Overhaul of mental health system required

Starving mental health services until they are at crisis point is barbaric, writes Nola Harris.

After a spate of depressing media releases in the past few months relating to the state of mental health services in New Zealand it was uplifting to read the ODT editorial (18.05.17) which highlights Mike King's sudden resignation from the Government's suicide-prevention panel and urges him ''to find an outlet in which he can work successfully to prevent the suicide of New Zealanders''.

The newspaper also strongly advises that both Mike King and Sir John Kirwan, also well-known for his work in the area of mental health, keep the pressure on officials to set achievable goals for reducing our soaring suicide rate and address other mental health issues.

In 2003 I attended the 25th annual conference of the Schizophrenia Fellowship of New Zealand (now rebranded Supporting Families in Mental Illness) in Christchurch.

The keynote speaker was Prof Charles Rapp, from the United States, founder of the ''strengths model'' of mental health care designed for delivery in the community and which had replaced the previous inquisitorial approach. The model focuses on an individual's personal strength and ability to control their own recovery rather than on the illness itself.

John Miller, of Dunedin, also spoke about his research into schizophrenia. He referred to his book Straight Talking About Mental Illness, first published in 1995, in which he proposes that mental illness is a science and as such should be a core part of school curriculum. A guest speaker was then Labour minister of health, Annette King.

NZ psychiatrist Prof Graham Mellsop demonstrated by means of graphs and whiteboards the reduction of hospital beds and falling re-admissions was proof of the success of community care.

The process of deinstitutionalis-ation started in the 1960s. Back then psychiatrist Fraser McDonald, one-time superintendent of both Kingseat and Carrington hospitals and in the 1970s, high-profile advocate for retention of high-quality psychiatric care, issued what has proven to be a prophetic warning, that there would be dire consequences for patients if the equivalent amount of money then allocated to psychiatric services was not transferred to community services.

In June 1966 the committal order that had banished me to Seacliff Hospital for a period of two years was quashed six months into its term and I was released from Cherry Farm after spending the final four months there.

Five decades on from what history has judged to be a barbarous period of psychiatric care, the number of mentally ill at any particular time is dictated by the number of hospital beds available and appropriate community care is difficult to access.

It is hard to see how depriving a society of mental health treatment until crisis point is reached, not providing appropriate clinical oversight for psychiatrically disturbed prison inmates who can be subjected to treatments recently condemned by the Ombudsman as amounting to torture, and refusing to commit to targets to reducing suicides is much less barbaric.

The Government should now tell us why $1 billion is being spent on building a new prison that current statistics indicate will house a significant proportion of inmates suffering psychiatric issues and at a time when the provision of community mental healthcare services is at an all-time low.

We need to know why it is more advantageous to the economy to criminalise individuals with known mental health issues rather than building appropriate clinical facilities in the community. The Health Minister needs to convince us that his denial of any crisis in mental health is not because he is comfortable with OECD suicide statistics which place us in the upper half of the list, flanked by Australia and the United States.

There have been many changes in government since the 1960s, and both major parties are complicit in creating the crisis that now exists. The 1984 Labour Government can take credit for accelerating the decline in provision of services across all public health sectors and current leader Andrew Little's promise of free GP visits for those seeking mental healthcare remains empty of any commitment to reinvest in necessary support systems.

Glaringly absent from his recent announcement is any mention of Labour's stance in relation to the absence of targets in the Government's Suicide Prevention Plan.

Nothing short of Mr Little standing beside Mike King, public acknowledging current suicide statistics as totally unacceptable and then committing to a comprehensive overhaul of the mental health system will prove he is not merely attempting to score points ahead of the upcoming general election.

It is also to be hoped that Mr King can convince his colleagues that ignoring the subject of suicide sends a clear signal Labour is not only comfortable with the status quo, but remains a long way from a stated intention of returning to its grass roots.

-Nola Harris is a Dunedin resident and self-confessed serial survivor.

[The Government announced an injection of $224 million over four years for mental health in Thursday's Budget. - Ed]

 

Comments

Nola, great column. Just a comment that the Clark government funded work placements through MSD, when Pete Hodgson was the Minister.