More patients than beds
The Henry Rongomau Bennett Centre is so crowded that patients are sleeping on mattresses in makeshift spaces.
The mental health inpatient unit at Waikato Hospital is averaging 115 per cent occupancy, district health board members heard at a recent meeting.
‘‘That means we have got people sleeping in places where there are no beds. On mattresses, in offices, in TV rooms,’’ interim chief medical officer Dr Rees Tapsell said.
‘‘It’s very important that everybody understands what 115 per cent means.’’
The centre can sleep 53, a July health board report said, but is regularly 12 or more patients over that.
Over the first half of 2018, the centre was over capacity by 667 ‘‘bed nights’’ – an average of about four extra patients a night in adult acute wards.
The number of people using mental health services has been rising steadily since 2015, interim executive director of mental health and addictions service Vicki Aitken said, and high demand is now the norm.
‘‘The people coming in are coming in sicker, they’re staying in for much longer periods of time, and their presentations are way more acute than has been ever seen before,’’ she said.
A portion of the people being admitted weren’t known by any of the health board’s mental health services beforehand. Between October 2017 to April 2018, they made up about 21 per cent of admissions – ‘‘quite a high number’’, Aitken said.
At any time, some of the centre’s patients could be spending a day or night back at home as a trial.
But if there aren’t enough beds, it has to start converting spaces, working with the general hospital, or looking at who could be cared for by community providers. Finding a placement is tough for those who have a mix of conditions, such as mental illness and a brain injury, which can make their hospital stays long.
Seven people had been at the centre for between 73 and 238 days by the end of July 2018, a health board report said. High demand puts staff under pressure, Aitken said, so the hospital has put more nurses into the centre and is using a bureau to supplement staff.
Community mental health providers will also be feeling the pinch. Long term, Aitken would like more options aside from the inpatient unit, such as a ‘‘sub acute’’ option as a step below, short-term crisis respite in the community, and home-based support. The health board is looking at working with police around methamphetamine arrests, Aitken said, to get people help earlier.
It’s also working on the design of a replacement for the Henry Rongomau Bennett Centre and a new model of care, including how it works with other providers in the mental health and primary health sectors.
A Ministry of Health statement said that, nationally, demand for mental health services has kept rising for several years.
DHBs are responsible for their own mental health services, deputy director of mental health Ian Soosay said, and the ministry encourages them to ‘‘develop a service mix that best suits the population and region that they serve’’.
‘‘The people coming in are coming in sicker, they’re staying in for much longer periods of time . . .’’
Vicki Aitken