As Mental Health Minister Matt Doocey says, sitting in a brightly lit, busy emergency department is not the best environment to be in when in mental distress.
Late last year, Dunedin Hospital became one of six major hospitals in the country to have peer support workers with lived experience on hand in ED to help those arriving in mental health crisis.
Before that, and possibly even now, we suspect many people have thought twice about exposing a family member or friend to an ED visit because of the feeling it might add to their trauma.
Sometimes that might mean the distressed person does not receive the help they need.
Crisis cafes offer what Mr Doocey describes as an alternative, calm, peer-led, non-clinical space to go to for support for people experiencing mental health or addiction challenges.
As well as that, he says, they also better connect people with community services.
So far, around the country, there are only plans for eight such outlets, and to date Christchurch and Dunedin are the only two South Island centres to have them.
The Dunedin cafe will operate over two sites, in Northeast Valley initially from the end of this month and South Dunedin from mid-May, run by experienced mental health provider Otago Mental Health Support Trust.
The support will be provided by people with lived experience of mental distress and recovery.
However, with limited opening hours only on Tuesdays and Saturdays, at a total of 16 hours a week, it is difficult to assess how effective the two centres might be as an alternative to an ED visit.
We would hope there will be a full evaluation of the impact of these cafes around the country to see what difference they are making for the people and the communities they serve.
If it is found they have a significant support role in the system, then consideration should include how more communities outside large centres might be involved.
While the involvement of those with lived experience is to be applauded, the push for more trained mental health workers in all roles within the system must continue apace.
Hopes for new unit
There will be high hopes the new nurse-led surgical assessment unit (SAU) at Dunedin Hospital will make a significant difference to pressure on the emergency department.
It will provide a dedicated space for clinical nurse specialists to begin assessments and order tests for patients presenting with acute surgical conditions, while also liaising closely with the surgical team.
It sounds like a no-brainer in terms of efficiency, an alternative to having acutely unwell patients languishing in ED wondering when they might eventually get to see a specialist. The unit can cater for 11 people, in six beds and five reclining chairs.
Patients referred to the unit are either admitted to a surgical ward or discharged with a care plan if surgery or inpatient care is not required.
The Southern district, which would also include Southland Hospital, in the quarter to December last year, had reached the shorter stays in ED milestone for 2025-26.
That was for 77% of all patients presenting to be admitted, discharged or transferred from an ED within six hours.
However, it is still a long way off the 2030 target of 95%.
The success of initiatives such as the SAU have much to do with staffing at all levels of the hospital.
Whether there will be enough staffed beds in the busy winter season for all patients who need to be admitted remains to be seen.
