Confronting our acute mental health crisis

By Kieran Madden June 28, 2021

In the 2019 Wellbeing Budget, the Government announced $1.9 billion of spending to transform the mental health system, to “take mental health seriously.” It’s time they actually did.

“There was such a euphoric feeling in the air, full of optimism and hope and I believed with all my heart things were about to change, finally we had a Government who cared,” reflected mental health advocate Mike King. “Three years on I feel like we have let everybody down.” In a symbolic gesture, a disheartened King went on to hand back his recently-conferred New Zealand Order of Merit.

Around a third of available beds intended for people seeking immediate help are occupied by longer-term patients.

He is right to be disappointed. Our acute mental health units—safe places for people at their breaking points—are now at breaking point. Around a third of available beds intended for people seeking immediate help are occupied by longer-term patients, leaving less space for those needing somewhere safe to be. In a memo to the Minister released under OIA, officials admitted that “the occupancy levels in our units, if compared to a hospital or medical ward, would compare to people having to wait longer than a six-hour wait in the emergency department and not being able to access an ICU when critically unwell.”

This comparison is jaw-dropping, and highlights the ongoing elevation of our system’s tendency to prioritise physical health over mental health. The shift towards a wellbeing focus has helped correct this, but I can’t imagine a New Zealand where there was consistently an over six-hour wait in our emergency departments, and we shouldn’t tolerate this situation in our acute mental health units either.

While some grace needs to be extended due to COVID-19, this Government’s lack of progress has been astonishing. Newshub revealed that since the funding was announced, a total of five acute beds had been added. Five. Of the $1.9 billion announced, $235 million was set aside for building new mental health and addiction facilities, a mere half a million dollars has been spent so far. Health Minister Andrew Little said he was “extraordinarily” frustrated about the situation, and a “long way behind actually getting a shovel in the ground.”

Since the $1.9B increase in funding was announced, a total of five acute beds have been added.

What it does reveal are some policy truths. Firstly, putting money aside signals priorities but does not mean it will be spent effectively in a timely manner. We need to be more realistic about what Government can do but be active in assessing actual outcomes not intentions. And secondly, policies that prioritise our most vulnerable are challenging but they are where we need to focus our attention and resources. Helen Garrick of the New Zealand Nurses’ Organisation said the Government had been focusing on the “warm and fuzzy end of things,” namely support for those with moderate problems rather than those needing acute care. This needs to shift.

There is nothing warm or fuzzy about having to sleep on a mattress on the floor like some mental health inpatients are. We can’t claim we’re taking mental health seriously when we are letting down those who need the most care.

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