Speaker: Election 2014: Mental Health Policies
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The following response from New Zealand First came through after this was posted:
"1. What are your parties priorities for mental health funding if you are returned to government?
New Zealand First would ensure resources and facilities are available for treatment. New Zealand First would also:
· Increase the options of mental health services available, working towards a community view instead of a medical view of services.
· Provide additional resourcing for child and youth mental health services, and the necessary resources and funding to address the continuing appalling state of mental health services by completing the full implementation of the recommendations of the Mason report.
· Increase the number of acute and non-acute beds and accommodation units for the mentally ill and modify the process of judicial review of decisions to release mentally ill patients into the community.
2. Do you support a return to ring-fence funding for mental health treatment as outlined in the Labour health policy?
New Zealand First would support ring fence funding for mental health."
Thanks Kyle, greatly appreciated.
I work in an addictions organisation, and contrary to ACT's statement, I know that the clients we work with value the free services they receive very much. I'm heartened by the promises of support and of increasing both the level and quality of service across the sector.
Just a minor note, I'd make clear above that AOD is a term which refers to "alcohol and other drugs".
Russell Brown, in reply to
I work in an addictions organisation, and contrary to ACT’s statement, I know that the clients we work with value the free services they receive very much.
That was such a banal statement that responding to it almost amounts to unduly dignifying it. But yeah.
Thanks Kyle, that's a really useful summary.
Valuable post, Kyle, thanks. As a former mental health professional careerist (Clinical Psychologist, once upon a time), I am only too familiar with the relative neglect of mental health both politically and by the health administration - but I think this just reflects our society's general discomfort with mental health issues. I have seen many individuals and systems within the mental health sector display this discomfort just as strongly as those outside of it!
My experience in the days of ring-fenced mental health budgets does not make me enthusiastic about their return. The distinction between mental and physical health is a largely spurious one and a social construct that I think does more harm than good - e.g the 'mentally ill' have tended to get comparatively poor physical health care and the psychosocial causes of many 'physical health' problems are often missed or actively avoided because no-one involved wants to face them or knows how to deal with them. Providing a(nother) structure reifying this spurious and unhelpful distinction is not good policy, in my view.
Kyle MacDonald, in reply to
I'm inclined to agree, at least at a political and sociological level. But practically, unless health budgets are fully and adequately funded, then I suspect health boards will internally be inclined to underfund mental health, at the cost of achieving other health targets. In this light I can't see another solution, outside of ring-fencing, but I'm open to suggestion!
Kyle MacDonald, in reply to
So the low wage sector in mental health is largely the care work provided to the chronically and long term mentally ill, what is loosely described as "supported accommodation."
Largely this is conducted by NGO's and this is a worthwhile policy in my view as it forces NGO's to not compete contracts by reducing staff wages.
I gritted my teeth, held my nose and read a puff piece by Ian Wishart interviewing Colin Craig for Investigate earlier this year. Anyway, CC stated that he thought public health expenditure should be diverted partially to alternative and complementary "medicine" and "remedies" like chiropractics, homeopathy and also opposes fluoridation. What one would expect, unfortunately :/
Thanks for the information in this post, showing mental health policy various parties have. I am not that surprised that Tony Ryall has not provided much information, and what National and their present government have been doing is not very convincing. It appears that mental health treatment and support has only been improved for certain target groups, like prison inmates and youth, and that it has otherwise been somewhat neglected, because figures for more elective surgery look “better” to the majority in the public.
I know enough persons who have suffered and are suffering from mental health conditions, and I have seen lives wasted, because of lack of support for them. Also have I at a time in my life used some mental health services myself, to overcome some personal challenges.
Besides of the government's talk about increased health funding (nominal, not so much per capita), there has been a tight cap on funding for mental health, in some areas a cut in real terms. For instance until a couple of years ago Procare Psychological Services here in Auckland were offering up to 5 free sessions with a counsellor (psychologist or so), as they received subsidies to do so for short term interventions. After that they suddenly had to reduce the sessions that were subsidised to 4, and for those 4 the persons using them had to make a minimum fee payment of 25 dollars or so, as the subsidies were no longer sufficient to fund that service.
Community Mental Health services offered by the DHB in Auckland are now turning away more people by telling them to seek treatment "in the community", as they only focus on high risk and serious cases. So people have to go around and try to find counselling somewhere else, costing hefty fees. While WINZ may pay for unemployed or low income people, they often do not cover the whole costs.
I have heard about CADS (Community Alcohol and Drug Services) struggling to maintain certain services, as they also have had limited funding, which does not meet the increased need they have experienced, not just due to population increase, but also due to increased awareness of addiction issues.
And so the list goes on, and I am sure there are other services around the country that have struggled to keep going, and to keep delivering services that are in increasing demand.
What really infuriated me was that the government did 2012/13 bring in "reforms" in social security and welfare (Social Development), which includes changes to medical and work ability assessments done by GPs and at times specialists, also WINZ's own "designated doctors" and now contracted private providers. More people with sickness and disability are not only "encouraged", but also pressured to look at work options and finding work on the job market, as doctors now rather look at "fitness" and "ability" of people with many conditions, than at their incapability or incapacity.
Many people on benefits due to health reasons suffer from mental health conditions, and one would have expected that the government would increase funding for treatment and support to actually try and help such persons get better and perhaps "fit" to work. Yet so far there is little indication of that happening, except perhaps for some youth, and most of extra funding is rather going into "intensive case management" by WINZ case managers and some private providers of new services, trying to place sick and disabled in work.
I read with some interest that Labour and Greens intend to spend more on mental health and want to ring fence spending in that area. I am also pleased to hear that Annette King and Labour want to increase spending on the HDC Office (Health and Disability Commissioner), as I have actually heard of them treating some people in a rather poor way, not bothering to investigate justified complaints. Indeed they need more funding, as last year they had over 1,600 complaints, of which only 60 or so were "formally" investigated.
As for the present welfare reforms and insufficient mental health and other treatments, and how the reforms potentially put people at risk, I recommend info available via 'nzsocialjusticeblog2013' (try Google or other search engine).
Mental health is a delicate area of medicine, and some new research into conditions, and how they result varying degrees of disability, has both been supported by some and disputed by others.
Here are links to some info about "findings" by controversial Professor Mansel Aylward that were used as "evidence" to justify changes in medical and work ability assessments, as part of welfare reforms by this government. Some posts are also about how MSD (the Ministry of Social Development) has under this government changed their approaches and implemented a new regime, and how this may represent risks for the affected, many suffering mental health problems.
According to Aylward and some of his colleagues work is now considered the "best medicine" to get well from illness and various mental health conditions. They conducted their research at the ‘Centre for Psychosocial and Disability Research’ at Cardiff University, Wales, which was for many years "sponsored" by equally controversial health and disability insurer UNUM Provident. It is worth noting too, that UNUM's US insurance branch was actually convicted for fraudulent abuse of medical assessments to deny insured rightful insurance claims. Here in New Zealand there was also much controversy about ACC's "exit strategy" for complex, costly claims cases. It can be said that in at least some cases ACC used similar methods as UNUM did in the US.
This is what the AFOEM and the medical profession now promote and propagate:
The following posts express criticism of MSD's and WINZ's new approach, based on what was tried and done in the UK:
Perhaps more real support is needed, in treatment, and in after care support, and certainly mentally ill should be involved in a very respectful, understanding way, rather than try and apply pressures, to save costs by whatever means.
I personally think a change of government may offer opportunities to do a better job in future.
Shocking news from Ashburton today, about a shooting in a WINZ Office there, may just sadly underscore that mental health policies and funding must be given absolute priority in New Zealand health policy. I heard the reports via the radio and at lunchtime I saw the TV news coverage, and at first I was in disbelief. But soon my mind moved to what I learned over the last two years, and I must admit, I feared some bad things may happen sooner or later.
This does also raise VERY SERIOUS questions about how WINZ handles certain cases! I was rather expecting that some people may resort to self harm, as has happened in many cases in the UK, where ruthless welfare reforms were pursued, and have only been partially reviewed more recently. Putting immense pressures on now even sick and disabled, to look for work, to do other things that especially mentally ill may struggle with, is creating a very dangerous environment, which can lead to unforeseen events.
While I will not jump to conclusions, I do strongly suspect that in this incident mental health issues were involved in the case of the person who is alleged to have now killed two WINZ workers, and injured another one seriously. Of course there is no justification for such actions, and the matter will be dealt with by police and other authorities. It is of great concern, at what risk front line staff at WINZ are being put, by flawed welfare policy they now push in every WINZ Office, and which staff have to deliver on.
Here is the latest news from 'The Press':
I am a bit critical about what Sue Bradford apparently tweeted, but on the other hand, I do agree with her previous criticism of the "welfare reforms" this government has forced upon tens of thousands of sick and disabled, facing re-assessments, where mental health conditions may not be taken serious enough by some assessors now, as they are told by MSD and the government, to rather look at what people supposedly "can do", than what impairments they have. Are we in some ways repeating the mistakes made in the UK? I fear we are, as there is little indication that MSD and WINZ have changed direction, and have their "designated doctors" and now also separate "work ability assessors" take a more principled and considerate approach.
I can only refer readers here to links in my comments above, to read and try to understand what is going on in New Zealand. For Paula Bennett, the main pusher behind all this, to now go to Ashburton to attend to the drama, that raises many questions in me.
This is an article critical of what Sue Bradford commented:
It is time to take mental health issues in this society damned more serious, I say!
Ian Dalziel, in reply to
Herald has the recent background stories as well...
Angela Hart, in reply to
Yes, mental health issues need to be taken seriously, along with other issues which make people vulnerable and people need to be treated with respect and compassion. Sue is correct in pointing out that current government policies are likely to cause terrible stress in some people who see nowhere else to turn. It doesn't excuse violent reaction but we should be asking why these things happen. There is a list here http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=11317363
I have an uncomfortable inkling that John Tully is just the tip of the iceberg.
Paul Williams, in reply to
I am a bit critical about what Sue Bradford apparently tweeted, but on the other hand, I do agree with her previous criticism of the “welfare reforms” this government has forced upon tens of thousands of sick and disabled, facing re-assessments, where mental health conditions may not be taken serious enough by some assessors now, as they are told by MSD and the government, to rather look at what people supposedly “can do”, than what impairments they have.
I'm not really well placed to comment on the 'appropriateness' of Bradford's tweet other than to note she is an individual with enormous personal and professional experience dealing with mental health and not someone that anyone could accuse of jumping on a bandwagon.
I am very critical of what she (Sue Bradford) tweeted. The tragic death of two innocent individuals shouldn't be politicised, at least not with in hours of the death. There will be plenty of time for a post-mortem and analysis. Now is not that time. To her credit she has since posted an apology, stating she was not yet aware at the time of tweeting, that two people were dead.
Marc C, in reply to
She later apologised, I understand, and she claimed that at the time she made the controversial tweet, she did not know the full details and that two persons had been killed.
Condolences must go to the work colleagues, family members and friends of the victims.
Yes, it is wrong to "politicise" such tragic events, but questions must be asked, and hopefully will be asked and answered later, to shed light on what is behind of all this.
In the end, everything we do and say is somehow "political". That applies also to what government departments may be expected to do and deliver, as expected from a government.
That does not mean though that people do "exploit" such a drama, by raising valid questions.
So let us first give time for all to cope and deal with the immediate harm and consequences, and hope that the person responsible will soon be found and taken into custody and care, to avoid further harm. I really hope that there will not be further fatalities.
A recent history of the man in question. Homeless on disability in Ashburton, a month sleeping rough with failing joints, only at WINZ in the first place because those on disability have to seek work now, like the shiftless lazy bastards we all know they are, only out of a home because privatising state houses is hilariously profitable and building them is a private sector matter.
But of course, there's no DPS for the staff at WINZ. The front line that National cares so much about. Can't politicise it? How is that not political? The man was asking for help from MPs for over a month, in the fucking southern winter, with stuffed joints.
Did I mention in another thread here how people were angry at the punitive shit this government puts on our poorest?
Here's a thought: what if there were thousands of John Tullys, instead of just one? Chances are the symptom will be attacked and not much more. A bit like Ferguson, Missouri.
One paragraph at the end of the Ashburton shooting story on The Press front page today caught my eye.
Social Development Minister Paula Bennett, who flew to Ashburton yesterday, said Tully tried to email her.
She either got an email or she didn't,
how would she know if he had only tried...?
a new way to say nothing...
Can't find that story on line yet but RNZ has this:
which shows Bennett wass CC'ed on some emails
Shooter may have asked Government minister for help
A spokesperson for New Zealand First leader Winston Peters said Russell John Tully emailed the party on 14 August about the difficulty he was having trying to find somewhere to live.
The spokesperson said Mr Tully also wrote to the local member of Parliament, National MP Jo Goodhew.
She said the email showed he also contacted Social Development Minister, Paula Bennett, the office of the Speaker, and Transport and Earthquake Recovery Minister Gerry Brownlee.
The spokesperson said New Zealand First replied to Mr Tully immediately but the emails kept bouncing back.
Ms Goodhew said while Mr Tully approached her office about getting a house, she had never met him.
“The personal, as everyone’s so fucking fond of saying, is political. So if some idiot politician, some power player, tries to execute policies that harm you or those you care about, take it personally. Get angry. The Machinery of Justice will not serve you here – it is slow and cold, and it is theirs, hardware and soft-. Only the little people suffer at the hands of Justice; the creatures of power slide from under it with a wink and a grin. If you want justice, you will have to claw it from them. Make it personal. Do as much damage as you can. Get your message across. That way, you stand a better chance of being taken seriously next time. Of being considered dangerous. And make no mistake about this: being taken seriously, being considered dangerous marks the difference - the only difference in their eyes - between players and little people. Players they will make deals with. Little people they liquidate. And time and again they cream your liquidation, your displacement, your torture and brutal execution with the ultimate insult that it’s just business, it’s politics, it’s the way of the world, it’s a tough life and that it’s nothing personal. Well, fuck them. Make it personal.”
― Richard K. Morgan, Altered Carbon
To clarify: I have no doubt that the tragic events in Ashburton are Political. However I continue to feel uncomfortable about how when we politicise, we loose sight of the individuals involved. The WINZ staff are not political figures and their families should be given space to grieve. Some comments (not here so much) have tended towards forgiving or even encouraging violence. This is a tragedy from every angle and I believe we need to keep our heads, and our humanity.
Yes: I suspect we actually agree with each other.
Kyle MacDonald, in reply to
Thanks, I think. It can be both of course. He was angry and this is a horrible criminal act. It's also true he was poorly treated by a political system. But he's not alone in that AND not all mis-treated by WINZ kill.
Great interview on Nine to Noon today about the very real effects of the cuts in DHB funding for mental health, and the risk we may lose a very effective service in Golden Bay, Te Whare Mahana...
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