16 Jul 2021

Fears lives are being put at risk due to mental health wait times

2:06 pm on 16 July 2021

Some Wellington children and teenagers with severe mental health needs are facing more than six month wait times.

A medical professional takes notes while talking to a female patient.

File photo. Photo: 123RF

A central Wellington youth mental health service has been operating at about half capacity at times this year after many staff left - some due to stress and overwork.

Meanwhile the delays are making people more distressed and harder to treat when they do get an appointment, raising fears lives are being put at risk.

*Sarah's son's story

Wellington mum Sarah's 12-year-old son had experienced behavioural issues, anger, depression and anxiety from a very young age.

Sarah, not her real name, had her son getting private treatment but about eight months ago his symptoms got much worse.

"He was very down, very flat, lying in his room most of the time, stopped wanting to hang out with his friends.

"And then, in February, he actually expressed some suicidal thoughts."

There was a crisis and he was then taken on by the District Health Board's child and adolescent mental health service - known as CAMHS - for those suffering moderate to severe mental health and addiction problems.

It took three months to get their first appointment - to discuss possible treatments, not actual therapy - which Sarah said was a long time to wait when your child has talked about killing themselves.

An appointment was then booked for a month later, but a week before it was due CAMHS called to say their clinician was leaving the service and asked if they could do a month later.

That would have been the end of July.

"I got very angry and lost it and said it wasn't good enough, and that I wasn't going to wait any longer," Sarah said.

The service relented, finding her an earlier slot.

Sarah, who works in the health industry, said she believes she only got the appointment because she caused such a fuss. She said waiting so long put significant strain on her family.

Jane's daughter's story

Wellington mother Jane's 16-year-old daughter suffers from post traumatic stress disorder, depression and extreme social anxiety.

She had been seeing a clinical psychologist but wasn't getting better and, a couple of months ago, CAMHS agreed to take her on.

But it told her the waiting list to start therapy was six-months long.

Her daughter's GP has written asking for it to be brought forward, and a clinician at the services told her they would love for her to file an official complaint about the delay.

Jane has had to quit her job to care for her daughter.

"When you've got a teenager at home who is just not engaging, who is suffering, you just want to do whatever you can.

"There is no assistance for parents who are trying to navigate their way through this stuff."

Longest ever wait times

Wellington clinician Jesse said, under normal circumstances, there would be about a three-week wait for an assessment, then three weeks again for treatment to start.

She said wait times were now "extraordinarily long" - the longest ever - and the delay meant patients turning up at appointments feeling hopeless and more distressed, making it harder to treat them.

"People are less collaborative with [the] treatment.

"It's painful to see that we're not able to deliver what the community expects to be delivered."

Union fears there will be deaths in "disaster" situation

The APEX union represents therapists, psychologists and social workers. Its secretary Dr Deborah Powell said half of the staff in the Wellington central service have left.

She said team morale is low and management has not given a plan for how the staff shortage will be remedied.

Jobs to replace departing staff were not advertised until after employees have already left.

Instead, she said, staff were being seconded to cover the shortfall which just caused issues in other areas.

She said wait times ramped up this year, from weeks to many months - up to seven months in some cases.

Dr Powell said a staff member who resigned recently had 70 clients when they should have had just 20.

"On top of an increasing workload [there is] a reducing number of staff - it's just a time bomb.

"And I cannot, I cannot find out why they did not replace the staff in a timely fashion.

"I just don't understand it and I can't get a straight answer out of [Capital and Coast District Health Board] on that one."

Dr Powell said the regional mental health triage centre Te Haika was also critically understaffed and CAMHS clinicians were having to help out there too - taking them away from therapeutic work.

She said labelling it at 50 percent capacity actually understated the real situation, because the compounding effect additional duties meant the service was effectively running at about a third capacity.

Dr Powell said the remaining staff were hanging in there, but they were rushing from crisis to crisis and it was not clear how long they could cope.

"More people are at risk of attempting suicide, or worse still, actually dying as a result of the situation.

"And the stress on the people working in the service, knowing that that is a potential outcome if they don't do their job properly, is just unbearable."

She said the situation was a "disaster", and the DHB had failed to respond to clear signals trouble was looming.

Documents released under the Official Information Act show requests by CAMHS and another another mental health service in the region to hire extra staff above what they were budgeted to deal with the increased demand were turned down by the Capital and Coast DHB for funding reasons.

That is despite services saying they were facing the "highest ever" demand, and that they have "no other options" but to hire more staff.

A hiring document states: "CAMHS Wellington are not able to provide a timely access and quality treatment to infants, children, young people and their families without more full time equivalents.

"This poses significant risk to the individual's, community and the organisation."

DHB currently recruiting

Mental Health, Addiction and Intellectual Disability Service executive director Karla Bergquist said, in the past year, general demand has increased, as has the number of people with acute needs.

She said average wait times for Wellington central for the year to April was 50 days - which was affected by Covid-19 alert level changes - and was 29 days in the most recent reporting period.

She said the DHB was recruiting to fill four full-time equivalent roles.

"We acknowledge the pressures and challenges the service faces, both here locally and nationwide. We are working closely with our team to provide support and remain committed to recruitment and improved systems and processes that support recruitment and retention of the workforce."

*RNZ has spoken to multiple parents for this story. We are using pseudonyms to protect children's identity and because parents fear speaking out could make it even harder for them to get access to treatment.

Where to get help:

Need to Talk? Free call or text 1737 any time to speak to a trained counsellor, for any reason.

Lifeline: 0800 543 354 or text HELP to 4357

Suicide Crisis Helpline: 0508 828 865 / 0508 TAUTOKO (24/7). This is a service for people who may be thinking about suicide, or those who are concerned about family or friends.

Depression Helpline: 0800 111 757 (24/7) or text 4202

Samaritans: 0800 726 666 (24/7)

Youthline: 0800 376 633 (24/7) or free text 234 (8am-12am), or email talk@youthline.co.nz

What's Up: online chat (3pm-10pm) or 0800 WHATSUP / 0800 9428 787 helpline (12pm-10pm weekdays, 3pm-11pm weekends)

Kidsline (ages 5-18): 0800 543 754 (24/7)

Rural Support Trust Helpline: 0800 787 254

Healthline: 0800 611 116

Rainbow Youth: (09) 376 4155

If it is an emergency and you feel like you or someone else is at risk, call 111.

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