SDHB halved medication, patient says
A MENTAL health patient says the Southern District Health Board’s decision to cut its ketamine clinic opening hours has upended her life.
The SDHB was playing Russian roulette with her, the 36yearold woman, who media agreed not to name, said.
Before the pandemic she had been receiving ketamine twice a week for three years to treat depression.
But she now faced an uncertain future after the SDHB cut its ketamine clinic from a twice a week service to just weekly.
Dunedin Hospital’s ketamine clinic has been administering the drug since 2015.
Originally used for surgical anaesthesia, there was growing evidence of the hallucinogenic drug’s benefit as an antidepressant for those with treatmentresistant depression.
The patient said the decision to reduce the service had upended her life.
‘‘It means that my entire life is a struggle not to selfharm, not to kill myself,’’ she said, holding back tears.
‘‘My fulltime job is not killing myself.’’
It stood in stark contrast to prepandemic, when she was a twiceweekly user of the clinic.
‘‘I wasn’t quite up to work but I was meeting friends.
‘‘I would call both my grandmothers pretty regularly — my mum has passed on and my dad’s in [the North Island].
‘‘I was exercising regularly. I
could do my groceries, going into the supermarket.
‘‘I wouldn’t have a complete meltdown and not be able to leave the house. And I could be trusted to live in my flat.’’
The drug had provided her a degree of independence, normality and, most importantly, dignity, she said.
She only found out about the reduction through the nurse administering it, she said.
‘‘I wanted one day to have a family and I don’t see that happening anymore. They’ve taken my future from me.’’
The change was initially made due to the Omicron wave, but the SDHB confirmed it was now permanent.
Her friend and supporter John Cosgrove, himself a former patient in the clinic, was now sleeping on her couch and providing around the clock care.
He said he understood mental health staff were stretched, but this was a matter of life and death.
‘‘I know there’s difficulties with highly trained professionals, but they let student nurses do this half the time because it’s just checking vitals,’’ he said.
‘‘Two hours of nurse time a week would save her life. If this was dialysis noone would question if that was worthwhile.’’
Before 2020, the clinic had six patients but it was stopped altogether for five weeks during the first lockdown that year.
Mr Cosgrove said his friend’s health suffered terribly as a result and she was offered little assistance or care.
Two patients at the clinic took their own lives during the pandemic, he said.
Of the four who used the clinic, his friend was the only one receiving twiceweekly treatment.
‘‘If I said to you we’re going to cut your kid’s treatment — your kid’s not getting their insulin this month so that they can have slightly more services.
‘‘I don’t think taking one nurse for half a day is going to result in other people’s deaths, but it could result in deaths in this clinic.’’
Mr Cosgrove said he was assisting his friend with lodging a complaint to the Health and Disability Commissioner.
University of Otago psychiatry professor Paul Glue, who researched ketamine as an antidepressant, said the results were remarkable.
‘‘For the people that I’ve looked after in clinical trials — and I can’t discuss individual patients — the change . . . is extraordinary,’’ he said.
However, its problem was its effects were temporary with depressive symptoms returning in half a week to a week and it provided no benefit for about a quarter of those who also did not respond to conventional treatment.
SDHB mental health, addictions and intellectual disability services executive director Toni Gutschlag said the clinic required two nursing staff to be present for two to three hours.
‘‘In 2020, during the first lockdown, ketamine clinics were paused due to a greater emphasis being placed on reducing facetoface contact for outpatients.
‘‘The service was paused from March 20, 2020 and resumed on April 28, 2020. During this time safe protocols for delivering ketamine were developed,’’ she said.
‘‘The ketamine protocol requires more intensive monitoring and support than usual depot treatment.
‘‘Some consumers report that ketamine has been a ‘lifesaver’ and others say it does not make a difference, so it very much depends on the individual.’’
The reduced service was not a case of costcutting, she said.
‘‘The costs of providing services during the pandemic are not the main consideration. We have been focused on providing essential services in a very complex and challenging environment.’’ — RNZ