Close Wakari, report says

Southern District Health Board acting mental health, addictions and intellectual disability lead executive Gilbert Taurua (left) and SDHB chief executive Chris Fleming hold ‘‘Time For Change’’, the organisation’s review of mental health services. PHOTO: GREGOR RICHARDSON

"Time For Change", an independent Southern District Health Board-commissioned review of mental health and addiction services in Otago and Southland, was released yesterday.

Among the 35 recommendations in the 136-page report is that the SDHB clearly signal that adult mental health and intellectual disability inpatient facilities at Wakari will be closed.

"An independent health and safety report has found the facilities to be unsafe and to pose ongoing and significant risk to staff and patients," the report, compiled by consultancy firm Synergia, said.

"The parts of the site currently configured to be inpatient wards/units could be repurposed for other uses but should no longer be used to provide inpatient care for people with mental health, addiction and intellectual disability needs."

Provision of forensic psychiatric services at Wakari was more complex and required considered and careful planning but that, too, should be closed in its current form, the report said.

"Closing the Wakari site is not just about closing an outdated facility.

It also signals that the DHB has heard the voice of consumers, respects the workforce that work at this facility, and is serious about people’s safety and wellbeing.

"It reinforces the fact that effective inpatient care is critical to any well-functioning mental health and addiction system, and it also signals a commitment to the scale of change required to improve the system."

SDHB chief executive Chris Fleming said the board accepted the report and was committed to funding the change.

"We need to signal that the facilities here [at Wakari] are nearing the end of their life.

"One of the options would be a closure of the site completely, another idea would be exploring other options within it.

"Spending too much money to modernise a building at the end of its life just doesn’t make sense."

Preliminary designs for the new Dunedin Hospital include a possible dedicated emergency psychiatric service, but mental health services were omitted.

The review’s other recommendations included reconsidering the future use of another facility considered inadequate, the Fraser building in central Dunedin, better resourcing rural hospitals and general practices to provide better mental health care, improving provision of youth mental health services, and boosting Queenstown and Central Lakes region community mental health teams, which were between 20% and 30% under-resourced.

Maori mental wellbeing also needed closer attention, and a 4% boost to that dedicated budget was recommended.

SDHB acting mental health, addictions and intellectual disability lead executive Gilbert Taurua said there had been under-investment in Maori mental health needs for some time.

"We have a really good spread of kaupapa Maori providers across the district ... but the report identifies a need to place greater focus in this so as to lower the number of patients coming through our inpatient units."

The review was commissioned by the SDHB after a similar national review of mental health services identified an urgent need for improvement.

DHBs are set to be scrapped in a year as part of a wide-ranging health system reform planned by the Government.

Yesterday Health Minister Andrew Little said two measures of improved mental wellbeing would be included in new national health indicators.

Miramare mental health service director Kerry Hand said the review was thorough and highlighted well-understood issues with how the mental health system functioned.

"It is hard to see the concrete reallocation of funds in this report ... resources are actually lavish but in the wrong places and shifting anything brings hell down upon the heads of the managers."

Mental health service reviews had been done in 2004 and 2010 but nothing had improved.

"Time For Change" key recommendations:

• "Signal intent" to close inadequate facilities at Wakari Hospital.
• Develop crisis response options; focus on Queenstown, Lakes and Waitaki.
• Day services to become community wellbeing hubs; focus on Invercargill and Dunedin.
• Increase funding for Maori providers from 2% of mental health budget to at least 6%.
• Create  new mental health and addiction services executive role.
• Introduce  mental health and addiction services workforce development plan.
• Further review alcohol and drug services.