Increased patient numbers, staff confusion over system changes and current systems not being user-friendly have led to just one in three mental health patients having a current discharge plan, the Southern District Health Board says.
The SDHB was quizzed over this poor result in supplementary questions asked by Parliament's health select committee following the board's annual review last month.
The supplementary answers also revealed the SDHB is still struggling to move mental health records from paper to electronic form, two years after an Auditor-general's report called for all DHBs to upgrade their information systems.
In its annual report, the SDHB recorded just 30% of people in specialist mental health services had a current transition (discharge) plan - its target was 95%.
"This result was disappointing for Southern DHB," its response to the committee said.
It was at present moving from its current mental health plans to a "more aligned `wellness transition plan'," but the change of names had caused some confusion for staff.
It was still trying to achieve consistency, with not all staff acknowledging in the electronic system that a discharge plan had been developed and completed.
The SDHB had developed a "clinical workstation [Health Connect South] `Paper-lite' project" to address upgrading to electronic recording, but it was taking "longer to achieve than anticipated", the board said.
"The current systems are not user-friendly for staff, have duplication and require people to move between electronic and paper systems," it said.
"A recent change in the data entry stage [all staff enter their own data] was not fully taken up in time for the quarter 2 report, which meant that many staff did not accurately input the correct value to `count' a discharge plan."
Corinda Taylor, from suicide prevention charity Life Matters, said the SDHB's mix of electronic and handwritten records was below acceptable standards of care, and handwritten records were unacceptable.
"The system that is still primary paper based in the 21 century is failing our people in crisis, since the clinical records cannot be accessed after hours and therefore many clinical decisions are then made without clinical details.
"General health clinicians would not accept that as good practice, so why should mental health clinicians be satisfied with the status quo."
In the modern world it should be an expectation patient records could be readily accessed electronically so a full picture was available for a clinician interacting with a patient, she said.
"Continuing to defend an outdated antiquated system instead of implementing the electronic system seems totally counterproductive and a waste of good resource ... "
The SDHB said it had undertaken some actions to address the Auditor-general's concerns, including increasing the integration of service delivery, greater monitoring of transition plans, reviewing discharge guidelines and auditing rural mental health services.
"We have high confidence that either a wellness, recovery or relapse prevention plan is in place for long-term service users," it said.
