Guest Post: Overhaul the mental health system and reduce suicides

A guest post by David Garrett:

A week or so ago  a fellow sufferer of long term mental illness made the papers. Due to her personal circumstances – amplified as is always the case by her illness – she was suicidal and sought help at an Emergency Department. She was “assessed” – if one can call her apparently cursory examination an assessment – by a nurse who apparently had little or no experience dealing with the mentally ill. This nurse decided the woman  did not warrant hospitalization, and sent the her away. I only hope that the lack of follow up to the initial story means she is still with us.

Suicide, particularly by those with mental health problems, is a massive problem in this country. In 2015, apparently the most recent year for which  figures are available, 527 people took their own lives in New Zealand. That same year, 319 people lost their lives on the roads. In other words, our suicide rate is getting close to twice the rate of road deaths.  But while we hear constantly about “road carnage”, and individual tragic  crashes lead the news, by comparison very little is heard about suicides, until a prominent person like Greg Boyed dies, apparently by his own hand. In my view, this is a national tragedy, and one that cries out for government attention.

And suicide arguably affects far more people than road deaths. I read this morning of a young woman whose father killed himself six years ago. She now suffers from depression and anxiety, and is plagued by suicidal thoughts herself. This is very common – the children of suicides are three or four times more  likely to also end their lives this way. Put another way, while roads deaths are a tragedy leaving pain and loss in their wake, suicide can be seen as  a form of intergenerational mental illness in which one tragic death frequently leads to others among those in the next generation who are left behind.

In my own situation, things were pretty well controlled for 30 years by successively better anti-depressant drugs. I was able to keep my malady from all but my family and very close friends. That changed dramatically in September 2010, and since that time, I have contemplated ending my life a number of times. It has never gone any further than contemplation, in large part because of my awareness of the probable effects of my actions on my much loved children. They already have a hefty  dose of Garrett genes – that is more than enough for anyone to cope with.

I am lucky – I have never had to put myself in the hands of an unqualified ED nurse. I have a number of people I can call upon who would drop things at a moment’s notice and come to my aid and give comfort if I asked them. But I have certainly felt the very same distress as the young woman I read about.

If this government really wanted to make a difference, instead of setting themselves the ludicrous goal of freeing 30% of  prisoners – all of whom absolutely deserve to be in jail –   they could aim to reduce deaths by suicide by 30% over the  same 15 year  time period. They wouldn’t even need to set up yet another working group. Mental health professionals would  tell them that there aren’t enough acute mental health beds, there aren’t enough trained psychiatric nurses, and there aren’t enough psychiatrists. There is both the problem and the solution,  without spending a dollar on consultants.

Yes, reducing suicides by 30% would be expensive, probably very expensive.  New buildings and trained staff cost money. Hiring trained psychiatrists from overseas would not be easy or cheap. Neither would persuading  medical students now in training, or GP’s at the beginning of their careers to train as psychiatrists. But in terms of public benefit, and “bang for buck” of taxpayers’ money, the return on investment in more people and more beds in the mental health system would be massively better than releasing dangerous prisoners into the community in the pursuit of an ideologically driven fantasy. A fantasy  that would put 30% of prisoners back in the community, where they can create more victims.

Rather than eventually being known as the government that caused a  huge  jump in criminal victimizations, it could become the government that faced up to a massive public health problem that has only got worse since the ill fated drive to close institutions and put the mentally ill into largely non-existent  “community care” began in the early 1990’s. The First Labour Government introduced a health system in which everyone, regardless of their income or station in life, was entitled to free hospital treatment. For all its creaks and strains, that system is now accepted as being part of our birthright by all political parties right across the spectrum.

The Sixth Labour Government could become as notable as the first, by recognizing the massive unmet need for mental health facilities and  treatment  in this country, and for beginning  to fix it. Unlike many of their other schemes – most notably the aim to reduce the prison population – putting money and resources into mental health is guaranteed to  have a huge and measurable  positive benefit, both  for those presently suffering mental illness and for  their children.

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