12 Aug 2016

Christchurch's mental health crisis

From Christchurch Dilemmas, 1:03 pm on 12 August 2016

Five years on from the earthquakes, many expected the mental health of the population to have recovered. Instead, mental illness statistics are continuing to climb in almost every measurable area. Christchurch Dilemmas asks how Canterbury can respond to its mental health crisis.

> Discuss ideas for addressing Christchurch's mental health issues at chchdilemmas.co.nz 

The outward signs of a natural disaster are beginning to disappear from Christchurch’s physical landscape. As the last damaged buildings of the business district are demolished, empty lots are replaced by tilt-slab offices and enormous sheets of glass. More than 90 percent of insurance claims are settled and repairs have been carried out on tens of thousands of homes.

But behind closed doors, experts say the psycho-social recovery of the city is in desperate need of attention. As the initial trauma and stress of the quakes fade from memory, many expected the mental health of the population to have recovered. Instead, mental illness statistics are continuing to climb in almost every measurable area.

The proportion of people reporting that they felt stressed “always or most of the time”  doubled from 8 percent in the pre-earthquake to 19 percent in 2015. Last year, police callouts for attempted suicides rose 60 percent from pre-quake levels, the highest in the country.

Canterbury saw a 37 percent increase in people entering mental health services compared to pre-quake levels. Rural mental health presentations were up 65 percent. Emergency health presentations have risen 104 per cent, psychiatric emergency assessments are up 124 percent.

In Christchurch Hospital's emergency department, clinical director Scott Pearson says he's seeing people who tell stories of multiple moves since the earthquakes and on-going debates with insurance companies. 

"There's no doubt that affects their physical health."

Dr Scott Pearson, Emergency Department clinical director.

Dr Scott Pearson, Emergency Department clinical director. Photo: Christchurch Dilemmas

Dr Alistair Humphrey, Canterbury District Health Board’s medical officer of health, says despite their efforts things are continuing to worsen.

“Before the earthquakes of 2010 and 2011, the people of Canterbury had mental health problems well below the national average,” he says, “but in five years since, mental health problems have climbed steadily, in all age groups and at all levels of severity. The problems that we’re seeing - in the hospitals and in the community - are continuing to climb.”

The eastern suburbs - already one of the most economically disadvantaged areas of the city - were also the worst hit by quake damage. Here, the lingering effects have been hardest felt. Almost half of the population of the eastern suburbs were categorised as “low wellbeing” on a World Health Organisation scale, compared to around 31- 40 percent across other regions of Christchurch and 25 percent nationwide.

Meanwhile, Humphrey claims Canterbury District Health Board is one of only two in the country which has had its funding decrease in the past two years. Figures provided by Dr Humphrey comparing the 2015/16 year to 2016/17 show Canterbury’s mental health funding has been cut by 4.5 percent. This makes the funding here $44 less than the national average of $251 per person.

Canterbury District Health Board (CDHB) reported the total shortfall for mental health funding for the year would be $23 million, most likely to be filled by pulling money from other services. A $20m funding injection to be rolled out over three years was announced in March - but Dr Humphrey says it’s not enough to balance the overall shortfall.

Meanwhile, around the edges, community groups are stepping into the gaps to meet the most urgent needs of their community.

Dr Sue Bagshaw runs the 298 Health Centre, which provides wraparound support to youth in crisis. “We’ve always had young people living under the bridge or living in tents, but it’s just way, way worse now,” she says.

“The earthquake was the stone in the pond, so you can’t see the stone anymore but the ripples are still there.” Now, Bagshaw wants to expand the health centre into a “one-stop-shop” for youth to come for counselling, health issues, employment and housing.

Dr Sue Bagshaw.

Dr Sue Bagshaw. Photo: Christchurch Dilemmas

Across the city, Home & Family provides residential programmes for vulnerable mothers and babies. Many of their clients are at risk of having children removed from their care, and the trust works with families to teach parenting skills, provide counselling and offer housing.

“Since the earthquakes we’ve been up there at capacity and with waiting lists,” says Sandra Talbot, parenting team leader. “I know people think that it’s getting easier in Christchurch, but it’s not.”

Director Val Carter says the needs are more urgent than ever. “We’ve got higher levels of anxiety, families finding it finding it difficult to find homes - warm comfortable homes for their children, especially that are affordable for them.”

For adults still feeling the effects of trauma and anxiety, Creative Spaces provides workshops for art therapy and creative output.

“After the earthquakes a lot of our voices were taken away, so we didn’t get a say in the things that affect us,” manager Kim Morton says. “But there’s an inherent power in creativity. It’s a way of expressing who you are and what you believe in.” Ms Morton says they have had 20 new participants in the last month alone, and can’t absorb the demand.

All of the community groups have three things in common: waiting lists, increased demand, and a desperate need for funding.

So how will Christchurch respond to its mental health crisis? And what resources are we prepared to dedicate to doing it?

For more on the ideas for helping mental health in Christchurch - and to join the discussion - go to ChchDilemmas.co.nz

*Christchurch Dilemmas is produced by Gerard Smyth and edited by Gaylene Barnes, with support from NZ On Air and RNZ. Written story by Tess McClure.

A new story from this six-part series will come out every Monday here on RNZ.CO.NZ and on ChchDilemmas.co.nz