Media Release

Waikato DHB Mental Health Services Investigation Report Released

Date:16 April 2016

A formal inspection of Waikato mental health services by the Director of Mental Health has found an appropriate model of care in place, but also makes recommendations for a number of changes.

Dr John Crawshaw says overall, the Waikato services were found to be well managed and led but facing considerable pressure.

He says many of the recommendations in his report, conducted under S99 of the Mental Health Act, support changes already planned by the DHB through its existing ‘Time for Change’ report and subsequent strategic plan for mental health services, but not yet fully in place.

The investigation was prompted by public concern following a series of serious events affecting the Waikato service in 2015: the suicide of one patient, the unplanned departures of three mental health patients in two incidents and the employment of an overseas doctor as a psychiatrist who now faces court charges related to identity fraud.

Apart from the employment of the overseas doctor, the S99 inspection does not look specifically at those events, which are being investigated or followed up separately, but instead examines how the services are functioning and whether there are any systemic issues.

The subsequent investigation or follow up of those incidents by other agencies may result in further recommendations for the Waikato mental health services. This inspection was to check that the overall model was sound so that the findings of any separate investigations could be incorporated within it.

Dr Crawshaw says one strength of the S99 investigation is its breadth and depth. It incorporates interviews with more than 200 front-line staff and 105 service users, family and whanau.

“There are families, and their loved ones with mental illness, who have been distressed by these incidents and by subsequent publicity. One incident resulted in a tragic death, and the Ministry extends its sympathy to those affected,” says Dr Crawshaw.

There has been a significant increase in demand for mental health services (21% over 5 years nationally) which has impacted on service delivery.

Key recommendations from the investigation are:

Immediately: address staff shortages - particularly in critical areas; have a clear strategy to balance risks with good clinical management and patient rights; build support for mental health services internally and externally; build governance within mental health services and provide regular progress reports to the board and public.

Longer term: make changes in light of agreed mental health service plans including integrated care pathways (patient focussed and evidence based) and strengthened cultural practices; these changes should be made over a realistic timeframe and done in a way to build community support.

A key focus of the recommendations is to build on existing change to increase public confidence in the services provided.

The investigation states: ‘a more consistent commitment across the services to engage with whânau members as equals to the individuals accessing services. This is likely to assist ensuring wider community support for the services.’

Dr Crawshaw notes that DHB has already made changes to its mental health services in some of these areas including appointing an Executive Director of Mental Health Services in February; getting a better balance of risk and rights through its training and management model; strengthening clinical governance and beginning a process of greater community engagement on mental health services.

Further changes will be regularly reported to the DHB Board and Director of Mental Health.

The DHB’s plans to improve communications with local stakeholders will help restore the balance between public expectation of mental health services and what the local Waikato mental health services can provide.

"I have recommended to the DHB that it uses these change reports to its Board and to me as a key part of its increased community engagement around its provision of mental health services," says Dr Crawshaw.

ENDS

http://www.health.govt.nz/publication/section-99-inspection-waikato-district-health-board-mental-health-and-addiction-services

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