By Laura Macdonald
A girl walks into a doctor’s office. It sounds like the start of a bad joke – and it really is. Said girl, with Panadol still dissolving in her system from last week’s attempted overdose, nervously reaches out to doctor for help. Doctor skates over girl’s suicide attempt confession and instead prescribes eating some vegetables and getting some fresh air. Girl walks out of doctor’s office.
That’s it. That’s the punchline.
That’s the sad joke of New Zealand’s mental health system.
Over the past twenty years, mental health awareness has been beamed into our living rooms in the form of rugby deity John Kirwan huskily admitting to his own depression. This then spawned an entire movement of organisations dedicated to scrubbing away the taboo around mental health. Within the past couple months alone, we’ve had a tear-stained Jono Pryor and controversial Netflix series 13 Reasons Why plastered across our screens. And while staunch, leathery farmers are still wary of the latest farmstrong.co.nz initiative, the millennial generation has grown up with John Kirwan’s affirmations ringing in our ears. And while I don’t speak for every millennial, our generation is the pioneer of putting hands up and confidently asking for help. Except that help isn’t there.
The New Zealand government’s answer to the mental health crisis is quite simply understaffed, under-qualified and under-funded. It can be seen in the suicidal people waiting for hours in emergency departments across the country, ‘psychiatric assistants’ that did an online course on mental health trying to grapple with complex patients and vital mental health facilities stuttering to a close as funding has run out.
Nationwide director of mental health services Doctor John Crawshaw insists that there’s been an 18 per cent increase in mental health funding since 2008. However, this meant nothing for Waves, New Plymouth’s centre for youth counselling, when it was forced to close in 2015 due to lack of government funding. And 18 per cent was just a figure to Wellington’s Evolve Youth Clinic when they were forced to turn away over 500 teenagers for six months’ due to under-funding. Youthline was also sucker punched with a Government funding cut late last year, leaving them struggling to answer one in every four calls they received.
Those that do manage to sniff out some help often find their needs aren’t met. Take for example the girl at the beginning of the story. Which, by the way, was me. Paying $78.50 to be told to go for a run and eat better to cure my crippling depression was a harder pill to swallow than the Panadol, but it was the only help I could find. Counsellors were booked up for weeks, and even then I was a little dubious of someone with a home-printed certificate from an online three-month course on mental health.
Hannah* is in her third year of nursing, and she expresses the same thought. “These people are under-qualified and they’re often dealing with really complex high-risk patients,” she says.
If the needs of these patients aren’t properly met, Hannah often greets them when they’re admitted to her in the mental health inpatient unit. But while they get the care they need under the roof of the inpatient unit, the same can’t be said after they’re waved goodbye at the door.
“I think there needs to be more monitoring after they’re let out,” says Hannah. “They have a ‘safety plan’ but not a lot of follow-up really, and people without strong family support almost always relapse and come in again.”
Luckily, I was a few pills short of being admitted to ED and then being wheeled into the mental health inpatient unit, but this speaks volumes in itself. Patients are admitted to the unit after an intervention from the mental health crisis team or a trip to the ED, which makes units like these the ambulance at the bottom of the cliff. If more resources and funding were pumped into keeping facilities like Waves open or training people to get the right qualifications, Hannah might actually get a break during the day and I might not have looked twice at painkillers.
Crawshaw maintains that mental health is influenced by social factors like low income and unemployment levels. This isn’t a hard claim to fathom when professional psychologists charge upwards of $150 an hour. The only facility where they can access help completely free of charge is inside a mental health inpatient unit. But by the time they’re in a bad enough state to be considered a referral to the unit, it’s often too late.
So what do the New Zealand Ministry of Health have to show for their 2016 report – optimistically called “Rising to the challenge” – and an 18 per cent increase in funding? Mental health facilities straining at the seams, under-qualified health professionals, and a girl with a bottle of pills fizzing in the pit of her stomach.
*name has been changed