How district health boards measure up

An attempt to use the Official Information Act to compare crisis response times across district health boards highlighted the difficulties police face dealing with 20 autonomous health boards. Some DHBs have crisis lines; some don’t. Some measure their call response time; some don’t.

Here are some snapshots from DHBs that do collect data: Auckland: During 2016, Auckland’s crisis line received 59,918 calls, but only 4870 of those were referred for an urgent response. Average call response time was 20 seconds. Sixty per cent of patients were seen in four hours or less, but the average wait was 10 hours. Waikato: After-hours calls are managed by Homecare Medical, which also runs the new national early mental health response service. During a three-month snapshot, it received 2368 calls, of which 75 per cent were answered within 30 seconds. Almost 10 per cent of callers gave up before the call was answered. Calls took an average of nine minutes, including paperwork. Callers were predominantly Pa¯keha (65 per cent) and women aged 17-25 were the biggest group.

Bay of Plenty: Received 7975 after hours mental health calls in 2016; 1009 calls went unanswered. Average answer time: 33 seconds. Capital & Coast, Hutt Valley and Wairarapa: 10,019 calls received during three-month sample period, of which 97 went unanswered. 198 callers hung up before the end of the welcome message. A quarter of those waiting to see the crisis resolution service in Wellington ED waited more than six hours. Taranaki: Based on two sample weeks, 25-60 per cent of crisis calls go to voicemail. Total response time averages 14-24 minutes. Canterbury: No longer has a standalone crisis response team. Reported 3453 crisis calls during 2016. Does not record response time. 2016 complaints about access to crisis mental health services:

❚ A helpline contacted Auckland DHB for crisis support for someone who had made a suicide attempt. ADHB promised to call back, but never did. The helpline ended up calling police instead.

❚ A consumer complained Auckland DHB doctors called police, who kicked down her door and placed her under the Mental Health Act, which she disagrees with.

❚ A man called Whanganui DHB’s mental health team worried about his wife’s behaviour. He left a message and no-one called back. The woman’s daughter also called and was told there was nothing they could do unless the mother willingly engaged with the service. Her husband then called an ambulance to take his wife to ED. She ran away twice, and police were called in. The daughter said neither ED nor the mental health service would take responsibility. The woman later told her family she was dragged out of the police car, thrown facedown on a bed, had her pants pulled down and was given a sedative.

❚ A person treated in a Canterbury DHB emergency department after an overdose was referred to crisis resolution services, but waited nearly 5 hours to be seen.

❚ A person called the Taranaki crisis team to request help for her partner, who had overdosed. The crisis team asked the caller to phone an ambulance, which she declined because it would be quicker for her to drive to Taranaki emergency department. The person arrived at ED at 10.30am, but was not seen by the crisis team until 4.15pm.

❚ The complainant called police and Hawke’s Bay crisis mental health services worried about their friend. They subsequently did not speak for two days because the person was angry the friend had called police. At that point, no-one from mental health had visited. It appears the patient later took their own life. ‘‘A lot of my complaint is probably my guilt,’’ the complainant wrote. ‘‘I could have called and checked why nobody had been to see [deleted name], but I should not have had to and the truth is it lies with your mental health team.’’

❚ The wife of a Bay of Plenty person drinking to excess complained the crisis service referred her to police rather than coming themselves. (The crisis team said they needed police support to deal with intoxication.)