21 Mar 2024

Mental health: When a pamphlet or helpline is not enough

8:21 am on 21 March 2024
Therapist writing notes during counseling session with single man sitting on couch, panorama, empty space

Wait times for psychologists are blowing out due to massive workforce shortages. File photo. Photo: 123RF

"Not sick enough to get help" - That's the message many people struggling with debilitating depression and other mental problems are getting from the health system.

Even for those who can afford to pay, wait times for private psychologists are blowing out due to massive workforce shortages.

Meanwhile, the government watchdog is warning there is no point in training more mental health workers if the health system does not do more to stop the exodus of those it already has.

Ren has suffered major depression since the age of 16 and been on anti-depressants for the past decade.

Referred to Christchurch's mental health service last year, Ren waited four months for an appointment - only to be told the only thing on offer was medication.

Their file was closed the next day.

Now 28, Ren said there was a big gap for people like them, who were not at crisis point - but for whom a pamphlet or even a helpline were not enough.

"There is nothing for me because I'm not 'bad enough' to get the next sort of level of help. It is really frustrating when you're being told you're not bad enough yet, it's almost like 'oh yet?' It almost feels like you should get worse so I can receive help.

"I do have to get up every day and shower and go to work. It seems like if you're not actually trying to sabotage yourself, they think you're not actually doing that badly."

After two years of searching, Ren finally managed to find a private psychologist.

"And it's great I'm now with someone but that's $195 a week. It's very lucky that I'm currently earning enough at the moment that I can afford that. But for someone who's not in my financial position, they literally have no options."

New Zealand Psychological Society president Tania Anstiss said there was "a tragic mismatch" between what services could offer and what most people needed.

"They're not yet at that crisis point where they might go to ED and access urgent care that way, but the biggest need is in that in-between space and that's where the real challenges lie because of the lack of workforce capacity."

In 2017, it was estimated district health boards needed to double the number of psychologists to meet demand - an extra 359 full-time people.

Today, it's 1000 - but the number of government-funded internships will only reach 50 next year, up from 28 in 2021.

New Zealand must train more psychologists - especially Maori and Pasifika - but it also needed to do more to stop them quitting the public system, Anstiss said.

"So there often is a lack of that experience in services and that means lack of supervision for younger staff members as well."

That was also a key finding of the Office of the Auditor-General in its report into youth mental health services.

Speaking to Parliament's health select committee yesterday Wed, senior auditor Rachel Patrick was blunt about the need to tackle critical workforce shortages.

"We know that workforce is under extreme stress. We don't want to put all our effort into recruiting new people, when actually we want to focus on keeping the ones we've got as well."

Te Whatu Ora has said previously it has developed a new mental health and addiction workforce plan as part of its overall Health Workforce Action plan - but it was still under consideration by the government.

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