Ahead of the general election next month, The Royal
Australian and New Zealand College of Psychiatrists (RANZCP)
is calling on all political parties for urgent, concrete
reform and action, ensuring the mental health care and
addiction system can meet the current and growing needs of
the community.
An alarming report from the
coal-face of Aotearoa’s mental health crisis describes a
mental health and addiction system that’s under pressure,
under-resourced and under-delivering for New
Zealanders.
The study of 540 psychiatrists by RANZCP
published in the Australian
& New Zealand Journal of Psychiatry revealed the
vast majority of psychiatrists – the people on the frontline
providing care – believe the nation’s mental health system
is not fit for purpose, and not heading in the right
direction.
The psychiatrists who participated in the
study assessed the system on a number of
fronts:
Resourcing: 94% believe the
resourcing of inpatient and secondary mental health and
addiction services is not fit for
purpose
Structure: 82% state the
structure of the system is not fit for
purpose
Funding: 88% believe funding
into the system is not fit for
purpose
Demand: 90% who work on an
acute on-call roster report that demand in their after-hours
work has increased or increased a
lot
Complexity: 88% who work on an
acute on-call roster report that complexity of people’s
needs after-hours has increased or increased a
lot
Workforce: Nearly two thirds
(60%) report staffing levels have decreased or decreased a
lot
Ahead of October’s election, the Royal
Australian and New Zealand College of Psychiatrists (RANZCP)
is calling for urgent and concrete action and
reform.
“People experiencing a mental health crisis
cannot be given enough help, or the right help, in a system
that’s operating at crisis-point,” said Dr Hiran
Thabrew, Chair of the RANZCP Tu Te Akaaka Roa, New Zealand
National Committee.
“About 1 in 5 New
Zealanders will experience mental illness each year, but
each year, demand is rising – particularly for our most
vulnerable.
“Over the last decade,
moderate-to-severe mental illness has risen by nearly 40%,
affecting around 5% of the population. That’s around
256,000 New Zealanders.
“Demand is growing, and
demand will continue to grow. But the system isn’t keeping
up.
“On a practical level, bed shortages mean
acutely unwell people risk not being admitted, or discharged
too early. Going longer without help increases the chances
of a condition getting worse, being harder to treat, and
taking longer to recover, creating a cycle of crisis-driven
reactive care.
“In short, people in crisis cannot be
served by a system operating in crisis.”
Those on
the frontline have described their distress at the lack of
capacity to provide adequate support to people in
crisis.
One Aotearoa based psychiatrist
commented: “Being on call is now the worst part
of my job and it makes me consider resigning my job. The
main problem is the lack of inpatient beds that are
available. It is knowing what would be a good thing to do
and being unable to do it, and then making an alternative
plan that you know is a bad one but you have no other
options – that is soul destroying.”
Another
added: “It is extremely stressful to consistently
be having to provide substandard care for people in need,
not to mention the lack of recovery time before returning
back to work for your day job. I have begun to dread being
on call.”
The RANZCP is calling on all political
parties to make mental health a priority for the next
parliament.
RANZCP is calling for commitments
to:
Urgently address the workforce
shortage
Invest $60 million investment over six years
to support 60 new psychiatry trainees through the system and
into practice.
Support the 260,000 New
Zealanders suffering from moderate-to-severe mental illness
with the greatest need:
Increase future
mental health budgets to meet population growth and the
rising cost of existing services by $7.7 million per year,
equating to $25m over three years
Commit to the
spending previously announced – provide the mental health
budget for mental health services.
Commit to making
evidence-based decisions:
Invest $27 million over
three years for a survey to provide a comprehensive
understanding of the mental health and wellbeing of New
Zealanders
Establish a clinical quality registry
program to monitor the quality of mental
healthcare
Funding to establish systematic, regular
collection of workforce data.
Aotearoa’s rates of
mental health-associated disability sit among the highest in
the world, and serious mental health and addiction issues
are estimated to cost the Aotearoa economy $12 billion a
year (New Zealand Ministry of Health, 2017).
“The
human and economic cost of in-action is dire and
expensive,” said Dr Thabrew.
“The risks of failure
to provide adequate mental health care include more chronic
illness, intergenerational trauma, death, preventable
incarceration and homelessness, which compound the pressure
placed on other parts of the system, which are already
stretched.
“Bad mental health policy is bad for the
economy. “From a clinical, policy and ultimately human
perspective, we must act
now.”