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Mental Health Units Not To Be Used For Long Term Accommodation, Says Ombudsman

The Chief Ombudsman today released a report identifying another mental health unit in the Auckland region in which people are staying longer than clinically needed.

A lack of suitable accommodation meant that 13 people were staying longer than they needed in Auckland City Hospital’s Te Whetu Tāwera Acute Mental Health Unit, one for up to 17 months.

His August 2020 report found that five people had been in Waitākere Hospital’s Waiatarau Mental Health Inpatient Unit for over six months, for the same reason.

‘The purpose of an acute mental health inpatient unit is to provide assessment, treatment and care for people who experience overwhelming mental distress', says Chief Ombudsman Peter Boshier. ‘It is not suitable accommodation for those who do not require care in an acute inpatient setting. It is not appropriate at Te Whetu Tāwera, or at any other mental health unit.’

Mr Boshier acknowledges that staff at both units were actively seeking accommodation for long term patients with high and complex needs, and often an intellectual disability.

‘I admire Te Whetu Tāwera’s position on not discharging service users into homelessness. I appreciate that staff at both hospitals find it frustrating and distressing to see the impact the lack of community housing in the region has on their patients.

‘I have been in contact with both the Auckland and Waitematā district health boards, and the Ministry of Health, to outline my concerns. I was informed that an initiative is under way in the Auckland region to address this, and I will be monitoring progress.’

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The Ombudsman’s inspectors made an unannounced visit to the unit to ensure the conditions and treatment of patients detained there comply with New Zealand’s international human rights obligations.

‘There was no evidence that any patient had been subject to torture or other cruel, inhuman or degrading treatment or punishment,’ says Mr Boshier.

‘Good work going on at the unit included concerted efforts to reduce placing patients in seclusion, and a comprehensive programme of activities for patients to help their recovery.’

But Mr Boshier also found areas of serious concern. These included:

- Some service users felt unsafe on the Unit, for example because they could not lock their bedroom doors.

- The Unit’s drug searching and strip searching practice needed review to ensure that the legal basis for all searches is clear and up-to-date, and that service users’ privacy and dignity is not compromised.

- Service users in seclusion could be seen while using the toilet.

‘These matters aren’t acceptable in a mental health facility,’ said Mr Boshier.

‘I have made recommendations for resolving them to the Auckland District Health Board. I’m pleased to see that some of my recommendations - for example a review of the drug and strip searching policy - have been accepted.

‘The DHB has also agreed to investigate why some patients feel unsafe, and make bedroom doors lockable.’

The Chief Ombudsman made 15 recommendations: three were accepted, eight partially accepted, and four were rejected.

The Ombudsman’s report can be found here.

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