Funding a problem for mental health changes

While pressure continues on the Otago District Health Board's short-staffed existing mental health system, planned new services are still dogged by funding uncertainty.

Last month, the board spent about $200,000 for 162 bed days at the private Ashburn Clinic because Dunedin Hospital's acute psychiatric ward 1A could not accommodate all those who required admission.

Nursing shortages in mental health mean staff are working plenty of overtime and the board is using clinical nurse specialists skilled in mental health and risk assessment to support staff in its wards at Dunedin and Wakari Hospitals.

The new services, if they had been introduced, might have taken some pressure off the existing system, but their funding is still not settled and board chairman Richard Thomson is no longer hopeful of a solution this financial year.

The nine new services announced a year ago were to use $5.5 million of mental health money, which cannot be transferred to other health areas, and should have been introduced from July.

They included a post-natal depression service, community and home support for children under 13 and a service to help clients retain their rented accommodation. Only one of the services, a residential youth recovery service, is in place.

The problem faced by the board was that while it could fund setting up the services, it might not be able to support their operation from its population-based funding without cuts to services other than mental health.

Mr Thomson said the board was still in discussions with the Ministry of Health over the matter. He understood the ministry, which had shown a genuine concern for Otago's predicament, was reviewing the whole issue of mental health funding, which he believed was also affecting other boards.

It was frustrating and disappointing, but any future funding system had to ‘‘get it right''.
He had no idea what the outcome of the review might be, but believed having separate formulas for mental health and other services could work.

Money would have to be spent in the area allocated and could not be shuffled between mental health and other services.

In the meantime, it would be irresponsible to prioritise the new services and set up some of them with the money in hand when their ongoing funding was not assured, Mr Thomson said.

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