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A brush with death

For thousands of New Zealanders living with mental health and addiction issues, the hardest part is being told they’ll have to wait months to get into treatment. Marine´ Lourens talks to those who nearly died before reaching the front of the queue.

Tania has lost count of how many sleepless nights she has spent worrying that her son would die of a drug overdose or take his own life. Over the phone Cameron would talk openly about suicide, telling Tania he didn’t want to go on. Often Cameron was holed up in his house, refusing to open the door to anyone, and there was nothing Tania could do to intervene.

At home in Lower Hutt, sitting at her dining room table, Tania (who requested her surname not be used) tells the complex story of Cameron’s mental illness and addiction struggle. It starts more than 20 years ago when Cameron was diagnosed with ADHD and today involves her caring for her mokopuna – Cameron’s children. On the table in front of her sits steaming cups of tea, banana bread and sausage rolls she has specially prepared for this occasion.

Tania (Nga¯ ti Tu¯ wharetoa) remembers making calls to Te Haika, a contact centre for people with mental health or addiction needs across the Wellington region, to ask for help when Cameron was suicidal. Staff said there was nothing they could do if Cameron didn’t want to willingly engage with a member of their crisis resolution team, and she should call police.

When she did that, officers said they were willing to do a welfare check, but had no powers to remove Cameron from his home against his will. Tania could only wait by the phone, hoping to hear Cameron was OK and dreading the opposite.

Karla Bergquist, a director at Te Haika (which falls under the Capital & Coast DHB), says the centre cannot respond to emergencies. Anyone concerned for someone else’s safety should call 111. ‘‘Once emergency services have attended, the person can be transported to ED for assessment by our Crisis Resolution Services, or police will contact Te Haika to complete a mental health assessment and make a plan for response,’’ she says.

Cameron was diagnosed with ADHD at 11. Soon he started selling his prescription medication to mates for cash. Drug and alcohol abuse followed, then a diagnosis of bipolar disorder. He got sober for a while, but relapsed and fell into depression. The cycle has repeated itself ever since, leaving Cameron unable to look after his children.

Tania has been caring for her mokopuna for nearly four years. She shares childcare duties with their other grandparents. She loves her ‘‘babies’’ more than anything, but it has been hard. ‘‘It has been so rewarding caring for my mokopuna, but on the other hand I am left worried sick about everything that is going on in Cam’s life.’’

Cameron’s interaction with mental health services over the years has been largely unsuccessful, Tania says. She talks about multiple visits to the emergency room where Cameron was made to lie on a bed for hours, only to be discharged the following morning without being seen by a mental health clinician. He has consistently been deemed ‘‘not sick enough’’ to be admitted to a psychiatric ward, but not offered any other treatment.

The exception was Rangiatea, a 16-week mental health programme run at a marae in Hamilton. Cameron was accepted into the course in his midteens, and enjoyed it so much he completed it twice. ‘‘[It] had every component he had missed out on in his learning,’’ Tania says. ‘‘They embraced him in manaakitanga, they nurtured him, and he was able to engage with people who understood him.’’

Tania believes culturally appropriate services are vital for Ma¯ ori and Pasifika patients, especially younger ones. ‘‘A feeling of isolation is very common for those struggling with mental illness,’’ she says. ‘‘Mental health and addiction services are missing a vital ‘anytime of the day, open-door in familiar surroundings’ approach.

‘‘When people ask for help, there should be someone available to sit down and talk to them and hear their story, instead of them being given a stack of forms to fill out and then being told, ‘Oh no, sorry, you don’t fit the criteria according to the Mental Health Act’.’’

Bergquist denies mental health services at Te Haika are limited by specific referral criteria, saying it is ‘‘guided by the person’s mental health needs, their ability to participate in daily activity, and their level of risk to themselves and others’’.

‘‘Our dedicated team of clinicians work incredibly hard to ensure that every referral and every person seeking support, is provided the right support, guidance and advice,’’ she says.

Over the past year, Cameron’s health has started to improve. He has been clean of methamphetamine

and moderated his cannabis use. He has gained weight. But the journey has been long.

Tania has met ‘‘awesome, great workers’’ along the way and is thankful to every doctor and nurse who has helped her son over the years, ‘‘but the process seems bureaucratic and singularly reliant on the patient’s willingness to follow a Western doctrine of repair and recovery’’.

Her mental health has also suffered, but she has had to stay strong and keep it together for her family. ‘‘Families and grandparents need support too. We shouldn’t be left to do this on our own.’’

Through it all, perhaps the most troubling element for Tania was watching her son fall through the cracks. He was not considered serious enough for immediate treatment, but languished waiting for less-intensive services.

Clinical psychologist Dr Marthinus Bekker says limited resources and overwhelming demand mean the most serious cases are given priority. Even when a patient is accepted into treatment, they are referred to clinicians who already have massive caseloads.

Bekker worked for a DHB for more than five years. He was passionate about his work, but resigned this year to move into an academic role. ‘‘It had become increasingly frustrating just how difficult it was to do that work in that environment.’’

The waitlist at the DHB where Bekker worked always ran to well over 100 people. The number of people on waitlists differs from one DHB to the next, but a wait time of six months or longer tends to be true across many services throughout New Zealand, he says. ‘‘Although those that need immediate help will usually still be able to get it.’’

Because the most serious cases are given priority, clinicians are not just dealing with a lot of cases, but also with the most complex cases. They’re also not able to see all of their patients every week, Bekker says.

‘‘Sure, an appointment with a patient lasts an hour, but then you’ve got 30 cases. You need time to read notes, to prepare for appointments, to consider the best treatment options, to write the notes and to fill out all the required forms that the DHB dictates need to be filled out. Then you’ve got a multidisciplinary team meeting that goes for two to three hours every week, we have to do mandated supervision, and somewhere in there we still have to fit in professional development. And lunch, which mostly just doesn’t happen.’’

Most clinicians are passionate about helping people, but the inevitable burnout leads to an exodus of skilled and experienced clinicians, he says. ‘‘I had been there for just over five years and during that time, almost all the clinicians I had worked with when I started had left.’’

Many managers arrive with ‘‘a hiss and a roar’’, but the cycle repeats as the fundamental supply of clinicians and demand of clients doesn’t improve. ‘‘I would see colleagues, often young, enthusiastic, amazing people come in and within a few months be overwhelmed and in tears and struggling. And then leave.’’

Focus

en-nz

2021-11-28T08:00:00.0000000Z

2021-11-28T08:00:00.0000000Z

https://stuff.pressreader.com/article/282016150599432

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