A psychiatrist says people with serious mental health and addiction problems should not need to commit crimes to get access to long-term secure treatment.
Clinical director of Auckland Hospital's acute mental health unit Gregory Finucane made the comments today at in inquest into the death of Isabella Brown.
Ms Brown died of an apparent morphine overdose in June 2012, about a week after running away from the unit, where she was being treated for psychosis and drug addiction.
Her sister Jaqi Brown told the inquest the family did not believe her sister's drug dependence was ever properly treated.
Dr Finucane said the acute unit was only designed for short stays and it is difficult to treat people like Ms Brown who have very complex drug and mental health issues.
He said the only long-term secure unit in the upper North Island was the Mason Centre, which was only for people with a background of violence or criminal offending.
Dr Finucane said there needed to be an equivalent facility for other patients.
He said Auckland and neighbouring DHBs have sent a proposal for such a unit - which would probably have six beds - to the Ministry of Health.
"We don't have access to secure female rehabilitation, so we have access to secure male rehabilitation, but again it's not many beds."
Jaqi Brown told the hearing her sister ,who was 37 when she died, had a long history of drug dependence dating back to when she lived in Australia in her early 20s.
Ms Brown said at one point in 2011, Isabella was found six months pregnant with her third child living in a garden shed in Auckland.
Her second child, now 10, was born with drug dependence.
Ms Brown said all three children are now in the care of the extended family and doing well.
She said at the start of the inquest the family had many unanswered questions about Isabella's death, including how she escaped from the mental health unit.
Dr Finucane explained to the hearing that Isabella had dashed towards the door of the ward - which was usually locked - as the receptionist unlocked it to leave.
He said she had put her hand in the door and kicked the receptionist so she could escape.
The unit was not officially a secure ward but is almost always locked to prevent patients escaping, he said.
However, he said about one patient a month still managed to abscond, usually by assaulting staff or getting out through windows.
The inquest also heard from Isabella's ex-partner Nicholas Whall who said he picked her up in central Auckland after she escaped the unit.
Mr Whall said she told him she'd been discharged and he took her to her uncle's house in Mt Roskill.
He said there were people using morphine and other drugs there and he was surprised that Isabella managed to stay clean for several days before overdosing.