Hard News by Russell Brown


Media Take: the poor health of mental health services (updated)

Last September on this site, psychotherapist Kyle Macdonald wrote a post under the provocative title The stark reality: New Zealand no longer has a functional Mental Health Service. In the post he noted that the week prior Auckland had lost eight acute psychiatric beds. Staffing levels at the North Shore Unit, He Puna Waiora were so low that it was not possible to staff the unit safely.

Kyle also noted:

Since then we’ve heard that the same situation exists within the Auckland District Health Board who currently have 18 vacancies within their acute unit.   Counties Manakau DHB is also experiencing staff shortages with many staff working double shifts just to keep the unit open.

The Auckland DHB Community Acute Services, who manage acutely unwell people in their home to prevent them going into hospital, has now been closed altogether due to not having any staff available to run it.

The PSA believes that many other regions face the same issue, including Wellington and the West Coast.  They have called these cuts just the “tip of the iceberg” when it comes to the reality of the problems we now face in the public mental health sector.

Last week, that happened: it was announced that up to four beds at Wellington Hospital are to close because of staffing issues.

Around the time of Kyle's original post, NZ Doctor published a news story headed Ryall’s removal of mental health from priority list persists under Coleman’s reign. The story noted that while mental health services were still officially (ie: according to the minister) "ring-fenced" as a result of the 1996 Mason Report, which led to sweeping reforms of the mental heathcare system, in practice that does not appear to be the case. It quotes then-Green party Health spokesperson Kevin Hague:

Hague cites the 1996 Mason Report and its “game-changing solutions” as evidence of what an inquiry can achieve, but says the gains have been eroded.

“Before Mason, mental health used to be called the Cinderella service,” Hague says.

“We’re absolutely back to those days, probably worse.”

He’s on the same page as Labour’s Annette King in arguing why. Both say it goes back to the decision by former health minister Tony Ryall to remove mental health from the list of priorities.

Hague's calls for a fresh inquiry into the system fell on deaf ears. But Kyle, Mike King and others embarked on a project with ActionStation called The People's Mental Health Review, the results of which are now being collated.

Kyle and Mike both appear in this week's episode of Media Take.

In researching the show I tracked down the 96 Mason Report – or to give it its full name, the Inquiry Under Section 47 of the Health and Disability Services Act In Respect of Certain Mental Health Services.

The report was commissioned after a series of tragedies associated with failures in the mental health system. Reading it, it's impossible not to be struck by the similarity between the conditions it described 20 years ago and the flaws critics are identifying now – most notably, the way that acute services are increasingly having to do the work of under-resourced community-based services. It feels as if the hugely important reforms after Mason are unravelling.

The show also features Mental Health Foundation CEO Shaun Robinson, who doesn't use such strong language as Kyle and Mike – and that's the subject of some friction on the show – but is nonethless frank about his "disappointment" with the state of the system and the government's failure to address its problems.

There's also Māori clinical psychologist Pikihuia Pomare, who is fascinating, and the excellent Lucy McSweeney, a protege of the Foundation's mentoring programme who has launched a petition seeking to have mental health education made a compulsory part of the schools curriculum.

And it's not all bad news. We note in the show that on the same day last month not only did Jono Pryor deliver a stigma-shattering message on talking about mental health issues after the suicide of a friend, but The Rock radio host Bryce Casey talked about the same thing.

Given the problems in the system, it seems especially useful that guys like these  – blokes talking to blokes – are using their public profiles to talk about mental illness.

Anyway, it's a good show, along with the additional 15 minutes of discussion with all the panelists together. There are links below to watch both on-demand and we'll also bundle it in together with some other stuff for the hour-long Media Take that screens at 11.30am on Sunday.


On-demand links:

Media Take Episode 4

Episode 4 extended "open floor" discussion

Media Take (the long version) screens at 11.30am Sunday on Māori Television.

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