Who becomes minister responsible for Oranga Tamariki will be very indicative.
Any trade off needs to be explicitly stated by the government so it can be transparently evaluated. Which is not happening.
For example, the continued policy of starving acute mental health of resources has resulted in people with mental health issues spending more time in police cells. That’s a trade off that is most likely to be both financially less efficient and with lower health benefits than funding safe places within mental health.
I bring this up because it’s an issue that gets very little coverage in the harm reduction discussion. Acute mental health needs more funding for harm reduction to be effective for those most in need and at risk..
That would indeed cost money but let’s have that on the table so a choice can be made.
I would have thought though that a policy predicated on harm reduction would pay special attention to those most at risk of harm.
And perhaps one would have good reason to be sceptical of the ability of a health system that scrimps on acute care to deliver on promises for non acute care.
The risk involved with a young person destroying their brain with solvents is not just to themselves but to the broader population who will have to cope with their often anti-social behaviour, fund their on-going increasing health and welfare needs and also deal with the moral responsibility of letting a young person destroy their life.
There’s benefit to all in preventing that.
I keep getting the impression that with harm reduction the most at risk of harm are being ignored.
The SACAT Act is basically unusable – very long delays in having someone placed under the act and then there won’t be an inpatient bed for them anyway.
And a four month – and growing – waiting list at the Kari Centre doesn’t suggest any urgency on the part of the government to put funding where it is most needed.
So the chances of a young person at very serious of harm from drugs getting the help they need is almost zero.
In Auckand the child and adolescent community mental health service - the Kari Centre - currently has a 4 month waiting list to be seen.
Harm reduction should include adequate provision of mental health services for those most at risk but the government continues to starve acute care of resources.
Is drug abuse the same as addiction? Synthetic weed didn’t seem that addictive but caused a shed load of mental health issues within my family.
Good point. Synthetics and Meth are unlike most other drugs in that any level of use has high probability of producing dangerous situations for both the user and others.
Addiction should be seen as a quite seperate issue to that of using a drug that produces anti- social behaviours as part of its intrinsic effect.
Some thoughts on mental health and drugs and alcohol.
- having mental health and addiction lumped together as one service makes no sense and is counter productive. There is some overlap - dual diagnosis - but they are quite different specialties. It’s a bit like having a Diabetes and Asthma Service.
- there is still no well established process for detox from severe meth binges. CMDHB has some dedicated facilities but that’s a rarity. Detoxing from meth often poses major risks to others which health services have not provided resources to deal with safely.
- there’s a huge issue with people who have addiction issues and who for various reasons will not engage with agencies such as CADS and continue to destroy their lives and often the lives of those around them. Parents and friends are increasingly approaching mental health services wanting services to require their loved ones to undergo treatment only to be informed that there is very little option for mental health services to intervene in some ones life if they do not agree to it. The Substance Addiction (Compulsory Assessment and Treatment Act) is very difficult to action and there is only one secure facility available. It is also taken pretty much word for word from the Mental Health Act - which the government wants to replace with a competency based formulation which will make treating people against their will even harder. That change will inevitably flow on to the SAC act . It’s a conversation about risk vs rights that the government is not involving the broader public in - rather they are listening to small, vocal lobby groups.
Can’t disagree with any of that!
Must be losing my touch.
Another well written piece on harm reduction.
One thing I’d like to add re mental health is there needs to be more action rather than words from the government on funding for acute mental health.
For a small number of people marijuana will cause a transient psychotic episode that will resolve over a period of time. For another group of people who have a preexisting psychosis marijuana will either cause a relapse or make symptoms worse.
The numbers a small relative to overall use but for those affected it’s a significant risk that can lead to the need for acute inpatient care and treatment.
However the current government has continued the defunding of acute mental health by stealth that has occurred over the psst 30 years. Bed and staff numbers have not kept pace with population growth and increasing acuity.
It’s expensive and does not play well with the anti-psychiatry lobby but it’s an essential part of making harm reduction work.
I think psychosis rather than mood disorder, which makes sense in terms of its propensity to cause paranoia.