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.

 

 

Minister of Health on colonisation and youth suicide

In an interview with NZ Herald new Minister of Health David Clark linked youth suicide with colonisation – New Health Minister David Clark on youth suicide: We have a problem and we need to talk about it

Labour campaigned on mental health and pledged the return of the mental health commissioner and an inquiry into mental health.

Terms of reference and other details around the inquiry were yet to be settled, Clark said, but forecast it as wide ranging, considering issues of colonisation and poverty.

He spoke of “hardship, or the after-effects of colonisation, or trauma in their own lives or personal histories”.

He was questioned about this in Parliament yesterday.

Hansard transcript (slightly edited):

7. Hon Dr JONATHAN COLEMAN (National—Northcote) to the Minister of Health: What quantifiable health service improvements, if any, will his policies deliver?

Hon Dr DAVID CLARK (Minister of Health): This Government is committed to providing affordable access to quality healthcare for all New Zealanders. This will happen in many ways; there are too many examples to list. However, to pick just one, I can tell the member that more people will be able to access affordable primary healthcare.

Hon Dr Jonathan Coleman: By exactly how much will he lift the number of elective surgeries above the 174,000 delivered in the past year, given his commitment to increase access to elective surgery?

Hon Dr DAVID CLARK: I will not be rushed into committing to specific targets. I want a health system that is honest and transparent with targets not like the previous Government’s one, which was pumping statistics by performing Avastin injections and skin legion removals that could have been done in primary care.

Hon Dr Jonathan Coleman: I raise a point of order, Mr Speaker. It was a very direct question. If he doesn’t have an answer, he should just say so.

Mr SPEAKER: No. I probably was a bit slack letting him go on after he answered the question in the first sentence.

Matt Doocey: By how much will he reduce the suicide rate over the next three years now that his Government has taken responsibility for the rate, as reported in the New Zealand Herald yesterday in the article entitled “… New Health Minister pledges change on youth suicide”?

Hon Dr DAVID CLARK: One suicide is one suicide too many. I do not believe it will be possible to eliminate suicide in the first term of this Government, but we are committed to lowering the rate of suicide in New Zealand, and I am looking forward to beginning the mental health inquiry.

Dr Shane Reti: What did he mean exactly by his statement to the New Zealand Herald yesterday that addressing colonisation will be an important part of his mental health inquiry?

Hon Dr DAVID CLARK: That is one factor that I said to the New Zealand Herald I expect will come up in the inquiry.

Hon Dr Jonathan Coleman: Can he explain the improvements his policies will have on the link that he believes exists between colonisation and youth suicide?

Hon Dr DAVID CLARK: This Government will commit to a mental health review—an inquiry, a ministerial inquiry—and that inquiry I have asked to be broad. It will cover a variety of topics, including the one the former Minister has raised, and I expect it to provide answers that will help us to provide mental health services that New Zealanders need.

It was a topic that the Minister raised in his interview with the Herald.

New Zealand has an alarmingly high level of youth suicide, and of all types of suicide. The annual suicide toll is now over 600, far higher than the road toll that has had huge funding to try to reduce it.

It is an urgent problem that needs action faster than a general mental health review, and the causes of suicide are much wider than just mental health. Many of those who commit suicide are never in the mental health system.

“I do not believe it will be possible to eliminate suicide in the first term of this Government” – it won’t be possible to eliminate suicide in any time frame.

“…we are committed to lowering the rate of suicide in New Zealand…” – as was the last Government, without success.

“…and I am looking forward to beginning the mental health inquiry” – I’d like to see more urgency and action than that.

Mental health worker pay crisis

Predictably, when pay rates were increased substantially for 55,000 care workers, this has put a strain on other sectors. Mental health care workers were not included in the settlement, and difficulties in retention of mental health workers is being described as a crisis.

Mental health services were already under serious pressure before this added to the problems caused by increasing health care being sought.

RNZ: Union ‘totally shocked’ at mental health pay equity warning

 

The Ministry of Health has written to district health boards telling them not to pay their mental health workers the same as aged-care and disability support staff.

The letter is a blow to those left out of the recent $2 billion pay equity settlement boosting the wages of 55,000 aged-care and disability workers.

The document, leaked to Checkpoint with John Campbell, tells DHB chief executives any top-up payments to mental health support providers would risk breaching the Public Finance Act.

It seeks confirmation that DHBs “do not intend to provide such funding, or will cease if any initial payment has been made”.

The pay equity settlement – announced by Prime Minister Bill English in April – increased wages for workers providing aged and residential care, but not for workers in mental health support.

Since then, the mental health sector has been reporting a loss of existing workers and difficulty attracting new ones.

One DHB told Checkpoint that the sector faced catastrophe if workers could not be retained.

Public Service Association (PSA) assistant national secretary Kerry Davies called the ministry’s letter “outrageous”.

“I’m totally shocked at that. I just cannot understand why the MOH [Ministry of Health] would do that,” she said.

“Why they would put a limit on what DHBs can fund and also what NGOs can actually pay mental health support workers.”

Platform Trust chief executive Marion Blake said mental health support workers currently earned $16-19 an hour, while those working in aged and residential care now received $19-23.50 an hour – or about 20 percent more.

The pay gap was beginning to have a serious impact, Ms Blake said.

“They’re losing staff at a time when we need mental health and addiction [support providers] to be as strong as they possibly can,” she said.

“Not only are people leaving the mental health services or have indicated that they will be leaving, it’s also becoming increasingly difficult to recruit people, because people can be paid a higher wage – sometimes as much as $6 an hour difference – by going to work in the disability services.”

There have been follow up interviews on RNZ this morning about this.

Minister of Health:

Reports aren’t available online yet.

See also Govt gives details for $100m mental health spend (announced in the budget in May).

And last month:  Figures reveal under-staffing of mental health sector

New information shows the extent of the country’s shortage of psychiatrists and mental health workers.

Figures released to Nine to Noon showed there were 55 vacancies for psychiatrists in the country’s hospitals, nearly 100 unfilled nurse positions in acute mental health wards and just under 40 unfilled jobs in crisis assessment teams in mid-May.

Coleman a growing risk for National

At the worst possible time for National there are growing sides that Minister of Health Jonathan Coleman is highlighting the Achilles Heel of multi-term governments – arrogance and ineptitude.

Stuff: Treasury found Minister of Health’s mental health strategy not ‘coherent’ two months before Budget

An “incredibly damning” Treasury report criticised the Minister and Ministry of Health’s (MOH) failure to deliver an effective mental health strategy.

A report published online shows Treasury officials pushed Finance Minister Steven Joyce to shelve Health Minister Jonathan Coleman’s strategy two months ahead of Budget 2017.

It sparked a new cross-agency approach, but Opposition parties say the report show the ministry and minister “don’t understand the mental health sector”, which is unacceptable. Coleman says mental health is a “complex area” and it is Treasury’s role to provide independent feedback.

The report comes as a potentially damning State Services Commission performance review of the embattled MOH is in the works and after the ministry’s $38 million budget blunder caused chaos for several district health boards (DHBs) around the country.

A March 2017 report briefing Joyce on Budget 2017’s health package highlighted the ministry’s failure to put forward a coherent mental health bid.

Even perceptions of ineptitude can be damaging. It isn’t helped by Coleman’s arrogant defences and fobbing off.

Coleman said: “The drivers of mental health and addition are complex, and there is no simple answer as to why across the world we are seeing increased demand.”

“We have taken a cross-agency approach to this issue. I expect to have more to say on the details of the new initiatives being funded in the coming weeks.”

Mental health has been an obvious and serious issue for a long time. The coming weeks will be dominated by election campaigning, and it’s far too late to be trying to talk about new initiatives.

Health in general and mental health particularly are complex and difficult to deal with. Costs and demands keep rising.

As well as competence something important to see in a Minister of Health is empathy, and Coleman does a poor job of showing that.

He stood for National leadership last year. At least he didn’t win that, but he is making things difficult for Bill English in an election campaign.

Mental health hospital “too awful”

Inadequate resources to deal with mental health is a growing problem in New Zealand. Here is an awful example:

Stuff:  Christchurch’s Princess Margaret Hospital too ‘awful’ for government reviewers to visit

Some of the South Island’s most vulnerable people are being treated at derelict Princess Margaret Hospital (PMH), but it’s too “awful” for government-appointed reviewers to visit.

Urgent plans to move the remaining mental health services from PMH have been in bureaucratic limbo for more than two years, despite staff and patients describing the facilities as “disgusting” and “appallingly depressing”. The rest of the services shifted out last year.

About 31 patients from the youth mental health, mothers and babies, eating disorders and long-term rehabilitation units were stuck at the facility, which the Canterbury District Health Board (CDHB) described as “substandard” and “not appropriate”.​

The reviewers tasked with assessing the services before they could move met with CDHB officials in June, but declined to visit the premises because they “sound awful, we don’t want to go there”.

There were serious problems with New Zealand’s institution based mental health care. Some of the treatments were horrific, the treatment of many patients was horrible.

Then in the 1980s there was a major and rapid shift to community care. In some respects this was certainly a much better approach. Good care delivered while people still function in their families and communities is a far better approach, in theory.

But mental health care seems to have been badly under-funded and under-resourced, so it has created new problems, some of them serious.

Not only have many mental health patients been let down, it has put everyone in the community at greater risk.

As a result people with mental health problems have suffered, and there have been adverse effects such as drug abuse and crime. Many people in prison have mental health issues that are obviously inadequately dealt with. It appears to be a growing problem.

There is massive pressure on the whole health budget. The lives and well being of people are at stake.

But there has to be a better way of funding and providing for mental health, otherwise mental sickness will keep increasing and causing a wide range of problems.

It’s not just Princess Margaret Hospital that’s awful.  The whole mental health system seems to be inadequate, and that’s awful for the people who rely on it – or should be able to rely on it.

Mental health workers claim decent pay

Mental health care is a real and growing problem for the National Government and for New Zealand Society.

There was a major move from institutional mental health care late last century.

It was correctly decided that many people with mental health problems could be better cared for in the community. The problem is that proper community care has never been adequate. And the problems seem to be getting worse.

Part of the problem is the shortage of resources, mainly mental health staffing levels. It is a demanding and sometimes very stressful field of work, and community care pay rates have been pathetic.

Aged care and supporter workers campaigned for and eventually won a significant pay rise, due to take effect next month.  They succeeded through the courts by proving that  their workers were underpaid because the majority were female.

Mental health care workers are trying to do the same.

RNZ: Mental health workers lodge equal pay claim

Christchurch mental health support worker Vicki Harmon works for Pukeko Blue, an organisation which provides community care for those with mental health needs.

She works at one of the 12 residential homes in the city, which provide 24-7 care for seven residents.

It’s tough and demanding work, for which Ms Harmon is paid $16.50 an hour – 75 cents an hour more than the minimum wage.

One of her clients is a woman with an intellectual disability who has spent the last six weeks in the grip of mental illness, something she describes as “exhausting” and “very demanding”.

“Having somebody with a dual diagnosis – an intellectual disability and mental health – means that you are constantly aware of their mental state, not just their intellectual disability, that’s the same every day.

“But you need to be aware of their mental state, it can go up in two days and then it will come back down in two days. You’ve go to be vigilant all the time,” she said.

Auckland mental health worker Pollyanna Alo agreed the job could be challenging.

“There have been occasions where I have been spat on, verbally abused, even had a knife thrown at me,” she said.

Both women are among the 3000 to 4000 community mental health support workers who were left out of the historic pay equity claim for care and support workers, because the government wouldn’t include them.

While they have similar experience, qualifications and responsibilities to their colleagues in the disability support and aged care sector, in a fortnight’s time they can expect to be paid about $6 – $7 less an hour.

Today, two of the country’s largest unions – E tū and the Public Service Association – will lodge an equal pay claim with the Employment Relations Authority.

E tū’s assistant national secretary John Ryall said this was the third group left out of the historic settlement and is similar to a group of workers employed in vocational services with the Ministry of Social Development, which the union is also negotiating.

Mr Ryall said the government needed to support this claim and move swiftly to avoid the impending crisis.

“If the authority decides that, then the government as the funder of the sector needs to either pay the money or watch these places shut.

“We think the job these people do is so important, that it’s important the government gets involved in it,” he said.

Ms Alo said reducing the number of mental health workers would place more stress on district health boards, which were already struggling.

It was inevitable that other sectors would try to benefit from the success of the Care and Support workers.

The problems facing mental health care are probably greater. Pay rates need to be raised, but more workers are also required to deal with the growing demand.

More funding was made available in last month’s budget but it was criticised as not enough.

Stuff:  Frustration, disappointment over health funding in Budget 2017

Patients and healthcare workers say they have been left frustrated and disappointed by “inadequate” funding for health in the 2017 Budget.

They said the Government’s announcements on Thursday would not go nearly far enough in addressing concerns about overworked staff, access to new medicines, and access to mental health treatment.

The Government said total health spending would be a record $16.77 billion in 2017/18 – an increase of $879 million, with an overall increase of $3.9b over the next four years.

There are growing demands right across the health sector. On mental health:

The government committed $224m in funding for mental health in this year’s Budget.

That includes $100m for a new cross-government social investment fund that will “target innovative new proposals to tackle mental health issues”.

A further $100m will go to District Health Boards to support local mental health and addiction services, with funding also earmarked for Maori suicide prevention.

Mental Health Foundation spokesperson Sophia Graham welcomed the funding announcement as a “really positive step in the right direction”.

“It seems like a lot of money, but we need to see a commitment to sustained increases in funding,” she said.

Meanwhile, mental health workers and union representatives said the funding was only a fraction of what was needed to adequately respond to demand.

Social worker Andy Colwell said he expected to see the gap between demand and funding get even worse as a result of Budget 2017.

“As a mental health worker, seeing families struggling with life-threatening situations not being seen as urgent is incredibly frustrating, and knowing it will get worse is incredibly distressing,” Colwell said.

“It’s critically important to look at how the money is spent, and make sure we don’t just keep doing the same things that don’t work.”

Graham said key measures for success would be a reduction in the number of suicides, and a reduction in the number of people presenting critically ill at mental health units.

Health Minister Jonathan Coleman acknowledged there had been an increase in demand for mental health and addiction services in recent years.

“Cabinet will soon consider a new mental health and addiction strategy, which will include our new approach to dealing with mental health issues,” he said.

Mental health was covered on Sunday last night: Trouble in mind

Has a mental health crisis put our police under siege? Police officers say the number of emergency callouts for mental health related emergencies is skyrocketing. And they are struggling to cope. Police officers, patient advocates and a frightened family affected speak out.

Coleman wouldn’t comment for that programme but said he was taking a proposal to Cabinet soon. At least with an election looking there may be some urgency.

Ardern’s Congress speech

Jacinda Ardern has given the key Saturday speech at Labour’s election year Congress, and has announced new policy on mental health.

Labour on Facebook:

And today, Jacinda Ardern has announced that we’ll deliver comprehensive health services to every state secondary school. These services have been shown to reduce the risk of suicide by two thirds.

We’ll make mental health an absolute priority.

It’s great to put more priority on dealing with mental health issues – in the shorter term this may put more pressure ion the Government to take more action.

But I question this claim: “These services have been shown to reduce the risk of suicide by two thirds”.  There’s no way of knowing in advance what degree of success it might have.

Ardern’s speech:

A curious personal intro to her speech by Ardern, trying to appeal to a social media audience.

Stuff reports: Labour promises a nurse in every secondary school

An emotional Jacinda Ardern has spoken about her grief at losing a childhood friend to suicide.

Speaking to Labour’s election year congress, Ardern put youth mental health on the political agenda, with a promise to place a nurse into every public secondary school.  Schools will also get the support of a GP.

“Evidence around existing services shows where students had more time with on-site professionals there was significantly less depression and suicide risk. Depression and suicide risk were up to two thirds lower in schools with comprehensive health services. Early intervention works.”

Ardern revealed that as a 13-year-old in Morrinsville, her best friend’s brother took his own life.

“I had just started high school and was waiting for class to start when I heard the news, I can remember exactly where I was standing, just outside the science block.

“I went straight to my friend’s home and spent the next few days with her as her and her family went through the unimaginable grief of losing their only boy, grief that was felt by everyone that knew him, and was captured in the handwritten notes and messages from his classmates that hung around the walls at his funeral. Every single thing about it seemed unfair and still does to this day.”

Ardern said school based health services were introduced by Labour in 2008  but were currently only funded directly for nurses in decile 1-3 public secondary schools, teen parent units and alternative education facilities.”

Under Saturday’s announcement, the average secondary school would have a full time nurse and also the support of a GP.

The cost would be around $40 million a year, funded out of Labour’s commitment to reverse National’s $1.7 billion of health cuts.

That doesn’t sound a lot in the whole scheme of things. The question to ask is whether it’s the most effective way to deal with a big problem.

Personal experiences can be a powerful driver of change that matters.

Full text: Jacinda Ardern: Labour Congress Speech

Clark v Coleman on mental health funding

Labour’s health spokesperson David Clark versus Health Minister Jonathan Coleman in Question Time on Tuesday – this approach doesn’t help the mental health debate.


Health, Minister—Statements on Authors of People’s Mental Health Report

11. Dr DAVID CLARK (Labour—Dunedin North) to the Minister of Health: Does he stand by his statement about the authors of the People’s Mental Health Report, “they’re very left-wing, anti-Government protesters”; if not, when will he apologise to the 500 people who wrote their own stories about experiences with the mental health system as part of the report?

Hon Dr JONATHAN COLEMAN (Minister of Health): Yes, and my statement distinguished between the genuinely motivated story submitters and those ActionStation organisers with some political agenda. My quote was: “When you look at the people behind it, [you know] they’re very left-wing, anti-Government protesters.” As I say, ActionStation is back on Thursday with another, separate, anti-Government protest within the health area, and it could be back week after week with different topics. And just for the record, the ActionStation campaign coordinator is Mr Rick Zwaan, the Green Party’s Wellington election campaign coordinator, who used to work as Kennedy Graham’s researcher. [Interruption]

Mr SPEAKER: Order! [Interruption] Order! Supplementary question, Dr David Clark. [Interruption] Order! I have asked for less interjection from everybody so that Dr David Clark can ask his supplementary questions.

Dr David Clark: Has he read the report; if so, does he accept that its aim, as recorded in the executive summary, is to give space to the stories of what is really going on and going wrong in our mental health services?

Hon Dr JONATHAN COLEMAN: Yes, I have read the report, and especially the executive summary, the first line of which is a totally false premise. It talks about $140 million being cut from health funding. Well, actually, health funding has gone up by $300 million, which kind of proves the point that this is a political document.

Dr David Clark: Does he think the contribution of Robbie, who described support services as expensive and inadequate, and which, he says, “almost drove him to take his own life”, should be dismissed as the experience of a left-wing, anti-Government campaign?

Hon Dr JONATHAN COLEMAN: I have already answered that. Look, I think Robbie’s experience is worth listening to, but that does not change the fact that this report is produced by a group of people who are permanent anti-Government protesters. If the member does not believe me, go and look at their website. They will be back here, week after week, on subject after subject after subject, because they do not like the Government.

Dr David Clark: Does he think the contribution of Mike King, who “describes despair and hopelessness in the face of inadequate access to mental health services”, should be dismissed as the experience of a left-wing, anti-Government campaigner?

Hon Dr JONATHAN COLEMAN: Look, I think the member needs to speak to Mrs King about how you think on your feet. I have answered that question already. The organisers are from ActionStation, and it is the permanent anti-Government, left-wing protester. Mr King is a very good man—Mike King, as opposed to Mrs Annette King—who is genuinely motivated, and I do not detract from his efforts. But, as I say, when you have people like Mr Rick Zwaan, who used to work for Kennedy Graham, and his friends from the Green Party, I think it is pretty obvious that this is political.

Dr David Clark: Does he think the contribution of “the many parents who submitted in regard of their children’s experience of huge waiting lists and lack of funding” should be dismissed as the experience of a left-wing, anti-Government campaign?

Hon Dr JONATHAN COLEMAN: I point out to the member that he does not have to take all his supplementary questions, and if he cannot think of new material in response to the answers, he should just stop. [Interruption]

Mr SPEAKER: Order! We will deal with them one at a time.

Chris Hipkins: I raise a point of order, Mr Speaker. For two answers in a row, the Minister began by insulting the questioner rather than addressing the question. But the main substantive point is that despite the abuse in that last answer, he did not even address the question that was asked.

Mr SPEAKER: On this occasion—[Interruption] Order! I have been increasingly worried about the interchange between these two members and some of the answers that have been given on occasion by the Hon Dr Jonathan Coleman, but, on this occasion, when I consider the three questions that were asked, they were, effectively, the same question each time. Therefore, I can understand the frustration of the Minister in having answered the question the first time—he, effectively, gets the same question for the next two occasions.

Dr David Clark: I raise a point of order, Mr Speaker. That question, in my view, was not addressed, because he had talked about ActionStation, which is the compiler of the report. I am asking a specific question about the comments from the parents within the report. That is a very specific and non – politically loaded question.

Mr SPEAKER: Order! I would like to assist the member, but when I consider the answer that was given to, I think, the second supplementary question, that, effectively, was an answer that was then quite suitable for the rest of the questions the member asked, which were, effectively, just drawing on the experience of someone else within the book. The Minister was quite clear in saying he is not in any way critical of the experiences that were detailed in the report; he was certainly critical of the authors who put the report together.

Hon David Parker: I raise a point of order, Mr Speaker. With respect, is the problem with that not that the Minister is trying to write this off as being a left-wing conspiracy—that is the essence of his answer? I think it is quite proper for members of the Opposition to put instance after instance after instance that paint a different picture. I think the Minister should have to address each of those instances, rather than just cast aside a political insult telling him he should learn how to ask different questions.

Mr SPEAKER: Order! I do not agree that it was a political insult. The question was answered. There was no attack on the various contributions that were made within that report by the Minister. There was certainly a feeling that the authors were not of the same political persuasion as the Minister. That is acceptable.

Dr David Clark: To clarify—

Mr SPEAKER: No. [Interruption] Order! [Interruption] Order! Would the member please resume his seat. [Interruption] Order! Would the member please resume his seat. I have ruled on that matter. The member is now starting to challenge the Chair and debate with the Chair. That in itself will lead to gross disorder in this House. Question No. 12—Melissa Lee—[Interruption] Order! [Interruption] If I hear a further interjection from Carmel Sepuloni while I am in the Chair today, she will be leaving the Chamber. She has been consistently interjecting throughout question time in a very—[Interruption] Order! If the member wants to go now, I can make that arrangement very easily. I expect cooperation, particularly from whips, and the level of interjection that has been coming from Carmel Sepuloni throughout question time is unacceptable. When I rise to my feet, for those interjections still to continue is just not acceptable to this House.

 

Labour’s ‘fresh approach’ on mental health

Labour has announced policy on trying to deal with difficult mental health issues.


Fresh approach on mental health

Labour will introduce a pilot scheme of specialist mental health teams across the country in government to ensure swifter and more effective treatment for those who need urgent help, says Labour’s Leader Andrew Little.

“Mental health is in crisis. It needs a fresh approach so we can make a difference quickly because what we’re doing now just isn’t working.

“This is something you can’t put a bandage on and a Labour Government will make it a priority to better equip our health system to cater for those crying out for help.

“Health professionals and those needing treatment tell us it’s hard to find the front door to access mental health services. The present service is over-stretched and fragmented with little co-ordination of the care people need.

“What the new mental health teams will do is offer free, accessible help for those in need and ensure their care is co-ordinated and effective.

“One in six New Zealanders will be diagnosed with a mental health problem in their lifetime. There’s been a 60 per cent increase in Kiwis accessing mental health treatment since National came to power but spending on this sector has only increased by 28 per cent.

“A quarter of all suicides are people who have been in contact with mental health services in the past month.

“Under the two year pilot specialist mental health teams will operate from eight sites across the country and work with doctors, NGOs and District Health Boards. One of the sites will be in Christchurch reflecting the city’s particular needs.

“We expect the teams will be able to help nearly 40,000 people each year at a cost of $43 million over the pilot.

“This is a small investment that we’re confident will make a big difference to those who struggle today to access the services they need. It will be funded through Labour’s budgeted commitment to reversing National’s $1.7 billion of health cuts and is in addition to Labour’s review of the mental health system.

“We believe early intervention and continuing care will help people avoid significant mental health distress and better assist them to live their lives to their fullest. It’s the right thing to do,” says Andrew Little.


This is a timely policy announcement by Labour given Health Minister Jonathan Coleman’s reaction to a mental health report.

The Spinoff: Jonathan Coleman’s attack on ‘anti-government’ ActionStation is a smokescreen. And it’s nonsense

The minister of health has dismissed a report on mental health claiming the authors are ‘left-wing anti-government protesters’. ActionStation’s Marianne Elliott responds.

You know the saying: ‘Don’t shoot the messenger’?

Well, the message is that New Zealanders are deeply concerned about the state of our mental health system, and heartbroken about the family and friends we lose to suicide every year. We’re just the messengers.

The “we” in that sentence is the ActionStation community of everyday New Zealanders, hundreds of whom shared their stories with the People’s Mental Health Review, and 12,800 more who added their names to an open letter asking the government to consider the findings of that review.

So when the minister of health, Dr Jonathan Coleman, dismissed the recommendations of the People’s Mental Health Report on Tuesday because “the people behind the report” were “left-wing anti-government protesters”, that is who he was dismissing.

Attacking the messenger is a classic diversionary tactic when you don’t want to face up to the message itself.

That’s how it looks – not good for Coleman.

Coleman needs to ditch the reactionary petulance and be seen be genuinely dealing with obvious mental health care shortcomings and difficulties. Otherwise voters may choose to go with Labour’s approach.

I’ve always been aware that ActionStation has some close connections with the Greens, and their regular petitions can seem a bit pointless and easy to ignore, but their mental health report was much more substantial and pertinent to current difficulties many people face.

And this from Parliament doesn’t help the metal health debate either: Clark v Coleman on mental health funding