Hard News: Dirty Politics
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Ian Dalziel, in reply to
on Budget confidentiality.
Steven Price makes good points.
Mr Bridges claiming ‘moral authority’ (on air today) is a bit rich – he is part of Parliament and should therefore be part of the quality control chain – the onus was on him to tell Treasury that there was a flaw in the system – That was the right thing to do.
If National had been in power this same system update glitch would most likely have occurred.
It’s not like Grant Robertson updated the Treasury site of his own volition.Bridges just keeps reinforcing what a shallow thinker he is, a bear of little brain…
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It's just a shame (though inevitable) how many commentators did the headless chicken on the whole story. It's the ultimate insider game, and pronouncing who "Wins", without regard to the actual voters, can only reinforce the negative public perception of politics.
To take just one example, I bet if you asked people on the street, they'd be far more interested in today's announcement on school donations, than in the Bridges/Treasury row. Something real and measurable, that makes a difference. But ... it will get 1% of the media coverage.
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Rob S, in reply to
To me it just comes across as a stupid dick move.
If that's the best he can do well...….why bother.
Bad faith attacks on drug policy and crime rates seem to be his modus.
Does he have a coherent political philosophy that doesn't boil down to tried and true lauranorder and taxes bad?
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Neil,
I think the emphasis the government has placed on mental health is significant and welcome.
Not agreeing to a zero rate of suicide as a goal for suicide prevention does make sense. Those working in acute mental health will know only to well that there will always be a small number of people who will complete suicide despite concerted mental health involvement sometimes over many years. A zero goal would place health professionals under extreme pressure and lead to a number of unintended consequences.
Including social housing funding along with mental health also makes sense. One of the major bottle necks in acute mental health is finding accomodation for inpatients once they have got well. But accomodation will have to come in various types including supervised settings and also some secure settings. It has to be a wrap around service.
The new front line service proposed is more problematic and on the face of the scant information we have looks like it may fall into the trap of reinventing the wheel. There already is an extensive community mental health system designed to provide a range of services over the spectrum of mental health. Increased funding for that could easily extend the ability to provide increased services to the mild to moderate part of the spectrum. There’s no need to duplicate administrative structures.
The biggest problem I have is that the inquiry and the budget proposals side step some of the most critical issues in mental health, issues that do not have easy solutions.
Repealing and replacing the Mental Health Act sounds straight forward but there has been no broad community discussion about the consequences. There has been no specific evidence put forward to explain why the current act is problematic and no explanation of how a new act would be any improvement. This will be contentious to a degree as it revolves around such issues as risk, safety, coercion and responsibility.
Health professionals I have spoken to believe that not having a compulsory treatment option will result in more mentally unwell winding up in prison.
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Moz, in reply to
Repealing and replacing the Mental Health Act sounds straight forward
While I agree that the act isn't great, I am also concerned that we have a classic "something must be done, this is something" moment in the making. Hopefully this will be something that disappears into committee for a decent amount of consideration before reappearing more fully-fledged.
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Sacha, in reply to
There’s no need to duplicate administrative structures.
Unless you want to avoid certain players.
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Neil, in reply to
Unless you want to avoid certain players.
I haven’t heard that the govt has any issues with existing community mental health services. I’m not sure they know much about them. But if true it would be an extremely expensive remedy to duplicate an entire service and probably unfeasible given that lack of mental health professionals.
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Neil, in reply to
One way around that is to change what prisons are.
I gather that the govt is looking at extending forensic mental health services in prisons.
But at one extreme of a possible mental health act reform is the removal any form of compulsion. The argument being that no one should be detained on the grounds of mental illness.
Under the current act if a young man with no previous mental health history assaults members of the public they can be detained by the Police if they believe the person may be mentally unwell – and not charged with an offence – and transported either to ED or the cells to be assessed by a psychiatrist.
If that provision under the act were not there the only option for the police would be to charge the person for assault and they would then be dealt with in the justice system.
Rumour has it that any review of the Act may focus on introducing capacity and treatability but none of it is straight forward.
Prior to any reform the govt should lunch a major education campaign which could include dramatisations of actual complex scenarios that occur in acute mental health for the public to get a sense of the dilemmas and risks involved. Most people will have seen fly on the wall documentaries on Emergency Departments and other areas of health but there’s been no equivalent for acute mental health.
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Moz, in reply to
police can arrest someone who commits a crime. And they don’t have to follow thru with prosecuting them
But they have to let them go as soon as practicable, or charge them with something and then have the judge agree they should be remanded in custody. Giving up that set of rights in order to simplify the process of indefinitely imprisoning people who are mentally ill does not seem like a good idea. On several grounds.
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Neil, in reply to
What you said is that the police can arrest someone who commits a crime. And they don’t have to follow thru with prosecuting them. That wouldn’t change under the proposals.
At present though the Police do not have to charge some one with an offense in order to detain them and have them assessed by mental health services if they believe there is a mental health issue involved.
Possible changes to the Act could remove that option leaving the police to deal with it as a legal issue not a mental health issue.
The next problem would be if some one was charged for an offence committed because of mental illness and they refused treatment - what should happen? They continue through the criminal justice system possibly to prison?
I don’t think there’s any non- controversial solution to these sorts of dilemmas but at present I’m seeing quite a lot of “mental health act takes away peoples’ rights” without any discussion of the possible consequences of not having the act.
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Neil,
Also, if the police cannot have someone assessed by a mental health team they then have no basis on which to drop charges as they themselves are not able to undertake a mental health assessment to determine if a mental health issue was involved or not. That they can’t is of course a deliberate safeguard.
At present someone can only be placed under the act if they have a mental disorder AND they are either a risk to themselves or to others or both. Treatment has to be provided in the least restrictive manner possible.
A very small percentage of people with mental health issues are placed under the act and most often for short periods of time. The high risks that a small number of people face will not go away if there is no compulsory assessment and treatment and could very well be exacerbated by such a move.
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Moz, in reply to
the police will not be allowed to pull someone up who is known to have a mental illness, and detain them just because.
So the mental illness is a get out of custody free card that the rest of us don't have? The legal system is full of pretexts that allow the plod to arrest almost anyone any time they like. The fact they don't is "discretion" and allows things like the hugely disproportionate rate at which Maori and poor are arrested compared to, say, all the dope smokers in suits along Lampton Quay.
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Moz, in reply to
I don’t know how it all overlaps with insanity as in the criminal justice system.
It doesn't, the legal system is inherently incapable of recognising its own insanity.
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Neil, in reply to
The police can drop charges by just dropping the charges! whats so hard to understand about that? If someone commits a criminal offence the police can arrest them, they can detain them, they can get an approval from the courts to remand them to a hospital. They do not have to follow thru with a prosecution! That will not change.
There would have to be some new legal provision for a court to remand someone to a mental health unit without any form of assessment by a mental health team. I think most would agree the justice system shouldn’t have such power.
Perhaps I’m not making myself clear. I’m supposing a possible repeal of the Act and consequent loss of compulsory assessment and treatment. The consequences of that would be the justice system would have no ability to detain someone for the purpose of having mental health assessment or treatment. A person with a mental health issue may just get stuck in the criminal justice system.
The UK mental health act has just recently been reviewed and has some worthwhile consideration of such issues:
We considered carefully whether we should rule out the use of detention where a person has capacity to consent to their admission, but does not consent. We recognise that there are human rights arguments in favour of this, but we do not think that those arguments are strong enough for such a large change at this stage. We think that a much greater debate is needed, involving service users, to see whether society is willing to accept the consequences of someone’s refusal to be admitted, especially where the consequence is the person’s death. The debate also needs to consider whether a person’s right to refuse to be admitted is given greater weight than the risk that the person might pose to other people.
(pg 112)
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Neil, in reply to
I have an extended family member who has been on a constant cycle of needing to be taken to hospital by the police for treatment, then when he gets well he starts fighting for his autonomy again, until the next major episode. There must be some middle ground somewhere.
Not uncommon. I’ve seen it quite a few times. People come into hospital, get well, go home, stop taking medication, get unwell, back into hospital. With illnesses such as psychosis every episode of unwellness reduces future functionality and reduces the effectiveness of medication so repeated cycles are very damaging over and above immediate consequences.
More funding to community mental health teams to resource more active outreach and crisis intervention is much needed. That’s essentially what the UK review concluded – the way to reduce compulsory treatment isn’t to change the law but to properly fund acute community mental health teams. Something our government isn’t currently proposing.
There’s a community team called ACOS – which is an assertive outreach team that can check in on people every day and spend decent periods of time with them. That service could easily be expanded to cover not just the most difficult cases they presently deal with.
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Neil,
Overall I tend to suspect the the govt may be replicating the Kiwibuild debacle with mental health – trying to throw $2b at a sector in desperate need but which they know little about.
The inquiry skipped along the surface of the most fundamental issues such as risk vs autonomy and ignored those who urgently need more resources – those with the most severe mental health issues who are the most vulnerable.
From the UK review:
We have heard many anecdotal reports that, over time, there has been a shift in the perception of what is ‘acceptable risk’ among professionals, which may have contributed to the rise in the use of the MHA. This appears to have been driven by professionals’ fears – often arising from court cases – that a decision not to detain someone, or to allow them out from hospital whilst under their care, may lead to serious incidents and, at the most extreme, deaths, resulting in a subsequent summons to a coroner’s court to defend their decision.
This probably is true for Orange Tamariki as well – people at the coal face are petrified of legal consequences of making the wrong judgment call.
The UK review is very good but I feel the big problem with it will be it gives two types of solutions – one expensive and try other not so. I doubt any government will opt for the most expensive.
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John Farrell, in reply to
"Kiwibuild debacle" - sounds like you have swallowed the National party line on this........what is wrong with trying to increase the number of houses available?
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Sacha, in reply to
those who urgently need more resources – those with the most severe mental health issues
And that is exactly the belief the govt has had to work around to get funding into supporting people in more widespread mental distress. You asked earlier why they weren't just channelling funds into existing organisations and networks.
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I'm confused. Is the government "ignoring those in most need", or is it "throwing money at" mental health? It seems a difficult combination to pull off.
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Moz, in reply to
“Kiwibuild debacle” – sounds like you have swallowed the National party line on this
The rule is that any government programme that succeeds is obvious and what the opposition would have done were they accorded the respect they desrve; and any programme that fails is a complete debacle, entirely the fault of the relevant minister (who should resign) and also symptomatic of the failings of the government in general.
(insert National, Labour or whatever as appropriate).
The above pretty much summarises what is wrong with modern parliamentary politics. It doesn't matter how good an idea is, or even if it was longstanding policy of the opposition when they formed the previous government and all that remains is to pass the bill they introduced to implement it, now that it is those morons in charge the bill will be opposed and if possible voted down.
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Neil, in reply to
I think the verdict passed by the PM on Kiwibuild is clear. It’s been a failure, many people have been trying to point this out to the government for sometime. Much like the proposed changes to mental health the risk is middle class capture.
Kiwibuild subsidised property developers to build houses for the middle class.
Current proposed mental health reforms will funnel money into the worried well and not the most at need.
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Neil, in reply to
And that is exactly the belief the govt has had to work around to get funding into supporting people in more widespread mental distress. You asked earlier why they weren’t just channelling funds into existing organisations and networks.
I’m not sure how that justifies underfunding the most at risk
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I don’t know if you could call the National party list of cars which will subsidise larger cars “dirty politics”, but it certainly displays ignorance……in the middle of the list is “Toyota Yaris 05-11”. The Yaris was sold new in New Zealand, not imported used. The model imported used is the “Toyota Vitz”. These don’t have an ANCAP rating, as they were not tested, and the model details are not the same as the NZ new version – some Vitz imports have 8 airbags, and mine, a 2011 ( not the same as the NZ 2011 Yaris) has stability control.
https://twitter.com/NZNationalParty/status/1150967497178222593
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Here are the Ancap ratings for the Toyota Yaris, which the National party link above, claims as 2 star.
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It's clear now that National's indifference to truth is a strategy, not simply an occasional lapse. Everything from whitebait to unemployment is subject to deliberate misinformation, with the all too familiar consequences we see daily in the USA (time wasted on rebuttal, false equivalence, we all know the drill).
If I were a National MP with thoughts beyond the next headline then I'd take 2 minutes to check out who is now supporting "us" on social media. Simon Bridges pushes the "part time PM" line, so then it's a trending hashtag and some very nasty people are gleefully promoting it. I'm sure Bridges doesn't think Ardern is a "lying commie bitch" (to give just one example of their insightful wit), but he seems entirely untroubled that his supporters are saying so.
Whale Oil is gone, but the spirit lives on. At the very top.
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