Quakes find faultlines in human hearts and minds

The rebuild of a city and a community following a disaster has to happen along many pathways. In Canterbury, enormous resources are being pumped into, for example, economic and central city recovery through the Cera and its blueprint. The Government’s costsharing agreement with the Christchurch City Council helps to facilitate the parallel civic recovery. The work of the Scirt consortium is devoted to ‘‘horizontal infrastructure’’ – the drains, roads, bridges etc that help make urban life liveable. The task of repairing and rebuilding homes is the responsibility of EQC.

But cities and communities are really all about people, and their health and wellbeing ought to be given equal weight in this gargantuan task of rebuild and recovery. Often, that seems not to be the case. Many people have been disadvantaged by the events since 2010, in all sort of ways, and figures given to the Canterbury District Health Board recently bear witness to the human cost of the events. We’re not talking in this moment about the bereaved and the injured, whose lives have been changed sometimes profoundly, but those who bear no physical injury, but who are now struggling to cope.

Before the earthquakes, the mental health of Cantabrians was much the same or better than people in the rest of the country. Since the quakes, there has been a 43 per cent increase in adults seeking the help of community mental health services, a 37 per cent rise in emergency presentations for mental health issues, a 69 per cent rise in the number of children and young people needing assistance, and a 65 per cent rise in the number of rural people.

These figures seem startling but are hard to imagine quantifiably without some baselines, so here is another figure – currently, about 400 people a month are seeking help from tertiary-level mental health services, and about 60 per cent of those are doing so for the first time. These figures do not include those who are managing to get by with treatment from their GPs or other primary providers. Hundreds of people a month, and thousands of people a year, are thus finding themselves in, for them, the previously uncharted territory of having to seek highlevel mental health care. Posttraumatic stress disorder, anxiety, depression, for some the sad slide into substance abuse – just as earthquakes seem to seek out the physical weaknesses in a city’s buildings and infrastructure, they can also seek out the vulnerable faultlines in human hearts and minds.

The CDHB has asked the Government for an extra $4.5 million a year to meet the rise in demand in mental health services; the Ministry of Health says the health board has already received $70m over and above its standard allocation since the quakes. In fact, the CDHB has only met the demand by prioritising mental health to the possible detriment of other services.

Mental health is always difficult to talk about; its wounds are also invisible, while physical injuries are usually obvious and elicit sympathy. Unmet need in the mental health area is likewise difficult to see, to measure, or to quantify. It is easy, therefore, for officials to disregard pleas for more resources. However, this problem is not going to go away in a hurry. The Government should take another look at what the CDHB is trying to tell them. When it comes to the funding of mental health services, Canterbury deserves to be made a special case.