Mental health failings

OUT OF MIND

Is New Zealand’s Mental Health System Failing Our Youth?

Words by Taleta McDonald

Olivia Smith’s parents watched in horror as their daughter was removed from the clinician’s room and returned demanding medication. “It was like a conspiracy had taken place” says Mrs Smith.

Olivia, 14, was referred to the Kari Centre (Auckland Central Child and Adolescent Mental Health Service), by the family’s GP in July 2012 with suspected depression and anxiety after having an emotional breakdown caused by school bullying.

Mrs Smith says they waited 3 months for their first visit and in the months leading up to Christmas her daughter attended regular sessions at the Kari Centre, however, she noticed there were no set goals or treatment plan in place.

In a tragic turn of events, Mrs Smith says her daughter was admitted into The Child and Family Unit (child and adolescent mental health inpatient unit), in December 2012 after attempting suicide and it was here she was administered her first round of medication.

Is our mental health system failing our youth?

It’s no secret New Zealand has one of the highest youth suicide rates in the developed world. Latest figures released by Chief Coroner Judge Neil MacLean show sixty-nine 10-19 year-olds took their own lives during 2012-2013 and the highest number of suicides was recorded for 20-24 year-olds.

Sadly, it is young people within the 15-24 year-old age bracket who are most at risk of suicide, and research shows mental illness is the largest contributing factor. According to statistics from the Canterbury University Suicide Project, 90 percent of all youth suicide deaths can be linked to mental health conditions.

In August this year, the Ministry of Health (MOH) released the Burden of Disease study which shows young people suffer an 11 percent health loss due to mental disorders.

A staggering 1 in every 5 young people will experience a mental health problem in this country and despite what we are being told the situation doesn’t appear to be improving.

Researchers supported by the National Institute of Mental Health (NIMH), the world’s largest mental health research institute, have found that half of all lifetime cases of mental illness begin by age 14 and three quarters have begun by age 24. The study also reveals that an untreated mental disorder can lead to more severe, difficult to treat illness and to the development of co-occurring mental illnesses.

The Smiths say their daughter became manic and more suicidal on medication so they took their concerns to the team of Kari Centre clinicians but they suggested they give her more time on it.

From here on in, Mrs Smith describes being in a state of crisis with her daughter every day for a period of 9 months.

“I felt the Kari Centre weren’t taking Olivia’s situation seriously. We tried ringing them for help when she continued to have violent flip outs but were told to either phone the police or the crisis number.” Mrs Smith said she waited 6 hours for a mental health professional to arrive after phoning the crisis number and soon realized that port of call was of no use.

Why does New Zealand have such a high youth suicide rate and what is the nation doing to reduce it?

Dr. David Codyre, Auckland Psychiatrist and Mental Health Lead at East Tamaki Healthcare, says there are many dimensions to what drives suicide rates.

“Countries that have retained a strong element of religious faith have lower suicide rates, for example the strongly Catholic countries. We have very easy access to alcohol and drugs and yet we know that the earlier the onset of drug and alcohol use, the greater the risk of subsequent addiction and mental health issues and therefore the greater the suicide rate. Adding to this, Maori and Pacific are ethnic groups who are much more on the receiving end of various kinds of socioeconomic and cultural adversity.

“These risk factors are present at a relatively high level in New Zealand, where currently we are in economically difficult times, and on the other hand, I guess the question is to what degree have we been effective in doing the things that we know will help to reduce the suicide rate.”

Dr. Codyre says these things include addressing economic disparity, good mental health promotion and early intervention through people in key gate keeping roles such as school counselors, GP’s and other people who are in position of having contact with young people who are struggling.

“It is vital to get them into effective help and support and getting good treatments in place for people who have an actual mental health condition which puts them at risk of suicide.”

2013 saw the release of the NZ Suicide Action Plan, with $8 million going towards Maori and Pasifika communities, following the Prime Minister’s $62 million youth mental health package in 2012.

Is throwing money at a system that appears to be failing, enough to improve it?

Hugh Norriss, Director of Policy and Development at the Ministry of Health, says the funding in mental health services is currently over represented towards adults and there needs to be more even funding between adults and children.

“DHBs have a very difficult time taking money off existing adult services and then putting it into children’s services so it was necessary to have something like the Prime Minister’s youth mental health initiative as a circuit breaker to start getting the money away from more and more adult services and getting the proportions right so that the services for young people have the same percentage of resources if not more going to them.” 

“Obviously if you look after the mental health of young people you get the benefits of that right through adulthood because if people don’t get good treatment as children then their problems get bigger and then when they become adults you’ve got to spend money looking after the problems in adulthood so it’s a much better investment of the health dollar to spend it early particularly in early intervention.”

Latest figures from the Ministry of Health reveal the government spent 12 percent of the total mental health budget on child and youth mental health services during 2011-2012.

If evidence shows that early intervention in a range of mental health conditions in youth can result in better outcomes, why is there a disproportionate amount of funding between adult and child mental health services?

In desperation, and after feeling like their medication concerns fell on death ears the Smiths went back to their family GP, who became the family go-between with the Kari Centre.

Mrs Smith says, “The Kari Centre were unhappy that we had sought alternative help outside of their system and things went downhill from there.”

Kari Centre clinicians prescribed another medication but the Smiths say their daughter became like a drugged zombie so after raising their concerns again and receiving the same response they decided to stop the medication for a period of time.

Mrs Smith explains, “I felt they weren’t listening and they wanted to continue her on the medication despite it having bad side effects and it not working. They would argue with us that it couldn’t possibly have those side effects as she was on such a low dose.”

Mrs Smith says the Kari Centre clinicians were unhappy they had stopped Olivia’s medication so in fear of lack of support, she and her husband decided to try it again, however, the same results bought even more despair and they became increasingly frustrated with the Kari Centre.

“I felt like my parental rights were being taken away. I did not want my child on that medication.”

The Smiths were eventually given a new team of clinicians, however, their experience was much the same.

“We once again felt ganged up on over the medication issue and we were horrified when one of the clinicians told us; we work as a team of three and if you can’t trust our judgement and expertise then we can’t work with you.”

“We were hoping for help, support, resolution, and answers. But we got heartache, disappointment and betrayal. We were made to feel judged and persecuted and they didn’t work with us to come up with resolutions within the home. We felt as though they were on a witch hunt.”

Mrs Smith says the Kari Centre diagnosed Olivia with emotional dysregulation even after her daughter disclosed to clinicians she had been hearing voices in her head since WOULD YOU LIKE TO READ MORE OF THIS STORY?

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