What’s the problem?
response service rolled out nationwide in November 2017 should help with Morris’s first plea. Run by Healthline operator Homecare Medical and staffed 24/7 by 25 mental health nurses, it aims to divert and assess 111 mental health calls, and to link people to local services where possible.
Manager and mental health nurse Liz Hosking says it’s early days but so far her team is seeing anxiety; psychosis – such as people hearing voices telling them the Mongrel Mob is coming to get them; drug and alcohol issues, and problems following on from growing homelessness and social deprivation. The biggest age groups are 25-39 and 45-49.
‘‘People call police because they’re in distress and they don’t know who to call.’’
About 15 per cent of calls are referred to local crisis teams for an urgent face-to-face follow-up, about 11 per cent are referred back to police to dispatch an officer; the rest are managed over the phone.
‘‘We don’t want everybody in this situation to get a police officer,’’ Hosking says. ‘‘We want them to get a personalised plan of support that actually suits them for where they live.’’
Morris’s second request – a place to take distressed people – is more difficult. Police have made a huge push to avoid detaining people in police cells while they await a mental health assessment, taking them instead to emergency departments. But that has its own problems, as Kelly’s experiences showed. Capital & Coast DHB figures show a quarter of people seeing the crisis resolution team in ED wait more than six hours for help.
Wellington policewoman Sally Wiffen thinks emergency departments are the wrong place for people suffering extreme mental distress, and would like to see a dedicated facility. Crisis nurse Fran Gibb would set up a six-bed unit next to ED. Wellington regional mental health boss Nigel Fairley thinks emergency departments are the right place for people suffering a mental health crisis, but agrees police shouldn’t have to wait with patients.
One innovation that seems to have universal approval is the previous government’s plan to set up an $8m co-response unit, bringing together police, ambulance and mental health staff to respond to crisis calls. That’s top of Fairley’s spending list, alongside more community and school support.
‘‘That will reduce pressure on emergency departments significantly,’’ he says. ‘‘And I reckon it would be a pretty popular job.’’
Overseas experience in places such as Perth has shown the system can cut costs and reduce the number of people left waiting in emergency departments.
The initiative, announced in August 2017, was to be trialled in two cities and one provincial or rural site. Police briefing papers say the project is due to be operating by September 2018, but new Health Minister David Clark is still considering all new initiatives.
Morris says a joint response team would solve the current problem of mental health staff turning up and realising they need police, or vice versa. ‘‘The biggest problem we have is the uncoordinated nature of the response. It Mental health episode Disturbance Violence Transportation Other is co-ordinated, but it’s not together.’’
Kelly also likes the joint response idea – care without the stigma. She’d also like to see better crisis team resourcing to enable longer phone chats to devise crisis plans. She got on to a long-term therapy programme and has been crisis-free for two years, highlighting the importance of having the right support to prevent total meltdowns. ‘‘I kind of consider myself out the other side. But it could happen again – it could happen to anyone – so you want the system to be working in a way that can help.’’ 30,000 25,000 20,000 15,000 10,000 5000 0