21 Jun 2021

Woman describes 'inhumane' conditions at mental health unit

From Checkpoint, 5:38 pm on 21 June 2021

A woman admitted to an overcrowded Taranaki mental health unit says she felt dehumanised and unsafe when, with all the bedrooms full, she was forced to sleep on a mattress on the floor of a lounge.

Kiana lives with a depressive disorder and bulimia. She has attempted to end her life before.

She was admitted to the secure mental health unit at Te Puna Waiora at Taranaki Base Hospital on Thursday after becoming unwell.

The 23-year-old shared her very raw experience on social media.

Kiana said she did not blame staff at Taranaki District Health Board but she wanted people to know what it was like to try to get help in a mental health system that was under unrelenting pressure.

She shared her experience with Checkpoint, describing the sensory room or lounge she was sleeping in.

"There's a couch that is bolted into the ground. There are bean bags, but I've put them up on a bench sort of thing to stop the window, because it's a pure glass window that people can look through, and look into where I'm sleeping, because I have a mattress on the floor in that room.

"They don't have enough beds for all the patients, so they have been delegating patients to lounges and putting mattresses on the floor for them to sleep. 

"There is a lock on the door, however the nurses are quite busy, so I don't always lock my door because they all want to get in and out of it, or there was one occasion where I was standing in there and I hadn't locked the door … and a patient came in and started yelling at me and bailed me up against the wall. 

"It's not a very private place and people don't treat it as your room, they treat it as [though] they're allowed in there."

Kiana told Checkpoint the unit's staff told her there were no rooms free, and she could pick between the two lounges available.

She had access to two bathrooms with showers, but the water was turned off at a certain time, she said.

"My initial words to them was this is the most inhumane thing that I have had in a long time.

"It's just dehumanising because I know that they're trying to give me help, but putting me in a lounge where there's other unwell patients around me is really scary. It's not comfortable, and it doesn't feel safe; I should feel safe."

Outside the lounge was an open common area, she said, with four bedrooms next to the lounge.

"If it wasn't for putting up those bean bags in the windows, I would feel even more exposed."

Staff had to find a mattress for her to use in the lounge.

"I just told them 'this is absolutely disgusting, I can't believe you would do this to people.' I just think it's not right."

She described the area as "disgusting".

"The carpet looks like it hasn't been cleaned in decades, there's spills everywhere, the paint's chipping, there's holes in the walls, it feels disgusting."

The buildings needed updating, Kiara said.

"They need attention, but the DHBs aren't giving the money to have attention to these places. And if they are, it's in two or three years' time - but they need it now. 

"When we're focused on charging people $3000 to drive a Hilux, why don't we instead of looking at that, look at where we're actually going to put money into helping people with mental illness to be safe, to feel comfortable, and to feel like they have a place, rather than putting them in a room with a mattress on the floor."

Kiana said the experience had made her feel unworthy of proper treatment.

Taranaki DHB told Checkpoint the demand for acute mental health inpatient services had been high, and occupancy in Te Puna Waiora had averaged 99 percent this financial year, and unfortunately this had resulted in at times being over capacity.

When the unit was over capacity, the DHB said it worked with clinical teams to ensure patients were cared for "in the most optimal way".

"This includes facilitating patients to take leave, sharing of rooms when appropriate, and using other rooms such as our sensory lounge. Our first priority is to keep all our patients and staff safe."

Taranaki DHB has government funding for an $8 million upgrade of mental health services, including further refurbishment work in its mental health inpatient ward areas. It said planning was well under way.

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Mattress on lounge floor 'just not good enough' – Mental Health Foundation boss

Mental Health Foundation chief executive Shaun Robinson told Checkpoint Kiana's situation did not pass the dignity test.

"If people are needing acute mental health support, they are some of the most vulnerable people in our community, so they deserve privacy. They deserve dignity, they deserve some reasonable level of creature comfort," Robinson said.

"I think being put on a mattress in what is a public space within a service doesn't really meet any of those criteria. It's just not good enough," he said.

"It's actually pretty widespread unfortunately, and I don't put this on to the staff at Taranaki DHB. I think this is a symptom of the huge amount of mental health need that there is in the community.

"The last few years we've now opened the doors and we can see that level of need, whereas in the past there was so much stigma around mental health. It was such an ignored area within our health system and by our politicians.

"Decades of that has led to a massive underestimation of the extent of the need in the community. Mental distress is arguably the biggest health issue that faces New Zealand, and our system is just decades behind in terms of having an integrated response that addresses it from a multi-pronged approach, and having enough acute services when people need them.

"We have to put resources everywhere into mental health.

"The bottom line is no, there aren't enough acute beds, and you'll find that most of the services across the country are operating close to 100 percent occupancy all the time.

"That doesn't mean the answer is just to build more hospitals and build more beds. We actually do need to address people's needs much earlier.

"Many people can avoid ending up in hospital if they get services earlier. Even before that, many people can avoid becoming unwell if they have the support in the community, if they are living lives that don't actually destroy the mental health.

"We need to do what the mental health inquiry said… Three legs to the stool, and they all need to be there at the same time, or the stool will fall over.

"That is prevent mental distress wherever we can, expand services across the whole continuum of services, and we need to promote wellness and wellbeing in the community.

"The only way we're going to get ahead of this massive demand and this massive issue of mental health is to do all three of those things."

Robinson said the government's efforts so far had been good, but not enough.

"They're not doing everything that they said they would do. That's where our disappointment lies.

"I think He Aranga Ora - the inquiry into mental health and addictions - did point a pathway towards how we resolve this, but I think the eye has gone off the ball from government.

"A critical part of that was, A, assess the size of the need - that's one of the recommendations. That hasn't been done since 2006 ... and, B, have an investment strategy across mental health. Throwing $1.9 billion at it back in 2019 sounds like a large number, but actually it's not.

"When you break that down into how underfunded mental health had been, how many things they're trying to do with that $1.9 billion, it had to be the beginning, not the end.

"I think the government does want to make a difference. I have started to hear signs that with Andrew Little as a new [Health] Minister and minister Ayesha Verrall as an associate, and others - that new crop of ministers post the last election, they are having another look at mental health.

"But the proof of the pudding will be in the eating. We need to see that full package of responses from the mental health inquiry put into place.

"Why spend millions on that inquiry if you're not going to follow its advice?"

Health Minister acknowledges mattress on floor 'not ideal'

In a statement to Checkpoint, Health Minister Andrew Little said: "I acknowledge it is not ideal that people would be given beds in lounge rooms or any other non-designated bedroom.

"There is pressure on specialist mental health services across the country, including inpatient services. The Ministry of Health is working with all DHBs - all of which are making efforts to respond to the demand and occupancy pressures of inpatient and community services.

"From time to time, some inpatient units are full. When this happens, each clinical team works as best they can to be flexible and make a bed available for someone who is acutely unwell. Staff in acute mental health facilities work really hard to make sure people are treated with dignity and respect, and kept safe within facilities.

"Over the past three months, adult inpatient units across the country have remained under 100 percent occupancy as a collective. However, there will have been some individual DHBs which have exceeded the 100 percent occupancy rate.

"The national mental health and addiction capital programme includes work on 16 inpatient units. This programme will see upgrades to existing facilities and will see more flexible inpatient units - which will allow for more flexible ways of providing for care and be more responsive to patient needs. However, this will take time.

"Taranaki DHB has received $8 million from the government to upgrade Mental Health and Addiction services. I'm advised planning for this is well under way."

Prime Minister Jacinda Ardern said youth services in high schools were being expanded, one-stop shops are being financed, Youthline was being funded and services extended into primary schools.

However, it had taken more time to build capability in the area of those suffering a mental health crisis, she said.

She said 10,000 mental health sessions a month that were not previously available were now being provided, but she would like to see services provided earlier so situations did not escalate into crises. She agreed there was more work to do.