22 Jun 2021

$1.9b mental health rollout to get stock-take - Andrew Little

From Checkpoint, 5:07 pm on 22 June 2021

Health Minister Andrew Little is frustrated some patients in acute mental health care are not getting the treatment they need. 

On Monday Checkpoint reported the story of Kiana, who was forced to sleep on a mattress on the floor of a lounge in an acute mental health unit at Taranaki Hospital because all the beds were full. She said the experience left her feeling dehumanised and unworthy of proper help.

Little said it was "never acceptable" for cases like that to be happening.

In the 2019 Budget, the government set aside $1.9 billion for mental health, about $235 million of that for mental health facilities.

"We have a lot of mental health facilities that are pretty rundown, and that's why we made the commitment in 2019 with the mental health package we put together, that four of the facilities would be completely rebuilt. Another would have a substantial upgrade. So that that work is now under way."

Little said because none of those projects had completed the design phase, he did not know how many more beds would be available in acute mental health units.

"That work is still being done and I won't know until the design phase is fully complete. 

"I would like it to move a lot faster, but this is the nature of health capital projects and possibly public capital projects.

"The one mental health facility that the previous government did build in their time in government opened in September last year. Approval for that was given in 2015. So that's five years.

"Four of the five projects we've approved and backed financially are due to commence construction next year, and I expect will be completed either late next year or early 2023."

He said it was unacceptable patients were being accommodated on mattresses on the floor in acute units.

"We know there is pressure on acute mental health units… the overall package we're trying to get to is, at least for some people, much earlier intervention at the mild-to-moderate mental health stage that can actually prevent many going onto the need for acute services.

"We will always need acute facilities. There will always be people whose mental unwellness is so severe that they do need that level of help."

Of the $1.9bn, Little told Checkpoint about $350m of it was due to be spent by the end of June.

"About $290 million of that has been spent. Actually a lot more has been committed because the commitments go through to years three and four of the four-year spending programme. 

"So a total of about $748 million has been committed in total. But there is more to do. 

"I know there's some talk about when it comes to these rebuilds and upgrades that only half a million odd dollars has been spent. Actually that is not correct.

"It's the way that DHBs account for their spending on their capital projects - they don't get reimbursed until further down the track. So in terms of the $235 million allocated for the mental health rebuilds and upgrades, I think roughly about $9 million has been spent so far, in the design… planning, getting consents phase. And construction starts next year. 

"If you look at completed things, we have a permanent Mental Health and Wellbeing Commission in place. We have a suicide prevention office in place. We have a long-term pathway - a 10-year horizon for dealing with, planning for the mental health services out for consultation.

"From the reports I've had so far, I'm reasonably satisfied. We are a bit behind, and that is [because of] Covid-19. But I think it's important that there is a level of independent reassurance ... which is why I'm talking to the ministry now about being absolutely sure that what was expected, and the objectives set out in 2019, that those expectations are being met.

"Just a bit of a stock-take, halfway through the expected programme. How close to on-track are we, and are we satisfied that what we expected to have been happening by now is happening. I'm talking to the ministry about that at the moment. 

"I get progress reports periodically already. It's just really… I'm concerned there seems to be an understanding more broadly that nothing is happening.

"We get people on public platforms saying, 'nothing is happening, nothing has changed.' I've seen things that are different and I've spoken to people who've had the benefit of new services. So I don't accept that nothing has changed.

"But I think the public are entitled to an assurance that actually what we started out doing in 2019 with a $1.9 billion investment – that good progress is being made. 

"These things do take time, regrettably as that is. And the people who end up suffering as a consequence I know are some of our most vulnerable.

"And I am deeply concerned about that, and I engage with the DHBs and the Ministry of Health to make sure that everything that can be done to make sure services available right now are available and at a quality that we would expect."