‘Screaming’ patient medicated against her will
Monday, 14 April 2025
In November 2024, just two days after the rollout of phase one of the new police policy on mental health callouts, a “young vulnerable patient” at risk of deliberate self harm needed to be taken to an acute mental health unit. In line with their newly minted policy, police refused to transport her. What happened next left the patient “screaming in distress” and injected with medication against her will while four security officers restrained her. The case is one of two revealed in months worth of leaked emails obtained by Stuff. As Paula Penfold reports, they provide an unfiltered picture as both staff and health bosses respond to the police withdrawal.
CONTENT WARNING: This article contains content that might be distressing to some readers.
It’s 2am at North Shore Hospital emergency department on November 6, 2024 and a young patient is waiting to be transferred to Haumaru Orite, the acute mental health unit for children and adolescents at Starship Hospital.
Emails record she has a background of significant trauma, and is assessed as having a risk of deliberate self harm and impulsivity, including jumping out of vehicles with intent to end her life.
Staff believe she’s at risk of absconding from the emergency department to get to a nearby overpass, with the intent to jump.
They believe she’s a risk to others; that she might assault staff.
Police are asked to transport her. They decline, “on several occasions”.
Two days earlier, November 4, phase one of the new police policy on mental health crisis callouts had kicked in, cutting back on the time police would spend escorting voluntary mental health patients to emergency departments and between hospitals.
At the North Shore Hospital ED, with each request for police help and each refusal, the patient’s “presentation and their distress” escalated.
She attempted to abscond, leading to four security staff having to physically restrain her, since staff were worried she would end her life if allowed to leave.
She suffered a bloody nose from hitting the floor as she was being restrained, the notes record.
And then she was given an intramuscular injection of medication, against her will.
Until that took effect, she was “screaming in distress” and fighting the security officers.
When she was prevented from leaving, she again became distressed, hitting her head against the wall multiple times causing abrasions.
She didn’t respond to attempts to de-escalate, leading to the four security officers further physically restraining her. She was given another intramuscular injection.
During that second restraining, she was “distressed, crying out for help and fighting the whole time”.
Then the medication kicked in, and she was transferred by ambulance.
Details of the event have emerged as part of a series of emails leaked to Stuff, which show increasing attempts from mental health staff and their union representatives to get assurances from Health NZ about how the police policy would be managed.
The email about the North Shore Hospital incident was sent the day after the event, signed by a registered nurse and clinical coordinator with input from mental health staff, setting out their concerns, primarily for the patient.
“Yesterday we as health professionals supported by security staff inflicted more trauma onto this young vulnerable person as a means of ensuring her safety,” he wrote.
He also expressed concerns for the impact on emergency department staff, the security officers, mental health staff, and other patients, “Witnessing the patient being held down by security, given medication against their will, hearing their screaming of distress.”
He asked what could have been done differently: “Should we have allowed the young person to AWOL then called Police 111 Urgent as they would have had no choice but to respond?” — an option it’s alleged was suggested by police comms staff.
In response, a senior health NZ manager emailed saying the incident was being taken “very seriously” and would be discussed with police locally and at national level.
In response to questions from Stuff last week, Health NZ’s director of specialist mental health and addiction, Karla Bergquist, said she could not provide details of the incident for privacy reasons, but “as is expected with any change of this nature, there were some challenging situations during the initial few weeks”.
“The learnings taken were used to improve our cross-agency communications and processes for liaison and transportation requests.”
Police said they had been unable to track down “the specifics of the North Shore matter”.
Not long after that event, in December, another incident caused distress to mental health staff, this time in Wānaka.
Two female mental health workers documented being asked to go to the Wānaka police station to see a man who had been found on a stranger’s property.
His car had broken down and he had nowhere to stay.
He was on leave from an inpatient clinic and known to carry a knife: the staff asked police to search him, and on doing so, they found two pocket knives.
It was assessed that the man needed to be transported to Dunedin for inpatient care, but police refused — twice.
“They suggested we hire a security guard to assist with transport,” the notes record.
The staff reported the patient was a known and recent risk for physically and sexually assaulting staff.
“The client was unknown to us, unpredictable and easily agitated.”
Unprepared to take the risk, the client was let go.
“We could not safely transport him”.
The staff wrote that they felt disempowered and unhappy that the man could not access the care and treatment “he clearly needed, in a timely and safe manner”.
A couple of days later, the emails record, police did transport the man, dropping him at a motel in Haast.
“From what we understand, he then disappeared into the mountains and a search and rescue was initiated to locate him. He was luckily found at a remote hut in a tee shirt and jeans. This could have been avoided by transferring the gentleman to Dunedin on the Monday.”
Responding to Stuff’s questions, a police spokesperson acknowledged there were “elements of our interactions with this man in December 2024 that could have been better, and these were discussed in a debrief after the fact.
“The lessons learned have been circulated. Our intentions are always to ensure the best outcome for an individual in mental distress, and every engagement has its own complexities.
“We take every opportunity to better engage with mental health services to help ensure positive outcomes.”
The two cases are pertinent because phase two of the police policy is being rolled out from Monday, having been delayed by two weeks from what was initially set to be its starting date on March 31.
In Bergquist’s statement to Stuff, she said a review in February of phase one indicated the changes had “largely been successfully implemented, with positive national and local relationships across agencies strengthened or re-established”.
“There were some recommendations for improvement, mainly related to adjusting practical details and communication pathways.”
The leaked emails, though, give an unfiltered insight into what was happening behind the scenes as that review was undertaken, and by the end of February unions were pressing for “more than a mere response acknowledgement” to their concerns.
The PSA’s Andrew Skelly pushed Health NZ to formally request that police pause the phased changes “until such time as they can be undertaken safely”.
In mid-March Health NZ sent out an email to say that there had been “significant work occurring during last week to consider readiness for phase two at district level”.
Skelly insisted phase two was coming too soon. “We are still seeking a pause to the phase two rollout on the 31st March. The unions and our members need more certainty before these changes occur.”
He was backed up by Ahlene McKee, an organiser for E Tū union representing security staff. She wrote, “members are not ready to shoulder the impact of a further police withdrawal”.
“On this basis we are calling phase two a ‘No Go’. We do not think sufficient resourcing and safety measures have been made to accommodate additional tasks from phase 1 yet … moving to phase 2 is not appropriate at this time.”
They got what they wanted — kind of: a delay, but only by two weeks.
On March 19 the emails recorded the first official confirmation that the rollout would not go to schedule: phase two would be pushed back from the end of March to April 14. The news would not be made public until nearly three weeks later.
“As with the phase one changes, we will be closely monitoring how this phase of change proceeds,” Bergquist said in her statement to Stuff.
“We want to reiterate that our focus is on ensuring people receive the right care at the right time, while maintaining staff safety and the integrity of our services.”