Response To The Chief Ombudsman’s OPCAT Report
The New Zealand Nurses Organisation Mental Health Nurse Section (MHNS) National Committee makes the following response to the Chief Ombudsman’s Optional Protocol to the Convention Against Torture (OPCAT) report into five mental health units around the country.
The MHNS Committee acknowledges the Ombudsman’s findings in regard to these units and makes the following comments:
We are concerned about the public perception of the media reports arising from these investigations. The focus of the reporting prioritises language such as "Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment". "Breached UN human rights" and "Exclusion zones".
When members of the public read these media reports, they do not generally reflect on the complexities of how mental health services are provided, facility design, staffing levels, staff education and government funding priorities. The image people receive is that those working in such facilities are engaged in human rights breaches, torture, inhuman treatment etc.
The negative consequence of this reporting is that potential service users and their families become frightened to access these services as a result of a negative portrayal of the role of mental health nurses. The Ministry of Health is currently engaged in a plan to recruit into mental health nursing - this negative portrayal of mental health will not encourage recruits.
Seclusion rooms have been used as accommodation because of over occupancy and over- crowding. Mental health nurses make difficult choices every day in terms of either admitting service users when units are over capacity or declining them, which may result in unsafe conditions in the community. Mental health staff are criticised when they discharge service users too soon and criticised when they do not create space for service users in acute need.
Mental health nurses have been concerned about staffing levels - both in numbers and levels of expertise.
Mental health nurses have been concerned about violence and the provision of sufficient well-trained staff, in-patient and community facilities with safe environments to appropriately respond to challenging and complex situations. They have been asking for provision of safe environments conducive to delivering safe and therapeutic care.
Mental health nurses have been concerned about access to acute services, the lack of acute care beds and the resourcing of services for people with high and complex needs and people presenting with co-existing serious mental illness and substance disorders - especially methamphetamine and alcohol. There is no flexibility in the health system to find temporary beds elsewhere - sometimes there is no option other than an open seclusion room.
The MHNS Committee asked the Panel from the Government Inquiry into Mental Health and Addiction to address all of the above issues, but they were not included in the final report. Our disappointment and frustration at the lack of inclusion of these issues within He Ara Oranga and the subsequent implementation of the recommendations by the Ministry of Health, has once again been heightened by these reports.