Dr Kate Allan, New Zealand chair for the Australasian College of Emergency Medicine. Photo \/ Jason Dorday<\/p>\n
The New Zealand chairwoman of the Australasian College for Emergency Medicine and ED physician Dr Kate Allan<\/a> said there were \u201cmany examples\u201d of mental health patients absconding from EDs as overrun staff were often unable to continually watch patients.<\/p>\n \u201cCare gets diverted and prioritised to those acute patients who are coming in who are significantly unwell, and we have to manage that, to ensure that we prevent people dying,\u201d she said.<\/p>\n AdvertisementAdvertise with NZME.<\/a><\/p>\n She said it wasn\u2019t an issue isolated to Middlemore\u2019s ED<\/a>.<\/p>\n \u201cThis is an example of what\u2019s happening in our [ED] departments every day. It\u2019s an example of patients who are spending typically very long times in emergency departments waiting for an inpatient bed.\u201d<\/p>\n Research published in the Australasia Psychiatry medical journal recently showed an almost four-fold increase in the number of young people seeking mental health support at Christchurch Hospital\u2019s ED, which is the country\u2019s busiest.<\/a><\/p>\n Rates of adolescent mental health ED presentations increased by 289% between 2007 and 2022. By comparison, rates of all adolescent ED presentations increased by 9.8%.<\/p>\n NZ\u2019s \u2018national emergency\u2019<\/p>\n Child and adolescent psychiatrist Dr Hiran Thabrew told the Herald EDs are now a \u201crevolving door\u201d for mental health services despite EDs \u201cnever being built or resourced\u201d to provide such support.<\/p>\n \u201cWe know that EDs are the default point now for accessing mental health care because people seem to not have anywhere else to go,\u201d he said.<\/p>\n Thabrew said this was a worrying trend and a symptom of the lack of community services and expert staff to work within them. <\/p>\n \u201cThose at greatest risk are not having their needs met in the community and are having to present to ED,\u201d he said.<\/p>\n New Zealand ranked the lowest among 36 other OECD countries for mental wellbeing, according to recently released Unicef research. <\/p>\n Thabrew, who\u2019s also chair of the New Zealand office of the Royal Australian and NZ College of Psychiatrists, likened the situation to a \u201cnational emergency\u201d, highlighting the country\u2019s lack of psychiatrists and record youth suicide rates<\/a>. <\/p>\n AdvertisementAdvertise with NZME.<\/a><\/p>\n Investment seems to have been patchy, poorly planned, and reactive.<\/b><\/p>\n Psychiatrist Dr Himan Thabrew<\/p><\/blockquote>\n Responding to the Government\u2019s Budget last week<\/a>, he said he believed there was no national plan to deal with the country\u2019s mental health crisis and called investment to date \u201cpatchy\u201d and \u201creactive\u201d.<\/p>\n That was something he said was disappointing.<\/p>\n The Budget included $28m to establish mental health teams to respond to 111 calls from people experiencing mental distress.<\/p>\n The funding followed the decision by police to opt out of providing some services.<\/p>\n Thabrew supported this and funding of \u201cpeer support\u201d workers at EDs \u2013 who comfort those in mental distress \u2013 but said major reform was needed.<\/p>\n \u201cWe\u2019ve seen no comprehensive strategy, no dedicated roadmap, and there\u2019s no urgency to meet the scale of need,\u201d he told the Herald.<\/p>\n AdvertisementAdvertise with NZME.<\/a><\/p>\n He said despite rising distress and workforce shortages, the Budget failed to deliver ringfenced funding for frontline mental health services.<\/p>\n \u2018No clear strategy\u2019 on mental health The CEO of the Mental Health Foundation Shaun Robinson was not surprised patients were absconding from EDs and agreed with Thabrew that EDs had become the \u201cde facto health service for many people\u201d experiencing mental health challenges.<\/p>\n He said EDs are not the appropriate place for such patients, especially if they end up in a corridor amid overcrowding issues.<\/p>\n \u201cWhat we need are a range of alternatives in the community. A lot of those people, if they could go to a centre in the community where they could get appropriate support and the de-escalation of that situation, they would probably never need to go into hospital,\u201d he said.<\/p>\n He said there was \u201cno clear strategy\u201d to deal with the mental health crisis in the Budget \u2013 a crisis which had snowballed over decades because of underfunding.<\/p>\n He supported Mental Health Minister Matt Doocey\u2019s efforts to find solutions.<\/p>\n AdvertisementAdvertise with NZME.<\/a><\/p>\n \u201cI think that the scale of what they\u2019re doing [the Government] compared to the scale of the need is woefully inadequate, but I don\u2019t think that that\u2019s the Minister of Mental Health\u2019s fault. I think he is doing the best he can to get the resources that people need,\u201d he said.<\/p>\n Minister: EDs should be \u2018final resort\u2019 Doocey sympathised with the plight of those in mental distress having to contend with overrun EDs, telling the Herald it should be the \u201cfinal resort\u201d for people seeking support.<\/p>\n \u201cBeing in a busy, loud environment with bright lights is not a therapeutic environment for those who are in mental distress,\u201d he told the Herald.<\/p>\n He said peer support workers, who are now in five EDs, including Middlemore, will help those in distress navigate what can be \u201ca very challenging place\u201d.<\/p>\n Doocey also referred to last year\u2019s announcement to set up six so-called \u201ccrisis recovery cafes\u201d \u2013 community-based centres he believed would prevent people ending up in EDs.<\/p>\n A national mental health and wellbeing strategy would be released in October and Doocey indicated a suicide prevention plan would be out imminently.<\/p>\n AdvertisementAdvertise with NZME.<\/a><\/p>\n Doocey said claims there had been no ringfenced funding for frontline services were not correct, referring the Herald to last year\u2019s Budget announcement of $2.6b being set aside for mental health.<\/p>\n However, psychiatrists say it\u2019s not clear precisely how much of that money is reaching specialist services and hospitals nor how much is being used to address workforce gaps.<\/p>\n In February, it was revealed money earmarked for frontline services was diverted into another mental health project.<\/a><\/p>\nA review written by clinicians and obtained by the Herald has raised serious concerns about staff and patient safety at Middlemore Hospital’s emergency department. Photo \/ Jason Dorday<\/p>\n
Dr Hiran Thabrew is a child and adolescent psychiatrist and chair of the NZ office of the Royal Australia and NZ College of Psychiatry. Photo \/ RNZ \/ Cole Eastham-Farrelly<\/p>\n
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Shaun Robinson is CEO of the Mental Health Foundation. Photo \/ Supplied<\/p>\n
Mental Health Minister Matt Doocey. Photo \/ Mike Scott<\/p>\n