Health NZ wants to close a mental health facility, staff say more people need it
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Warning: This story mentions suicide.
Staff at an Auckland mental health facility are rallying to save what they say is a vital service for people who otherwise fall through the cracks.
Health New Zealand is proposing to close Rauaroha Segar House, a publicly funded intensive programme for people with long-standing or chronic mental health problems.
The proposal says not enough people are treated there and staff will be better deployed elsewhere, but staff say it can be saved.
RNZ has spoken to a clinician at Segar, who said the central city service must remain.
"Our main concern is that Segar House is a unique service. It's actually one-of-a-kind in the North Island," they said.
"It treats people with chronic suicidality and trauma. It's offering gold-standard treatment for people who couldn't get proper treatment in the community mental health service."
The clinician requested anonymity because they feared speaking out following a recent directive from Health NZ reminding staff not to talk publicly.
The directive said Health NZ's communications team could respond to media in a timely, accurate and consistent manner, while representing the organisation in a positive manner.
Despite that, the clinician said the public had a right to know what it stood to lose.
"It works. The clients that are coming to Segar House are probably clients who are bouncing between the urgent services [or have] longer admissions to the hospital inpatient units.
"Most of our clients, when they graduate the programme they don't require any more mental health service inputs."
The intensive programme is a mixture of individual and group sessions, and for the people attending it's like a full-time job.
After a change in 2019 tightened the criteria of who could enter the programme, it was now for people who haven't found a programme that worked elsewhere.
Staff said that's limited the numbers of people the programme could see and Health NZ cited low numbers - there were about 10 people at any given time - as one of the reasons behind the proposal to close.
But the clinician said that could change.
"We're calling for an immediate halt to the disestablishment proposal and for a revitalisation plan that will help us be responsive to the clients and the service's need.
"I do think we should increase the number of clients that are being treated at Segar House."
The staff proposal sent to Health NZ this week has called for a loosening of the programme's entry criteria and said it could treat people drawn from a bigger area.
It was thought a decision on the proposal to close could be made as soon as Thursday - and Health NZ's original proposal said it would happen this week - but mental health minister Matt Doocey has confirmed it now won't be that soon.
Kyle MacDonald, a psychotherapist who previously worked at Segar House, said closing it would mean more costs later.
"From the moment I first read the proposal I was both shocked and upset because I know not only how vital a service Segar House is, but also how high risk the clients they serve are.
"The reality is if we lose Segar House as a service there will not be a replacement service for these extremely high-risk, chronically suicidal patients who do very very well under this treatment."
The service was operating on about half its full staff capacity of seven full-time equivalent positions, but was fully supporting its clients, he said.
"People will be there four or five days a week. They will attend three or four groups a week. Those will be skills groups, learning particular behavioural skills... around regulating your emotions and dealing with high levels of distress.
"It also includes things like mindfulness groups, and also trauma-focused group therapy, where people learn to manage and process past traumatic experiences."
Health NZ group director of operations for Auckland Michael Shepherd said the proposal to close Segar House wouldn't reduce the number of frontline mental health staff, and would instead mean their expertise was available to more people when they're redeployed.
It had very low numbers of people access the programme and in other districts they would be treated in other individual and group-based programmes, which was proposed here.
"The consultation process is still under way and no decision as to the proposal has been made," Shepherd said.
"While the consultation process is occurring people will continue to receive the same service and support that they are currently receiving."
Labour spokeswoman for mental health Ingrid Leary said it felt like a decision had already been made to close the facility.
"The Minister for Mental Health, Matt Doocey, needs to show some leadership to pause the closure and get some proper independent advice before he rushes to make yet another cut, which will actually have serious safety and financial consequences."
Staff from Segar House could end up in the private sector, where pay and conditions were better, and the service should stay open while it was properly reviewed, she said.
Doocey said he'd sought and received assurance from Health NZ it would take as long as needed to carefully consider feedback, and a decision was some time away.
"It would not meet my expectations for a decision to be made this week, days after consultation has closed," he said.
"As I said previously at the time this was announced, I expect to be briefed on the outcome of the consultation.
"I would not want to get ahead of having the opportunity to consider the feedback and advice from officials, therefore I have nothing further to add at this stage."
Segar House's lease agreement on its Khyber Pass Road property runs out at the end of June.
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