Speaker by Various Artists

Yes Article 14 - so powerful and clear. I understand Mary O'Hagan, then Mental Health Commissioner, had a say in its drafting. But until we have rights enshrined in a proper Geoffrey Palmer approved constitution the Mental Health Act will have more power than any of our international rights obligations and even the NZ Bill of Rights Act can be tossed aside on a whim.
(By the way I do recommend Mary O'Hagan's memoir Madness made me, for its insights into our system.)

I survived the 1969 Mental Health Act and the tail end of the institutions. Like many others I was miraculously "cured" by virtue of the new Act and the closure of the Bins, ie when they suddenly didn't have anywhere to lock people up for any reason indefinitely anymore. Those of us still alive from those days are very much survivors because many didn't make it out alive or cope with being deinstitutionalised. (Please don't forget it was purely financial, not idealogical reasons that institutions were shut down in the Anglo countries in the 80s/90s).

Some of us chose to give evidence about our experiences to the Confidential Forum under the Clark Govt over 10 years ago; the extremely damaging report was subsequently published, but we're still waiting for an apology from ANYONE. So offically the State will not even acknowledge what they did to us, yet alone apologise.

The general public has never wanted to know, or cared about the "loonies" and while I'm very pleased to see that mental illness in general is more spoken about now, and that a few brave high profile people are speaking about their experiences, the harsh reality is MH has been so stigmatised for so long it's ingrained in the public and politicians not not care until it affects them personally.

It took me almost 20 years to escape the System because I was institutionalised, and ironically left with PTSD as a direct result of my incarceration. But there are rare times I've need acute contact with the system and am well aware that it's flipped from they couldn't lock me up fast enough to "we'll call you back when we can". And you're right- like many others I know, I will NEVER tell anyone connected to the health sector if I'm remotely suicidal. Either they'll leave you too it or the cops will be breaking down your door. I'm still scared of them 30 years later even when I know they can't legally can't touch me. Friends who have been sectioned under the 1992 Act have similar problems. Once you've been sectioned for what ever reason, you can never trust them again. There is nothing worse than being incarcerated and losing your civil and many human rights without having commited a crime.

Apologies if I've rambled a bit; this topic's a bit hard for me to summarise.

Kay, it's great to hear from you and terrible to understand how the system operates.

Yes, Kay, we need an official, respectful national apology from the top on behalf of the State to all those abused by the State. At the launch of Elizabeth Stanley's recent book on the history of children in care, Jacinda Ardern promised such an action from the future Labour/Greens government.

Can anyone recommend any resources/sites for friends of people who have had mental health crises?

Great piece Andrea, and I agree more funding isn’t THE answer. But in my experience when the money and resources shrink, sectioning to ‘ensure safety’ becomes a proxy for meaningful engagement. When clinicians have more time and autonomy to form therapeutic relationships, in other words free to do their job, people are kept safe and contained.
When they don’t or can’t do this, an adversarial system flourishes fuelled by clinician burnout and clients feeling alientated, uncared for and dehumanised.
This is where we are now, sadly.

But in my experience when the money and resources shrink, sectioning to ‘ensure safety’ becomes a proxy for meaningful engagement.

That has been my own experience as a patient, and seems to accord with the statistics.

Over the 10 years from 2005 to 2014, use of section 29 community treatment orders rose from 60 per 100,000 population, to 85 per 100,000, increasing in a reasonably linear fashion year on year over that period. Some regions are much higher, in 2014 Northland DHB was the highest at 177, followed by Tairāwhiti DHB at 119 and Capital & Coast DHB at 111 (all per 100,000 population)

However the rates are much higher when you consider the gender and ethnicity of patients. In 2014 Māori men were subject to section 29 community treatment orders at a rate of 438 per 100,000, vs 116 for non-Māori men, or 3.8 times more likely. For women it was 195 per 100,000 for Māori women vs 62 for non-Māori women, or 3.1 times more likely.

When teams lack the resources to provide the levels of ongoing support required, they are more likely to have to resort to the Act to forcibly impose treatment. Which seems especially relevant for Māori – they are more likely to have difficulty accessing services, and therefore are likely to be more unwell on initial presentation. And when mental health services lack the resources to provide high quality culturally relevant support, they are more likely to use tools such as s 29 CTOs.

[All statistics from Director of Mental Health annual reports]