I’m a mental health nurse and I know how challenging the role can be at the best of times. So when Canterbury DHB announced that, because of funding cuts being forced on them by the current Government, they may have to cut funding to mental health services I was very worried.
Today is the anniversary of that awful 2011 quake. My thoughts are with the people of Christchurch and with the families of those who were killed. My thoughts are with every person who still bears the scars of the earthquakes, be they physical or mental.
Things are pretty tough in Christchurch and I fear they’re going to get tougher.
I have been talking with some of my Christchurch-based mental health colleagues over the last couple of days and I share their concerns.
Mental health needs
- The anniversary of the February 2011 quake is today. This, along with the recent earthquakes is re-traumatising people.
- The long-term prognosis for mental health in the city is deteriorating, because young people aren’t getting early intervention from specialist mental health services. There is a rise in young people who have little resilience left and just aren’t coping being referred onto adult mental health services.
- The referral rate to child and adolescent mental health services has doubled, and there’s been a huge increase in presentations to the Crisis Resolution Team. It’s really hit home in the last 12-18 months.
- People are moving from place to place, relationships are breaking down, and children’s mental health is suffering.
- Some Special Education Services staff have been told not to give a diagnosis of PTSD to children they are working with, partly because there is not enough funding to treat them.
- People with long-term, chronic mental illness have been destabilised after being ousted from their council house, losing the support of nearby friends and familiar shops.
- There has been an increase in Alcohol and Other Drug (AOD) use.
- 100,000 people have come to Christchurch for the rebuild. The guys are working up to 16-hour days, burning out and turning to alcohol and drugs. A lot of them are turning up in mental health services. The DHB is expected to absorb that increase out of existing budgets.
- There is noticeable rise in mental health problems among Canterbury farmers.
Impact on mental health services
- There are long delays to be seen in specialist mental health services, especially for new referrals and especially for children and young people. There is a waiting list at Whakatata House, a community mental health service for children and families.
- The delays are due to wider system pressures, as well as rising need among Christchurch residents. So, for example:
- The biggest and widest impact of funding cuts has been felt by NGOs who support people in the community, so they don’t become so unwell that they need specialist services (this trend is expected to continue).
- All sexual assault support services were closed last year, along with Relationships Aotearoa.
- Recently, The Pacific Island Trust has gone, and the drop-in centre at Latnam House has been forced to shut its doors.
- Even some DHB mental health services have shut down. The Day Programme at the Youth Inpatient Unit at Princess Margaret Hospital closed about a month ago.
- Caseloads for community mental health nurses are 30-40. This means nurses do not have enough time to do their job. Case managers are staying at work until 6pm routinely – doctors even later, until 7 or 8 in the evening. This is overtime is unpaid. Running a service on the goodwill of staff in this way is not sustainable.
- Staff in community mental health were recently told that they’re not allowed to organise taxis any more, to help clients get to appointments. Now the next cut which they have been told is coming, is that they are going to lose some of their DHB cars, so staff will be less able to visit clients in their homes.
- The increasing use of “Level 2 specials” (ie. one-to-one care in the inpatient unit, for high needs service users) has meant that nurses have to push to get the extra staff they need.
- Staff are being cut by not filling vacancies.
The mental health of the nursing team
- Staff are having to deal with the same issues as the rest of Canterbury: dealing with EQC, fighting Fletchers, moving house. People are tired.
- All the staff are on edge. Some say it’s almost like they are suffering from post-traumatic stress themselves.
- There is huge staff turnover. Since last weekend’s earthquake, three staff in one ward have resigned. They say they are looking for work in other regions and who can blame them?
All the people I spoke to said they and their colleagues are dismayed and disgusted at this Government’s decision to not adequately fund Christchurch’s mental health services.
It doesn’t have to be like this. We all chose to prioritise some things in our lives over others. And the Government is no different. They have not prioritised the health and well-being of Christchurch people.
I guess the good thing about priorities is that they can changed. I’d like this Government to prioritise mental health services in Canterbury. I urge them to do it!
by Grant Brookes, NZNO president