Heather Roy's Diary: Mental Health

Published: Fri 2 Dec 2005 04:14 PM
Heather Roy's Diary
Mental Health
On Monday a psychiatric patient ran amok in Henderson, West Auckland and killed a passer-by, Mr Kevin Newman. The attacker began by assaulting two men in a fishing equipment shop and then attacked Mr Newman in the street with a knife. He was then confronted by armed police officers and attempted to attack them, despite being shot. It has been reported that he had three bullet wounds but was grappling with a female police officer before being tackled by a parking warden, Mr Pes Fa'aui. This enabled police to apprehend the attacker who is now in hospital being treated for his own wounds.
The parking warden, Mr Fa'aui, had previously applied to join the police but was turned down because he couldn't swim. In light of these events the police should reconsider his application.
There was no obvious motive for the attack but it is generally assumed that the patient was psychotic at the time. This incident has raised, and not for the first time, the question of community treatment of psychiatric patients. Local Mayor, Bob Harvey, has said that the number of psychiatric patients walking the streets was "a big issue".
If Mayor Harvey means that there needs to be an increase in the number of long stay psychiatric beds then I agree with him. It does, however, need to be pointed out that for the last 20 years there has been a progressive closing down of nearly all psychiatric hospitals throughout the country. This has occurred under both Labour and National Governments and was done at a time when there was increasing use of marijuana and other recreational drugs.
Before people get on their high horse about psychiatric patients being "discharged into the community" it is worth remembering that, by and large, there is no alternative. Change needs to be made at a political level, as there is nothing mental health workers can do. They are not the ones making decisions on the structure of the mental health system although they often bear the blame for its failings. It is government that needs to make changes.
There now exists a large number of people with "double pathology" or "dual diagnosis" - patients who suffer from a mental illness and alcohol and/or drug addiction. Alcohol and drugs frequently make psychiatric symptoms worse and patients are often not compliant with treatment. The expectation of government is that the vast majority of these patients be treated in the community.
Sometimes patients need respite from the pressures that exist within our communities. Those addicted to drugs and alcohol for example find it very difficult to abstain while living in the community where both are easily accessible. The current system is fragmented. When people fall through the cracks it is often prisons that are left to pick up the slack. Prisons and living rough on the streets are no way to care for the mentally unwell. Society would be outraged if those were the options for people with physical conditions. Mental health has remained the 'poor cousin' in the health system for too long.
As Opposition health spokesman in the late 1990's, Annette King was very critical of the then Health Minister and said this of the mental health system:
"We see a 'cycle of tragedy - followed by investigations - then recommendations which appear to make no difference - then frustration - followed by rounds of people blaming each other - and finally another tragedy to kick-start it all off again".
She went on to say that "this was no way to run a health system"
Well, I agree. Unfortunately in her six years as Health Minister she did nothing to improve the situation for the mentally unwell. They are still being sent to prison and living rough on the streets. The system is still as fragmented as ever. Let's hope the new minister can do something for a system that is failing everyone - patients, their families, psychiatric staff caring for them and communities.
In the meantime Mr Newman's tragic death will no doubt result in an inquiry, plenty of hand wringing, recommendations that will change very little and we will sit and wait for the next tragedy to occur so that the process can start all over again. Until a government has the courage to tackle the real problems in mental health nothing will change.

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