari Hospital's emergency psychiatric beds are
almost always full, and the wait for help from the Community
Alcohol and Drug Service can take weeks, she says.
Add to that discrimination by prospective employers and you
truly have "a vicious cycle".
The cases she knows of, involving people with mental illness
who have been in prison, are as plentiful as they are sad:
someone living under bushes near Dunedin's Otago Settlers
Museum during the past winter until the bushes were removed;
a man presently living under trees in the city's Town Belt;
another recently returned to prison for parole breaches ...
"When he takes his medication he feels good," she says of the
man sent back to prison.
"So then he feels he shouldn't have to take it and so he gets
"A number of mental-health people are thrown in jail because
there is nowhere else to keep them and others safe.
"At another time they would have been in a secure place,
where they would feel secure." Mrs Frost thinks an effective
solution would require "lots of money and a change of
attitude from government and society".
"But that won't happen. We've become too selfish," she adds.
Critics say New Zealand "threw out the baby with the bath
water'' when it closed many of its mental health hospitals
including Cherry Farm (pictured), north of Dunedin, during
the 1990s. Photo from ODT files.
Dr Warwick Brunton, of the University of Otago's
department of social and preventive medicine, said that for
more than 100 years we locked up an increasingly wide variety
of people who threatened or concerned us.
But by the 1970s there was a growing realisation that a
proportion of those in mental hospitals did not need to be
"A 1974 survey showed a quarter of all patients with a
psychiatric diagnosis, and 45% of those with an intellectual
handicap diagnosis, were capable of independent living," Dr
Brunton, who is a mental-health policy researcher, said.
This late-blooming tolerance did not result in much change at
the time, but was used by those promoting fiscal austerity in
the 1980s to help justify the wholesale closures of the
In the course of a few decades New Zealand went from 10,000
state psychiatric hospital beds to fewer than 1000.
The aim, since the mid-1990s, has been for the Ministry of
Health's specialised mental-health services to care for the
3% of the population with the most severe mental illness,
while primary health services cater to the remaining 17% with
mild to severe mental illness.
It is often community organisations, such as the New Zealand
Prisoners Aid and Rehabilitation Society and churches, who
end up having the most regular contact with the more unwell
component of this larger cohort.
The Rev David Brown, of Church of Christ Community, says
"mental-health difficulties" are common among the 40 to 70
people who turn up to the Dunedin church's St Andrew St
drop-in centre on Friday evenings. Some of the regulars have
been in and out of prison several times.
"You often see them function well for a while and then go
downhill and get in trouble and go to Wakari [hospital] or
prison, and then it all starts again."
They have become the detritus of 21st-century life, he says.
People with mental illness living in the community used to be
able to find work, often low-skilled, which gave them
something useful to do and a group of people to keep an eye
"But now there is no place where they fit and no sense of
dignity. How do you feel hope?" Mr Brown asked.
"Society runs on this super-efficient model. But it means we
leave a whole lot of people behind. We need to provide them
not just with benefits but also a place in society."