City bears brunt of people falling through cracks in New Zealand’s mental health system

Wednesday, 13 March 2024

The central city is bearing the brunt of a flood of mentally unwell people who have been falling through cracks in the mental health system since psychiatric institutions were shuttered in the ‘90s, according to those working in the field.

While the Hamilton Christian Nightshelter/Te Whare Korowai has become a “dumping ground”, an expert says it’s a symptom of a larger issue in New Zealand society.

Senior psychology lecturer at the University of Waikato, Dr Ottilie Stolte, told the Waikato Times that the shelter is a “worst case housing option, not a health facility”.

There hasn’t been an “in-between” place for mental health patients who’re “not unwell enough” to be admitted to Henry Bennett and “not well enough to live independently” since the psychiatric institutions shut in the 1990s.

Nightshelter Kaiwhakahaere Matua Joanne Turner said there was no help for people who turn up with noticeable mental health issues.

The good point to intervene is when a problem is identified and “see if we need to do a medication change or if there's anything that we can do to support them to pull back from getting too unwell”.

However, every time she called the mental health team, she would be referred to the police “if they’re at risk”.

“That decline happens relatively slowly, it can happen over three or four weeks.”

Turner said it’s like watching a ticking time bomb until they are forced to involve the police because the patients have become so unwell they are a risk to themselves and others.

“So what we know about people when they are in the throes of the mental health diagnosis and in a psychosis, they're hearing things, they're seeing things, they're delusional … the longer a person sits in that space, the harder it is to ever pull them back into a state of wellness where they'll be able to function again.

“There's a whole lot of people out there now that have been in psychosis or in the state of unwellness for so long that it is going to be there for the rest of their lives. They’re never going to be able to function well in society.

“Those are the people who end up in our shelters, they’ve moved past a point of no return.”

Turner said the shelter had become a dump and run service, “once the person is in our accommodation facility, that's pretty much it”.

Dr Stolte finished her four-year research on homelessness in 2011 and spent another decade writing about it, but had seen no improvement so far: “if anything it’s got worse”.

Stolte argued one would not place someone who’s just had a stroke or broken a body part to live in a homeless shelter where there was no support.

The homeless were the forgotten people, she said.

“This has been a problem for years, basically since we closed all the psychiatric institutions like Tokanui or Carrington Hospital.

“There's not really been anywhere else for people to go who are not unwell enough to be admitted to Henry Bennett, but are not well enough to live independently or even in so called supported housing.

“They're out of sight and out of mind until middle class people trip over them in the streets or when something really tragic happens.”

Stolte said it would take many experts to come up with a solution to the homeless problem, but it had to be better than the current “inhumane and expensive” one.

She had seen homeless people cycle from the night shelter to the streets then end up in hospital or jail before ending up on the streets again. Every time it involved a huge admin cost.

“It would be cheaper just to put these people somewhere in housing and then you work on all the other issues.”

One housing option was the mental health rehabilitation beds, however, Turner said she’d never been able to get any of their guests into the facility.

“Most of the time they say we're not taking any referrals at this time because they're full.

“All these services are bottlenecked and they end up with us.

“This is not our job - we do homelessness, you do mental health - but the reality is if we don't do it, they end up on the street.”

The facility had to extend its services to be more than just a “nightshelter” and Turner said they now provided support for mental health and addictions, social work, housing navigator, support workers and more.

Residential accommodation (supported accommodation) offered a range of mental health services and levels of support for the purposes of undertaking rehabilitation, normally with a view to return to independent community living.

The services provided a mixed model of support for mental health and addiction service users up to, where required, wrap-around 24/7 support.

A Te Whatu Ora spokesperson said the facility provided a nurturing and home-like environment, where residents could stay until they were ready for independent living, away from a clinical environment.

There are 214 mental health residential rehabilitation beds funded across the Waikato and an additional 55 beds available for crisis or planned respite in the community.

As at 31 January, there were 34 people awaiting a bed, majority residing in the Henry Rongomau Bennett Centre.