Government and Opposition on fixing the mental health crisis

It has long been known that mental health was being inadequately addressed by governments. It could be claimed (and is) that all health is inadequately funded, but mental health is a special case, and has been since the large mental health institutions were emptied and closed in the 1970s and 1980s. Community care was seen as a better option, but it has never really been done properly, at great human, family and community cost.

The last National government did the usual inquiries and came up with a plan late in their tenure, but the incoming Labour-led government scrapped that and went back to the drawing board – another inquiry. A year on they have just announced a plan that will still take some time to implement.

Labour’s health spokesperson Annette King on  21 February 2017 Kids suffering under mental health strain

A newly released report from the Ministry of Health on the mental health and addictions workforce shows a worryingly large vacancy rate in child and youth mental health services, says Labour’s Health spokesperson Annette King.

“The Mental Health and Addiction Workforce Action Plan 2017-2021 shows a whopping eight per cent vacancy rate in infant, child and adolescent mental health and alcohol and other drug services, the estimated equivalent of 141 full time positions unfilled.

“Every week we hear of failings in our mental health system from deaths in care, patient attacks, overstretched counselling services and crisis teams, with staff working more than 60 hours a week.

“The Government needs to do more than look at staff per 100,000 population, they need to look at how many staff are needed to meet demand and fund mental health properly.”

“A Labour Government will review mental health services…

King cited specific problems from a Ministry report but called for a review. Jacinda Ardern commented on it  on Facebook:

I find this staggering. There is such a huge demand for services and yet the vacancy rate for Child and Youth Mental Health Services is equivalent to an estimated 141 full time positions.

Mental health services have come up A LOT during this campaign, and for good reason. It’s time to review mental health services…

I find the call for reviews staggering, although one person (Liam McConnell-Whiting) laauded her words:

Yes Omg yes! Jacinda you speak the speak! NZs history of ignoring mental health issues, primary and secondary to other (better funded) health issues is a phenomenal shame.
Love to see you identifying this!!!

September 2017: What Labour promised, but will they deliver?

Labour promised to increase resourcing for frontline health workers, put nurses in all high schools and conduct a review of the mental health system in their first 100 days. It would put mental health workers in schools affected by Canterbury earthquakes and target suicide prevention funding into mainstream and rainbow community support organisations.

Labour would put $193m over three years into mental health, on top of the Government’s increase announced in the budget. It would conduct a two-year pilot programme placing mental health teams at eight sites – such as GPs – across the country. The programme would offer free crisis help for people.

A number of specific plans.

And Labour put together a government. Mental health was listed as a priority in the Labour-Green confidence and supply agreement:

16. Ensure everyone has access to timely and high quality mental health services, including free
counselling for those under 25 years.

There was a minor mention in the Labour-NZ First coalition agreement:

Re-establish the Mental Health Commission

In Taking action in our first 100 days Labour implied urgency saying they will hit the ground running in government, with a programme of work across housing, health, education, families, the environment and other priority areas.

  • Set up a Ministerial Inquiry in order to fix our mental health crisis

So they referred to it as a crisis, but chose an inquiry that has taken a year. On 4 December 2018: Mental Health and Addiction report charts new direction

Health Minister Dr David Clark says the Inquiry into Mental Health and Addiction represents a once-in-a-generation opportunity to rethink how we handle some of the biggest challenges we face as a country.

The Government has today publicly released the report of the Inquiry in full, less than a week after receiving it.

“It is clear we need to do more to support people as they deal with these issues – and do a lot more to intervene earlier and support wellbeing in our communities.

That has been clear for a long time.

“We are working our way carefully through the 40 recommendations and will formally respond in March. I want to be upfront with the public, however, that many of the issues we’re facing, such as workforce shortages, will take years to fix.

‘Fixing’ mental health care will always be an ongoing challenge, but there is a lack of urgency here.

“Reshaping our approach to mental health and addiction is no small task and will take some time. But I’m confident this report points us in the right direction, and today marks the start of real change for the better,” David Clark says.

“Today marks the start of real change for the better” is a nonsense statement, and will sound hollow to those who have been struggling with mental health for a along time, for some people a lifetime.

Two MPs, one from National and one from Labour, comment on progress in Virtue signalling or concrete action on mental health crisis?

Stuart Smith (National MP for Kaikoura):

Eighteen months ago, we established a $100 million fund to support mental health, which the current government duly scrapped after the election.

They then set about reinventing the wheel by launching their own inquiry into mental health and addiction services which, a full year later, supports the very initiatives that we had already identified for targeted funding.

The Prime Minister chose not to keep these initiatives in place, yet at the same time wanted a zero tolerance on suicides, a goal she has now shifted to a percentage reduction of 20 per cent by 2030.

This is nothing short of virtue signalling, and that is incredibly irresponsible. What we need at this time is action, and instead this government cut programmes, then spent a year coming to the conclusion that those programmes were exactly what the mental health system needed.

Priyanca Radhakrishnan (​Labour List MP based in Auckland’s Maungakiekie):

Over the last nine years, demand for mental health services increased by 60 per cent – but funding for these services did not increase by even half that.

Fixing the mental health system is a priority for this government – and it can be done. It requires commitment to understand the problems and implement sustainable solutions – and time. Almost a decade of underfunding and neglect cannot be turned around in one Budget.

The Prime Minister has spoken about her personal commitment to addressing it. The Finance Minister has signalled that it will be a priority in our first wellbeing Budget in 2019. So how are we tracking?

The Government committed to an inquiry into mental health and addiction services in its first hundred days. The report from that inquiry has just been completed and released and the Government will respond formally in March. This response will be a considered one that focuses on long-term, sustainable change rather than political expediency.

In the meantime, the government has committed an extra $200 million to district health board mental health services over the next four years. Low-decile schools, especially those affected by earthquakes, will be better resourced to assist children who may need support. It’s now cheaper for 540,000 New Zealanders on modest incomes to see a doctor, and free for children under 14. A pilot programme that will provide free counselling for 18 to 25 year olds is being developed. Our mental health and addiction support workers – 5000 of them – have been included in the Care and Support Workers Pay Equity Settlement. I’m proud to be supporting a government that cares enough to act.

Finally, as we work to fix the mental health crisis, we must remember that one size does not fit all.

As we work to fix the mental health crisis, we must make sure that we fix it for all New Zealanders.

Not all New Zealanders need mental health assistance. Some measures have been implemented, but after a year in Government it is warned that it will time to fix but is still being referred to as a crisis.

We will find out next March – 18 months after the election – what the Labour-led government plan to do to fix the mental health crisis.

Mental health discrimination or prudence in job applications?

It’s reasonable to expect that employers check properly whether job applicants are suitable candidates for the position. It’s also reasonable to expect job applications to not be too intrusive on a personal level.

Should an employer be able to find out whether an applicant is suffering from mental illness, being treated for mental illness or taking medication to treat mental illness?

RNZ: Job applicants face mental health discrimination – Greens

A Green Party investigation has concluded that there appears to be widespread discrimination against job applicants with mental health issues.

The investigation was launched after Green Party spokesperson for mental health Chloe Swarbrick held hui at eight universities across the country to better understand the mental health challenges facing young people.

It was during these hui that Ms Swarbrick said she was surprised to find out from people that they were being expected to disclose their mental health history on job applications so she launched an investigation.

“[We] heard some pretty harrowing and stressful stories – a number of people who were being required to offer up an entire shopping list of the medication that they’re on, other people who believe that they had been prejudiced from the job application process and denied the opportunity to prove their skill set.”

A number of the 59 submitters expressed concerns about what their mental health or medication information would be used for.

“What was highlighted was the number of people who weren’t given clarity around what that information was going to be used for but also, I think what people have to realise is that in a job application process there is a massive power imbalance.

“So when somebody is put in a position where they are being expected to disclose things and may not actually know their rights, that’s a really problematic situation for them to be put in.”

Perhaps that could be addressed by notifying applications of their rights in advance.

The investigation also highlighted that a number of large companies including Wishbone, Coca-Cola, Air New Zealand, New World, Countdown and PWC appeared to be avoiding hiring people with anxiety and depression.

“Rather than reinforcing a culture of stigma and fear around mental health, employers should be providing supportive workplaces and promotion well-being.”

Of course employers should provide supportive workplaces. The well-being of employees has an impact on the well-being of a business.

But employers should be able to consider whether a degree of anxiety or depression was a potential problem in someone being capable of doing a reasonable job.

Mental ‘illness’ can range from minor (and inconsequential in employment) to severe and a major risk.

We all probably suffer from some sort of mental problems at some stage of our lives – degrees of depression can vary a lot, relationship issues, stress (from work or home) can all affect just about anyone.

We already have a situation where discrimination in job applications is not allowed legally – for example on gender, age, race, religion.

But what this means in practice is that employers just have to be careful in what reasons they give for not choosing an applicant – bland ‘someone else was more suitable’ explanations are safe. Saying ‘your age of seventy five, and wanting six months off to go to China for a sex change, skin lightening and hair transplant operations as soon as your probation office and your psychiatrist allows’ risks a complaint of discrimination.

It is difficult to say how much an employer has a right to know about job applicants.

It could also be difficult in differentiating between discrimination and prudence in checking out the suitability of job applicants.

 

Mental Health Inquiry report being released today

RNZ:  Govt to release Mental Health Inquiry report today

The panel, led by the former health watchdog Ron Paterson, has spent roughly 10 months consulting people around the country, holding more than 400 meetings and considering about 5000 submissions.

It delivered a 200 page report and 40 recommendations to the Health Minister David Clark last week.

The government will release the report today, but will not formally respond with its plan until March.

Dr Clark has said the inquiry will shape the country’s response to mental health for years to come.

There is pressure on the Government to act quickly with claims that current mental health care is in crisis.

Like:  Teens face up to three month wait for mental health services

Teens needing non-urgent mental health services in the top of the south currently face a wait of up to three months before they are seen.

There had been five resignations in CAMHS team across the district in the past six months and there were three vacancies.

Working in mental health care is very demanding.

The Inquiry website:  Government Inquiry into Mental Health and Addiction

Our purpose was to identify unmet needs and develop recommendations for a better mental health and addiction system for Aotearoa New Zealand.

We wanted to set a clear direction for the next five to ten years that Government, the mental health and addiction sectors and the whole community can pick up and make happen.

On 28 November 2018, we presented He Ara Oranga : report of the Government Inquiry into Mental Health and Addiction to the Government.

The Government has indicated it needs time to consider the report’s findings, but expects to release the report prior to the end of the year.

Once the report has been released it will be available on this website in various formats.

That should be today.

 

Jami-Lee Ross ‘improving’, uncertainty over future

Jami-Lee Ross is said to be improving after surviving a “very real situation” on Saturday night and being sectioned and admitted in mental health care, but it will likely take time to find out what impact this will have on his future as a now independent electorate MP after the National caucus ejected him last week.

The Mental health Foundation is disappointed in how Ross’ mental health situation has been described and discussed in media including social media, and says it is necessary to separate political decisions from mental health problems – but this may not be simple given that Ross’ political decisions have been obviously influenced by his mental health situation.

NZ Herald – Jami-Lee Ross improving, getting the mental health help he needs – friend

Botany MP Jami-Lee Ross is improving but remains in the mental health wing at Middlemore Hospital, after surviving a “very real situation” on Saturday night, a friend says.

Concern for Ross’ health has amplified since he was picked up by police on Sunday and sectioned to a mental health facility.

“He’s a bit rough at the moment, but getting the help he needs. He’s in good care. Staff are wonderful,” said the friend, who did not want to be named.

“This was definitely not attention-seeking. It was a very real situation he was in on Saturday night,” the friend added.

It could take some time before we know what will happen from here.

Ross will continue to hold the seat of Botany unless he resigns, National leader Simon Bridges uses the waka-jumping law (a process that takes at least 21 working days), or Ross is deemed unfit due to mental health reasons (a process that takes at least six months).

The friend said there had been no discussion about whether he might resign, as Ross had “more important things” to think about at this stage.

Following Ross’ admission to hospital, several steps need to occur before Speaker Trevor Mallard would be notified that an MP was the subject of a compulsory treatment order.

Mallard said he had not received any such notice, but constitutional lawyer Graeme Edgeler said informing the Speaker was the last step in a process that could take weeks.

It was standard practice to take five days to make a mental health assessment, Edgeler said.

“But if the five days isn’t enough, it can be extended to 14 days. If those have happened and they still wish to compulsorily treat someone, they then ask a Family Court judge.

“If the judge makes a compulsory treatment order or an equivalent order, at that point the court notifies the Speaker.

“It would be exceedingly unlikely for a court to be involved at this early stage.”

If the court issued a compulsory treatment order, the Speaker would then ask the Director-General of Health and a medical practitioner to assess if the MP was considered “mentally disordered”.

If so, a further assessment would follow six months later. If the patient was still unwell, the Speaker would be obliged to inform the House and vacate the MP’s seat, triggering a by-election.

So unless Ross resigns the uncertainty looks like extending well into next year.

Early last week Ross said he intended resigning from Parliament on Friday, but on Friday he said he had changed his mind and would remain in Parliament.

It’s hard to see how Ross could function effectively now as an electorate MP, and he is likely to have lost a lot of support in Botany. Even if he recovers mental health-wise he would also have difficulty operating alone and discredited in Parliament.

Also uncertain is whether Ross will resume his threatened attacks on National and whether he will try to ‘uncover the bed sheets’ in Parliament. He seems to be confusing consensual promiscuity, which appears to be common amongst some MPs and associated staff and journalists, and the harassment and abuses of power that he has been accused of.

Cameron Slater, who has been giving mixed messages about his involvement with Ross before he was committed to a health facility, has threatened a number of times over the weekend to reveal some sort of information – “Just wait and watch what happens this week.”

One might think both Ross and Slater have enough problems to deal with already without lashing out further – they both may have little more to lose politically given how toxic and isolated they have both become, but as has been demonstrated in the weekend they are at personal risk from the pressures they create for themselves.

 

MPs and mental health

Mental health in Parliament was raised an an issue recently when the leaker of Simon Bridges expenses claimed to be at risk if the inquiry continued, but it is not a new issue.

Newsroom recounts in Where is politics’ John Kirwan?

The topic of mental health has been highly politicised in recent years, and is currently the subject of an inquiry, but the country’s decision-makers still face immense stigma from the public, the media and each other when it comes to their own mental health.

Last year, Prime Minister Jacinda Ardern spoke about her anxiety in media interviews, and some members of the public cited this as an argument against her taking on the role of prime minister.

Earlier this month, National Party MP Nick Smith was yet again the target of personal attacks implying he had mental health issues, with Civil Defence Minister Kris Faafoi referring to Smith’s “medication” in an interjection in the House.

Smith took stress leave in 2004 but says he has never experienced mental health issues or taken medication. Regardless, politicians – including now Speaker of the House Trevor Mallard – have used the subject of mental health as a way to personally attack Smith in the House over a number of years.

Not good when mental health is used as a political weapon. Smith was suggested by some as a potential leaker simply due to his past publicly acknowledged stress.

Being an MP is inherently stressful. It involves big responsibilities, long hours, a lot of travel, and the ever hovering chance of unflattering and exposing media attention.

Labour Party senior whip Ruth Dyson says like many other jobs, aspects of being an MP are stressful. Being away from home three days a week takes the biggest toll.

First term Green MP Chlöe Swarbrick has proven to be thoughtful, responsible and willing to address issues that other MPs avoid, without being an attention seeker. She earns credit.

And she has been prepared to talk openly about mental health issues.

Only a handful of politicians have spoken openly about their mental health, including Green MP Chlöe Swarbrick and former Green MP Holly Walker, but it’s a small group. And it’s not surprising given the type of reaction, and questions, which follow these disclosures.

Swarbrick has talked about living with depression and anxiety but says sharing her story wasn’t easy.

“It’s scary. Being honest about any facet of yourself, that isn’t necessarily socially acceptable – or where there isn’t a defined pathway in terms of how you declare, or how people react – it’s not a comfortable thing, so you take a risk.

“You always take a risk by being open, transparent, and vulnerable.”

Doing something that isn’t anticipated, or isn’t part of the norm, requires explanation, but politicians live in a world where the common refrain is “explaining is losing”, she says.

Swarbrick doesn’t believe MPs should have to put their entire personal life on the table for people to pick apart, “especially when we still have a culture that stigmatises that kind of stuff”. But politicians do have a responsibility to represent themselves with all their flaws. And Swarbrick says her mental health isn’t something she’s ever sought to hide.

But it is incumbent on politicians to not continue fronting with a façade, where people have a disdain for that kind of politics.

“People want genuine engagement, and that looks like taking off the cloak of impenetrability, and having humanity.”

Swarbrick says the worst environment for disparaging comments are in the House, late at night.

“To be perfectly honest, those issues that are being joked and jested about, actually probably affect a whole bunch of people in these buildings, because there’s such an intensive work environment.”

Being open and talking about mental health is risky for an MP, but it will help normalise something that virtually all of us have to contend with to varying degrees.

In order to improve New Zealand’s mental health situation, systemic changes are needed to make it easier for people to access effective services, but there’s also a need for a societal change, she says.

Robinson says that change could start in the halls of power, and MPs should be modelling non-stigmatising behaviour for the rest of the country.

MPs should be modelling a range of behaviours and set an example to the rest of the country. This will be radical for some old school attrition orientated politicians, but with a new type of MP gradually taking over this can improve.

Bridges leak saga continues

It is amazing to see how the leak a few days early of Simon Bridges’ expenses has become such a big and persistent story.

Newshub (Tova O’Brien) kicked the story off, framing it as a big scandal of overspending. But it has become more a scandal of leaks, and now of why the Speaker Trevor Mallard suddenly called of a planned inquiry, why he involved Jacinda Ardern, and why Bridges and National are being so persistent in pushing for a resolution.

Last Friday O’Brien became strangely indignant that RNZ gave the story new legs, ironically citing concern over the welfare of the leaker her provided her with the story she broke, but Newshub have now given the story another nudge (but via Jenna Lynch): Simon Bridges still unconvinced expenses leaker is a National MP

The National party will launch its own secret internal investigation into who leaked Simon Bridges travel expenses.

On Friday, Speaker Trevor Mallard ditched his inquiry, telling National it was an internal matter for them to sort out.

Even though most signs point to the leaker being a National MP, Mr Bridges still isn’t convinced.

Newshub must know who the leaker is. O’Brien must know at least. They quote Bridges:

“I will do my best and the National Party is united in doing its best to get to the bottom of who the leaker is”

The text – which was sent days earlier to Mr Bridges, Mr Mallard and Newshub – asked for the inquiry to be abandoned, citing ongoing mental health issues.

The leaker’s text provided three specific details of closed-door National Party caucus meetings, yet Mr Bridges remains stuck on the idea the leaker came from outside his party.

“It may not be a National MP or a National Party staffer,” he says.

That doesn’t sound “stuck on the idea the leaker came from outside his party”.

Ardern: “This is a matter for the National Party”.

Bridges: “Well why, on what evidence, on what basis does she say that?”

A fair question. Why does Ardern know with certainty it’s a matter for only the National Party?

Newshub: “Despite the leaker’s text providing specific details of closed door National Party caucus meetings, Bridges isn’t convinced.

Newshub displayed what looks like a mock up of the start of the text message:

That is curiously worded and vague.  Newshub do not give further details would that indicate the knowledge claimed proves they are a member of the National caucus. Jenna Lynch on National’s inquity:

“Because it will be internal, even if the Nats do find the person responsible they may choose to keep that a secret, so we may never  learn the identity of the leaker…unless of course, someone was to leak that.”

An odd closing statement. ‘We’ the public may never find out who the leaker was, but ‘we’ the Newshub (or at least O’Brien’) must know who it is.

And questions are being asked about what Mallard and Ardern know about the identity of the leaker too.

NZH: Jacinda Ardern admits speaking to Trevor Mallard about leak inquiry but says it was perfectly innocent

Prime Minister Jacinda Ardern has confirmed she spoke to Speaker Trevor Mallard last Friday before he announced the cancellation of the inquiry into leaked travel expenses but says their conversation was to advise her of his decision.

“It was not a dialogue,” her spokesman said. “She did not have any input into the decision.”

She did not know who the leaker was and she did not have any conversation with the Speaker about who it might be, the spokesman said.

So she must have based her statements like “This is a matter for the National Party” on what Mallard told her.

National leader Simon Bridges, who also received the text, has suggested Mallard was influenced by Ardern’s public comments when she said it was an internal matter for National and should be dealt with sensitively.

Shadow leader of the House Gerry Brownlee said today there had been no need for Mallard to advise the Prime Minister of his decision to cancel the inquiry.

“On what basis did he do that?”

Mallard had said he believed the leak came from National and the Prime Minister had said it should be dealt with sensitively, said Brownlee.

“On what basis do they make that statement? Do they know? And are they simply not telling us because of some commitments around parliamentary security and diplomatic protection security.”

Brownlee said if Mallard knew who the person was who leaked the document and sent the texts, he should tell National.

“He has made it very clear that his concerns are about the well-being of the individual concerned and we would share that concern and want to do something about it.”

“Most MPs are pretty incensed that the Speaker has gone out and effectively pointed the finger at our caucus and made a couple of pretty serious accusations – one of extreme disloyalty and another of a problematic mental illness.”

The police have been in contact with the leaker, but won’t give further details:

“We reiterate our comment from Friday that Police will not be disclosing any information about the identity of the individual for privacy reasons”.

“We also reiterate that Police assessed the information supplied [by Simon Bridges about the text] as a mental health issue requiring an immediate response.

“It is not subject to other investigative steps. We are not going to discuss any matters regarding specific steps taken regarding the welfare of the individual. “

I’m not sure it’s clear how the police found out the leaker’s identity, as it has been claimed the contact was made via an anonymous phone. Were they able to track the source to a specific office in Parliament? A specific residence in Wellington? or somewhere else?

Timeline (NZH):

August 13 – Newshub publish story based on Simon Bridges’ leaked expenses.
August 15 – Speaker Mallard agrees to hold inquiry.
August 16 – Bridges, Mallard and Newshub receive anonymous text message allegedly from National MP pleading for inquiry to be called off on mental health grounds.
August 17 – Bridges talks to mental health experts and tells police about text on advice.
August 19 – Police tell Bridges they have identified and contacted texter (won’t name them) and that the person is getting support.
August 23 – Mallard names Michael Heron QC to conduct inquiry.
August 24 – RNZ reveals texts were sent previous week to Bridges and Mallard; Ardern and others comment publicly.
August 24 – Mallard cancels inquiry.

The day the text was sent was a Thursday. Parliament wasn’t sitting so MPs may or may not have been at Parliament.

How did the police find out who the leaker was.

Were the three texts identical? Did Bridges or Mallard tell the police who it was? Or did they identify themselves only to O’Brien and she told them?

Last Friday:

But also:

O’Brien has said she was sent the same text message:

I was sent the same text message Simon Bridges and Trevor Mallard were sent last week by the leaker of Bridges’ expenses.

The leaker’s message was simple, in their words:

“There is no security breach in the parliament or problem to be fixed in the system.”

“Just say you know there is no security breach”.

They shared anecdotes from National Party caucus meetings that only National Party MPs would know in an attempt to prove that they’re an MP, and that the leak shouldn’t be dealt with at a Parliamentary level overseen by a Queen’s Counsel or High Court judge.

But Bridges and other National MPs say they are not convinced it proves it was a National MP.

Newshub chose not to report on the text message after we received it last Thursday. I held grave concerns for my source’s safety and wellbeing.

I would like to make it clear that when I was leaked Simon Bridges’ expenses I was completely unaware of my source’s history of mental health issues.

With some details of the text having been cherry picked, leaked and then discussed by Simon Bridges we have made the decision to release other elements to balance and include our source’s voice.

She refers to both “my source” and “our source”. She at least must know who it was – and as a journalist should protect the identity of her source.

But can she be sure the person who sent the text was her source? Did she verify it with them perhaps?

More importantly given the current state of this saga, does Mallard know who it is? It would appear so given his apparent confidence that it’s only an internal National Party problem now. So did he get a different text?

And why is Bridges and National so driven to keep this story alive and identify the leaker?

If there is a National MP with serious mental health issues, and/or who has said their life was at risk if the inquiry continued (effectively blackmailing Mallard), this is surely a concern of parliament and therefore of the Speaker.

The way things are now, if it is a National MP, then National have a major problem. It would mean they have an MP with serious mental health issues and/or threatened the Speaker.

And they have someone in their caucus who has leaked relatively trivial information to attack their leader. That makes things very awkward for Bridges and National, knowing that whatever caucus says could be leaked again. No wonder they want to identify the leaker.

UPDATE (Tuesday pm):

Bizarre and more bizarre expenses leak – questions unanswered

It was a bizarre day yesterday as revelations and media conferences added information but raised further questions in the already odd case of the leaked expenses of Simon Bridges.

Just one bizarre part of yesterday’s unfolding was Tova O’Brien, the Newshub journalist who broke the story in the first place after being provided with leaked information, riding a high horse criticising RNZ for adding to her story yesterday, claiming insensitivities when someone was a significant mental health risk.

The inquiry into the leak has been called off, but National party internal inquiries should be continuing, as should journalist inquiries.

Sam Sachdeva (Newsroom): Fittingly strange end to leak scandal  – I don’t think it is anywhere near the end of the leak saga, but there is a good summary:

Speaker Trevor Mallard’s decision to call off an investigation into the leak of MPs’ expenses, following a text message from the leaker saying their health was at risk, has put an ellipsis rather than a full stop on “Limogate”.

As first reported by RNZ, the anonymous texter contacted National leader Simon Bridges and Speaker Trevor Mallard last week, urging an end to the investigation due to fears it would worsen their serious mental health issues.

The texter claimed to be a National MP, providing evidence which supposedly could only have been obtained if that was in fact the case.

The original decision to leak the expenses to the media only days before they were due for release was puzzling enough.

Then there was Bridges’ reaction, initially brushing off the media attention only to change his mind and call for a High Court judge to look into the matter (he got a Queen’s Counsel instead, with Michael Heron QC in the job for all of 24 hours).

In a week where news presenter Greg Boyed’s death has put the spotlight on New Zealand’s high rates of depression and suicide, responding with anything other than sensitivity and care would have been cruel.

We have been assured that the leaker was having mental health difficulties but whose life should not be at risk any more if it ever was (it’s unknown whether the plea to end the inquiry was genuinely fraught, or was an attempt at a form of emotional blackmail.

On balance, you could argue both Bridges and Mallard made good decisions: Bridges in contacting the police so they could identify the person and provide support, and Mallard in deciding that the leaker’s wellbeing outweighed any benefits of pushing ahead with an inquiry.

Bridges disagrees with the Speaker’s call, but if there is any question of someone’s health being at risk then that is what should be the top priority.

While Bridges suggests the integrity of Parliament is at sake, Mallard’s reading of the text has led him to conclude that it is almost certainly a member of National’s caucus or wider staff who is responsible.

I think that Bridges must make it publicly clear what the outcome is. If a National MP tries to quietly resign in a while it will be immediately seen as to have a connection, or at least suspected.

If it is a staff member or someone else who is not an MP, failing to reveal details leaves all 56 of the National MPs under suspicion. That is unfair on them.

For the ultimate good of the culprit, and for the good of the National caucus, we need to be told more.

Police disappointed in scrapping of mental health pilot scheme

National’s spokesperson on the police, Chris Bishop, has uncovered the scrapping of a pilot project that would have added mental health expertise to front line policing.

The Government’s decision to axe a universally-supported pilot to improve the response to 111 mental health calls is nothing short of disgraceful, especially after Labour pledged to make mental health a priority, National’s Police spokesperson Chris Bishop says.

“It has been revealed that Labour has scrapped a pilot in which a mental health nurse would attend mental health incidents alongside police and paramedics to ensure that people in distress receive timely responses that are tailored to their needs.

“Police spend around 280 hours a day responding to mental health calls. They do a good job, but are not mental health professionals so having a mental health nurse deployed to incidents with police would make a real difference.

“The increasing demand on police to respond to mental health crises is set to continue. That’s why the National Government set aside $8 million for the pilot as part of our $100 million mental health package.

“Police Minister Stuart Nash confirmed in answers to written questions the day of the Police Estimates hearing that the pilot would be canned, yet Police Commissioner Mike Bush told the hearing that police were very hopeful it would continue – in front of Mr Nash.

“Mr Nash has admitted that police are dealing with more and more mental health cases. The pilot would have eased pressure on police and improved the quality of the response for those experiencing mental distress.

RNZ: Police disappointed after mental health pilot dropped

Police officers are upset a proposal to improve 111 callouts has been dumped and mental health advocates hope it may yet be salvaged.

The former National government last year announced an $8 million pilot scheme where mental health workers would attend crisis calls along with police and ambulance staff.

The trial was due to start in September, but police headquarters said the new government had “re-allocated” the funding and so the pilot had been dropped.

Police Association president Chris Cahill said the decision was “disappointing” and officers needed practical support “sooner rather than later”.

“It’s all good to have inquiries and to have think-tanks, but people need help now. They’re crying out for it.”

Front-line officers were overwhelmed by the sheer volume of calls relating to mental health, he said.

“Police aren’t the best equipped to do this. It needs to be people in mental health services who look after them. It’s a medical issue, not a policing issue.”

Health Minister fobbed off queries.

Health Minister David Clark turned down an interview request, but in a statement said the proposal “was never fully developed” and it appeared National had cobbled it together in a hurry.

He expected the government’s mental health inquiry, announced in January, would include advice on how to improve the emergency response, he said.

How long will that take? What if that inquiry recommends the pilot project or something similar? Labour said there was a mental health crisis, but they are not acting like it is a pressing problem now.

The Mental Health Foundation…

…had been supportive of the scheme and its chief executive Shaun Robinson said it was a shame to see it fall by the wayside.

“The police have unfortunately been left to be the mental health service of last resort.”

Mr Robinson said he would be keeping a close eye on the inquiry’s findings and was hopeful it would come up with a similar or even better idea.

“We would really hope to see that there’s something significant in the crisis response area,” he said.

“It may be a short-term loss for a longer-term gain.”

Fiona Howard, from Mental Health Advocacy and Peer Support in Christchurch…

…also hoped the inquiry would report back with a similar project.

She said she empathised with police frustration, but understood the government’s approach to first assess the entire mental health system.

“What I hope is that we can sort of pause – even though I know it’s hard to wait – to make sure that we get all the results from that inquiry in to make sure all parts of our system that are under stress get the resourcing and new initiatives they need.”

Reporting back with a similar project, and then implementing it, will take some time. Scrapping the pilot scheme seems very strange.

Smaller Waikeria prison upgrade plus mental health facility

The Government has announced that it will build a far smaller (500 bed) replacement high security prison at Waikeria than what the previous Government had proposed, plus a special purpose 100 bed mental health facility.

The only problem with the later may be that it is too small.

With the former being substantially scaled down there will be increased pressure on the Government on how to deal with the quickly expanding prison population.

Media statement from Minister of Corrections Kelvin Davis:


• 500 bed high security prison to be constructed at Waikeria

• First-of-its-kind 100 bed mental health facility

• Completion due by early 2022

The Government will build a world-leading high security replacement prison at Waikeria, setting a new direction for Corrections in New Zealand while ditching the American-style mega prison planned by the previous National Government, Minister of Corrections Kelvin Davis announced today.

The prison will include a first-of-its-kind in New Zealand mental health facility to address the high rate of mental health issues prevalent in the prison population.

“Today sets a new direction for prisons in New Zealand, putting public safety first while delivering real rehabilitation and mental health support to reduce reoffending,” said Corrections Minister Kelvin Davis at the site of the new prison at Waikeria.

The new high-security prison, to be delivered by early 2022, will accommodate 500 prisoners, with the ability to provide mental health treatment for a further 100 offenders.

“New Zealand is safer when the most violent offenders are locked away, but prison is also a place where offenders should be rehabilitated, not trained by other prisoners to become more hardened criminals.

“This strikes the right balance between showing hardened criminals the consequences of their actions, and providing a new facility that can work to rehabilitate prisoners and reduce our appalling rate of re-offending.

“The new mental health facility will service urgent need within our prison system. 62 per cent of prisoners have been diagnosed with a mental health or substance abuse disorder in the last twelve months. We currently do very little to help turn these people’s lives around.

“National’s plan to build a mega prison for up to 2,000 prisoners at Waikeria was a clear sign it had given up. They are expensive and ineffective, becoming super-sized factories that just turn low level criminals into hardened criminals.

“This will be one of New Zealand’s smallest prisons. We know smaller prisons make rehabilitation more likely, are closer to communities and link better to local work programmes.

“Prisons shouldn’t be resorts and offenders must face consequences, but we can’t expect prisoners to turn their lives around and walk out the doors ready to be better people if we lock them away in a breeding ground for crime.

“Today’s decision draws a line under New Zealand’s failed prison policy and sets us on a new path towards better prisons, that make our communities safer,” said Kelvin Davis.

http://img.scoop.co.nz/media/pdfs/1806/Waikeria_speech_Kelvin_Davis.docx

http://img.scoop.co.nz/media/pdfs/1806/Waikeria_FAQs.docx


Odd that this was available via Scoop but not from the Beehive website.

Mental health crisis talk, but no urgency walk

There have been claims that our health system is in crisis. I guess it depends on what constitutes a crisis.

Speaking out of one side of his mouth Minister of Health David Clark says that parts of the health system are in crisis due to chronic ‘underfunding’, but out of the other side of his mouth he praises the state of Health.

And even though he sees a crisis in Mental Health he is happy to wait for a committee to investigate before taking action. He has justifiably been criticised for this contradiction.

On Q&A yesterday:

Corin Dann: The other criticism is that you’re manufacturing a crisis. Is there a crisis in health, for a start?

David Clark: There are some areas where there is a crisis. I think mental health – people will acknowledge is at a crisis level. But the reason our health system is holding together so well, and it is, is because of the dedicated staff. We have doctors and nurses and allied health workers who have turned up every day in an underfunded environment for years, and they deliver an amazing service, and New Zealanders know that.

There is a crisis, but the health system is holding up well?

Later the interview addresses mental health.

Corin Dann: We’re going to talk mental health now. Talking again to people in the health sector this week, one of the things that came up with mental health was actually an ED nurse, who said they are just seeing a massive increase in the number of presentations at emergency departments from people suffering from mental illness. What are you going to do about that?

David Clark: We know that we have an aging demographic, which includes dementia, and we have a growing population. As more people get weeded out for care in primary care, we have more acute demand at the emergency level. We’re going to need new approaches, new ideas to tackling these issues. And we’re going to need increased capacity in some areas.

No indication of what Clark intends to do, just “we’re going to need increased capacity in some areas”.

Corin Dann: Okay, I know you’ve got an inquiry looking at this issue and presumably that’s going to come up with some big, challenging recommendations for you on mental health, and you’ll deal with that. How quickly can you implement those?

David Clark: Yeah. I’m imaging we won’t be able to implement them all at once. We’ll take it budget by budget, step by step. But the purpose of making that inquiry independent is that it will bring forward hard recommendations. It will bring forward challenging recommendations. And we as a government will then have to wrestle with them. But I don’t want to get some watered-down version as minister. My job is to manage the prioritisation and the politics, and I’ll do that. 

Corin Dann: Sure. Big picture here, because I know you’ve got an inquiry, what is your feeling about the balance in terms of our mental health? Are we keeping people in the community too much? Are we not putting people in care enough? Where is the balance?

David Clark: My gut feeling is we’ve devolved care to the community without putting resource after it. And sometimes it’s been used as a cost-cutting measure. We need to change community attitudes. We need to change the way we’re delivering primary services to some extent. And we need to just make sure that mental health is afforded the priority that it should have. It shouldn’t be possible to cut corners for our most vulnerable.

Corin Dann: You’ve got other promises in mental health, in particular in schools and those sorts of things. Are you going to be able to deliver on those, having nurses or mental health care workers in those sorts of facilities?

David Clark: There are some things that have strong evidence behind them. Nurses in schools is one of those things. We will continue to roll out that programme. The cheaper doctor visits is another way of ensuring that those services are more accessible to people. So we will do some things in the interim. I’m not going to announce the budget detail today, Corin.

Labour rushed in an expensive tertiary fees-free policy, without claiming there was a crisis in education.

The did claim there was a mental health crisis in their Taking action in our first 100 days:

  • Set up a Ministerial Inquiry in order to fix our mental health crisis

One could think that a crisis would be treated a bit more urgently than deferring to a committee.

Labour’s post-100 day brag sheet includes this, but it is well down the list of priorities – 100 days. Here’s what we’ve done.

We’ve announced a ministerial inquiry into our mental health system. It’s time to do better by New Zealanders.

But this isn’t the time to do it apparently.

More details: Inquiry to improve mental health services

The Government has taken a major step towards improving mental health and addiction services with Prime Minister Jacinda Ardern announcing details of a ministerial inquiry.

The Inquiry into Mental Health and Addiction will be chaired by former Health and Disability Commissioner, Professor Ron Paterson, and will report back to the Government by the end of October.

Then any spending to address the so-called crisis will have to wait until the budget in May 2019, unless things get deferred further.

“Nothing is off the table. We all know we have a problem with mental health in this country and our suicide rate is shameful. It is well past time for us to do something about it.”

That was in January. Perhaps something will be done about it in this year’s budget, but even then one could suggest ‘it is well past time for us to do something about it’.

In the meantime: Funding uncertainty for Dunedin rehab service

A Dunedin rehab centre with a waiting list of 142 people, most addicted to methamphetamine, will run out of money in two months.

Addiction treatment services say the public funding model they operate under is creating stress, fostering competition between providers and, worst of all, detracting from the work of rehabilitating addicts.

With only 62 days left in the financial year Ms Aitken still had not been able to secure funding – which comes from a mix of government departments – to continue to run past July.

Perhaps they could go and talk to the mental health crisis working group. Drug addiction is a symptom of mental health problems.

Claims of crisis are not new. from may 2018:  New Zealand’s mental health system is in crisis

The Auditor-General’s new report on discharge planning for mental health patients shows more than ever that the system is in crisis.

The report by Greg Schollum, Deputy Controller and Auditor-General, diagnoses several acute ailments in the system – a lack of planning and liaison between DHBs and community services, limited bed numbers available in inpatient units, and rushed discharges into the community because DHBs cannot cope with growing demand.

“This report provides some alarming insights into the slow decay of the mental health system under this Government, particularly in terms of supporting severely vulnerable patients to re-enter their communities after time in DHB inpatient units,” says Erin Polaczuk, PSA national secretary.

“It’s clear that empty rhetoric and the hollow promises of prioritisation by this Government aren’t enough,” says Ms Polaczuk.

See also (Stuff, 3 February 2018): A growing emergency: Why are cops looking after mental health patients in crisis?

If things go according to current plans another report will be released in October. Perhaps that will call it a crisis too.

Then what?


David Clark has been asked (on RNZ) about the Moana House funding crisis and says it is something that needs to be worked out over time. And pushed on whether urgent funding would be provided he said he won’t be announcing the budget in advance and again said solutions would be forthcoming “over time”.

No apparent urgency given the claims of a crisis.

It is a very difficult situation for Clark (as the portfolio is for any Minister of Health).  But if the Government talks the crisis talk surely they should walk the urgency walk.