Former DHB psychologist claims chronic failures in mental health services

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A healthcare professional who has been on the front line of the mental health crisis in Aotearoa says the sector is “chronically underfunded” and fears dire consequences if it continues.

Dr Marthinus Bekker quit his job as a clinical psychologist with the Auckland District Health Board this month.

He said Checkpoint staff exhaustion and growing waiting lists are major issues that require immediate attention.

Photo: RNZ / Richard Tindiller

Dr Bekker has spent six years helping a growing number of at-risk young Aucklanders.

“Mental health services do more with less. We often received more referrals month after month than ever before. Yet the number of clinicians to see them has remained the same,” he said.

The resource and burnout issues Dr Bekker and his colleagues face are not just about his former workplace, he said, but they are realities for public mental health services in Nova Scotia. Zealand.

Dr Bekker left Auckland DHB earlier in February. He was part of a team of specialists helping young people who self-harm and commit suicide.

Before leaving, he interviewed his colleagues using a scale known as the Copenhagen Burnout Inventory.

About 75% of those polled scored above a high burnout threshold, he said.

Dr Bekker and his colleagues used a 24/7 hotline to help young people who committed suicide or self-harm use their skills to manage their emotions.

“To run a child care service like this, you need a large and substantial staff to do it, and it has been more difficult. Over the past two years, we have lost staff in this team and are got to the point where we had to shut down the phone completely… We didn’t have enough people to make this list. “

He said access to public mental health services depended on the severity of a mental difficulty.

Services run by DHB, he said, were only funded to cope with moderate to severe hardship.

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Other services, like Fresh Minds and school guidance counselors, are left in the care of young people who do not reach this threshold.

“Getting into the public service has gotten to the point where sometimes our waiting list is over four to five months. These are young people who, at least after quickly neglecting the case, probably met our criteria.”

These are young people struggling with increased mental health problems who wait almost six months to access public mental health services.

At any one time, the waiting lists for services would include well over 100 young people.

“These are often young people with significant anxiety, significant depression, which impacts their lives in various ways. And very often, too, they risk themselves.

Dr Bekker said it often causes people to seek private care, but it can be expensive, sometimes ranging from $ 180 to $ 225 an hour.

His ideas come as no surprise to Mental Health Foundation CEO Shaun Robinson.

He said seizing $ 1.9 billion in Budget 2019 for a mental health program actually made no difference to those working on the front lines.

“Nothing has improved on the ground for them. Staff turnover and staff burnout are huge. We hear reports that people are in cribs in offices because there was no no room in the rooms, ”he said.

“The situation is absolutely dire and remains in crisis.”

Robinson accused the government of being too slow to implement 38 recommendations from the He Ara Oranga mental health inquiry, released in 2018.

Two years later, he said there was no plan for how these recommendations would be put into practice.

The Department of Health had also stopped reporting on the state of mental health services in New Zealand, meaning there was no tracking of what was being offered and the effectiveness of these. services, said Robinson.

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Dr Bekker said if New Zealand’s mental health services remained underfunded, more clinicians would move into private practice, making it more difficult to access public services.

He feared that if the underfunding continued, there could be much more serious results.

“ Things are improving ” – Minister of Health

Health Minister Andrew Little said Checkpoint he regularly heard from mental health workers and clients, “and the message I’m getting is that things are getting better.”

“We have a four year program that we are rolling out, we are at the end of December, 18 months later. We will be there for two years at the end of June, but it was a four-year period. One of the big challenges we have is adding more manpower, and that will take time, ”he said.

Implementation of the recommendations of the He Ara Oranga report on mental health has started, Little said, but will be completed throughout the four-year program.

“We have a plan for every element of the He Ara Oranga report,” Little said, but acknowledged that there was no comprehensive long-term plan for mental health services in New Zealand.

“This is an issue that will be addressed by the Standing Committee on Mental Health and Welfare. It is a priority for them, but it is a priority for the Ministry of Health to continue to work with the sector to develop this plan.

Strengthening the workforce takes time, he said. “We have to start, and the issues identified… will not all have been resolved in the 18 months we have invested in recommendations so far.

“Is it still urgent? Absolutely, yes. And are people still struggling and suffering to get the help they need? Yes, they are. We have started, the work is in progress. We still have a way to go. And it will always be a top priority for us to do this job. “

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Little said they were at the start of a process of rebuilding a system “that had been in disrepair for many, many years”.

The mental health money promised in 2019 was there and wouldn’t be distributed anywhere else, he said.

“Covid-19 adds new pressures and new problems in terms of mental health services and treatment, new demands for people who feel isolated, people who feel anxious. And we have to make sure that these services and treatments are here too.

“But what we are doing in the area of ​​mental health will not be distracted by the rollout of the Covid-19 vaccination program or other health reforms that we know we need to do.”

Phone line working again – Auckland DHB

In a statement, Auckland DHB said the Kari center phone line had been temporarily cut off, but was operational again.

He said a mental health crisis line was running continuously 24 hours a day, seven days a week.

Co-Director of Mental Health and Addictions Tracy Silva Garay said the safety and well-being of the staff and the people he cares for is the top priority.

“We take our obligation to them very seriously,” she said in a statement.

She said that following the Covid-19 lockdowns, some people have waited longer for mental health care appointments than DHB would like.

She said the Kari Center adopted new ways of working, including the use of telehealth, which helped make services more accessible to people and reduced wait times.

DHB is also recruiting 13 new employees to work at the Kari center.

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