Difficulty getting access to the Otago District Health Board's emergency psychiatric service was one concern raised to the Mental Health Commission in its annual visit to Dunedin in November.
In a letter to the board giving feedback on the visit, chairman of the commission Dr Peter McGeorge said some consumers, families and non-government organisations (NGOs) felt help was not forthcoming until there was a life-threatening situation.
"Groups we spoke to wanted services coming in at a much earlier stage to prevent crises occurring."
The commission understood some work had been done on a model of care which would address these concerns.
In rural areas, access to specialty services remained a challenge because of travel distances and transport costs for poorer families, he said.
The commission spent three days in Dunedin, some of it with board staff, but much of it listening to the views of service users and community providers.
Its letter giving its findings has been circulated by the board to those in the community who participated.
Positive comments were made by the commission about work done to improve access to child and family services and alcohol and drug services.
In some instances this meant waiting lists had diminished or been resolved entirely.
In discussion on integrated care, the commission noted that transition out of services was patchy, with issues around sudden discharges where there could be little time to put support services in place for patients.
It noted there was work towards a more integrative approach, although some services were further advanced than others.
Some of those at the NGO forum felt they were being treated quite differently from the services provided by the board and considered this unfair.
School guidance counsellors and NGOs saw a serious gap in services to assist families where parents had a mental illness.
The counsellors also felt they had lost traction with the board because of the absence of a board liaison person.
The commission noted the people they met in services were very positive and enthusiastic about their work.
The commission viewed staffing as reasonably stable, although it thought this could change as the economy started to recover.
There was concern about NGOs maintaining services with flat funding, and some had indicated the possibility of redundancies to make ends meet.
Another challenge for the board would be developing the capacity to care for large numbers of elderly people who would be using the services over the next few years.
Dr McGeorge said expressions of concern had been noted from most groups that the current facilities needed replacement or redevelopment.
The commission is "very supportive of these initiatives proceeding".
The commission will write to the board in six months for an update on progress made in the areas identified as challenges, and will request that the board highlights areas where improvements have been made.
• Among the outmoded facilities for which the health board has been seeking funding for redevelopment is the acute psychiatric ward at Dunedin Hospital, which it wants to move to Wakari Hospital.
