Police Won't Spend More Than An Hour On Most Mental Health Cases
Shorter hand-overs to Emergency Departments (EDs), and tighter rules for people in distress in police custody will be rolled out across more health districts in a little over a week's time.
The changes are part of Phase Two of the police's withdrawal from mental health events, which were announced in August last year.
They were initially planned to be implemented between January and March, but have been pushed amid safety concerns.
The key changes in Phase Two are:
Police spending no more than 60 minutes when handing over a person detained under the Mental Health Act to EDs, unless they consider there is an immediate risk to life or safety;
People in custody under the Mental Health Act need to be taken to a health facility within 30 minutes.
The changes kicked in across a first tranche of health districts on 14 April – including Waitematā, Counties Manukau, Waikato (excluding Tokoroa and Taumarunui), Nelson-Marlborough, and West Coast.
On Tuesday, the police and Health New Zealand (HNZ) announced that from 19 May, the changes will be extended to Auckland, Canterbury, South Canterbury, Capital Coast and Hutt Valley, Wairarapa, Bay of Plenty, Lakes (excluding Taupō), Hawke's Bay (excluding Wairoa), Tairāwhiti, and Southern (excluding Waitaki and Southern Lakes) districts.
The police said they expect that a third tranche of districts will see the Phase Two changes implemented after 16 June, pending final readiness assessments.
Police Assistant Commissioner Mike Johnson said police remained committed to a system that supported mental wellbeing, and gave people access to the best help that 'works for them'.
'Outside of an emergency, police have a threshold for what mental health related work sits with police and what doesn't,' he said.
'This supports us all to clarify roles and responses, ensuring police are only involved where it's appropriate – that means where there is an offence identified (that we would attend through normal prioritisation) or where there is an immediate risk to life or safety,' he added.
HNZ national director of mental health and addiction Phil Grady said workforce shortages were a long-standing issue, with many comparable countries struggling with similar challenges.
He said HNZ was continuing to recruit and fill mental health vacancies.
Grady said HNZ continued to work with police, the Ministry of Health, St John ambulance and Wellington Free Ambulance on the changes to how agencies respond to mental health.
HNZ director of specialist mental health and addiction, Karla Bergquist, said the safety and wellbeing of patients and staff was paramount.
'We have adopted a staged approach and extended our timeframes for Phase Two, introducing it in a planned and safe way,' she said.
'As part of this planning work, we have developed new procedures with clinical input and created training materials for staff to support them through this change.'
The Minister for Mental Health Matt Doocey said in a statement that the safety of patients and staff has been and will remain the top priority through the change process.
'This is evident by this being a phased approach with each phase only being activated when and if it is safe to do so,' he said, pointing to that the districts greenlighted for Phase Two have been assessed for their readiness.
'At the end of the day, we want what's best for those suffering from mental distress. The approach we are transitioning to moves away from those seeking support to now receive a mental health response, rather than a criminal justice response,' he said.
Doocey said he's made it a priority ensure that the government grows the mental health workforce.
PSA union calling for better support
Meanwhile the Public Service Association (PSA) is calling on the government to take urgent action to address what it said was an acute shortage of mental health workers.
The union said it had sighted a draft report to Doocey, which stated that 1485 more frontline mental health and addiction workers were needed right now, including 470 specialist nurses, 145 psychiatrists and 145 clinical psychologists.
'There is a crisis in every hospital where mental health workers are under more pressure than ever. The phased withdrawal of police support is compounding the problem,' PSA's national secretary Fleur Fitzsimons said.
PSA was asking the government to fill all vacancies, lift the hiring ban across the country, and reinstate police support for all mental health call outs.
RNZ has asked police, Health NZ and Police Minister Mark Mitchell for comment.
Recent HNZ data showed hundreds more health workers were assaulted at work last year – with Auckland central and Waikato seeing the biggest spikes.
Nationally, about 14,000 assaults on staff by patients, family members and visitors, were recorded in the two-year period between January 2023 and December 2024 – amounting to a 30 percent increase over the period.
Auckland central (covering Auckland City Hospital, Starship Children's Hospital and Greenlane Clinical Centre) saw the number of attacks double over the period, and accounted for 57 percent of the national increase.
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Otago Daily Times
2 days ago
- Otago Daily Times
Health plan doubts
Anyone ploughing through the 85-page New Zealand Health Plan document might wonder if the wait was worth it. The lack of detail and some of the disconnection between it and planned amendments to existing health law, and other actions already taken or signalled by the government, are among the issues. There is also the thorny question of whether it can do what it says it will. According to Health Minister Simeon Brown, the plan, covering financial years from 2024 to 2027, outlines how Health New Zealand Te Whatu Ora will deliver on the government's health priorities. But Auditor-general (AG) John Ryan, who, under existing law, must audit the costed plan before it goes to the minister, could not give it a green light. He was unable to form an opinion on whether the plan provided a reasonable basis for delivering publicly funded health services to achieve desired improvements in health or gave reasonable effect to the Government Policy Statement on Health. Mr Ryan said the plan did not provide a clear explanation of how the actions intended to improve aspects of the health system had been selected and prioritised, and how they would contribute to the achievement of the desired improvements and targets. Health New Zealand said the plan was indicative of the level of maturity of the organisation and not costed to the level of traceability and integration between the financials, activities and desired improvements from a fully mature plan. The government plans to do away with the requirement for the AG to audit the plan, and its delivery. This move is included in the wide-ranging Healthy Futures (Pae Ora) Amendment Bill, submissions on which close today. Mr Brown says removing requirements for auditing the plan pre- and post-delivery aligns HNZ with other crown entities. The organisation would still have its annual financial statements and statement of performance audited by the AG. While we understand there might be concern such an audit before the plan becomes public may be time-consuming, it is hard not to see this removal of specific scrutiny of the plan altogether is more about avoiding criticism rather than ensuring greater transparency and accountability. It is not the only time recently the Auditor-general's office has been critical of health plans. We have already written of the AG's concerns about whether the government's push for more planned surgery to the private sector may result in patients with complex issues, not suited for such referral, waiting longer than they otherwise might have. As the office pointed out at the health select committee last week, faster care did not necessarily mean more equitable care. It is still not clear how HNZ plans to ensure its plans do not exacerbate inequity, which should include looking at unmet need. The health plan has some clangers in it which do not align with the current government position. In the section on improving timely access to primary and community care, it says "we are resolving pay equity claims and improving nursing recruitment and retention by ensuring there is consistency in nurses' pay". That would have been a surprise to those in the sector who still do not have pay parity with their colleagues in HNZ and whose pay equity claims were scuppered after the government's ambush law changes earlier this year. Public health advocates may have been buoyed by the statement "we aim to reduce the availability and social acceptance of alcohol" in the section on modifiable risk factors, along with reference to strengthening compliance and regulatory approaches in this area. However, recent RNZ reporting showed initial plans to reduce off-licence sale hours now appear to be off the table nationally, and there will be an emphasis on reducing red tape for alcohol retailers to make life easier for them. Hard on the heels of the release of the health plan came another damning report about the health post-code lottery, this time for the treatment of heart disease, the biggest single cause of death in New Zealand. It was another illustration of how much work the government has to do to convince the public it has a cohesive plan for an equitable health system.
Otago Daily Times
7 days ago
- Otago Daily Times
Mental Health Services inquiry findings 'really concerning'
By Sam Sherwood of RNZ A forensic psychiatrist with nearly 30 years experience says unless an inquiry into Canterbury's Mental Health Services prompts real change there will be "more adverse incidents". The inquiry, by Director of Mental Health Dr John Crawshaw, found "significant" problems in the service's governance, care model and resourcing. Dr Crawshaw began his inquiry under section 99 of the Mental Health Act in June 2022, after Hillmorton forensic mental health patient Zakariye Mohamed Hussein murdered Laisa Waka Tunidau as she walked home from work. Hussein was on community leave at the time of the killing. The findings, released on Tuesday, included "critical staff shortages", staffing vacancies affecting admissions and discharge processes, a "siloed culture and care model", concerns about the service's governance and delayed resourcing decisions at the regional governance level. The final report, released three years after it began, has 18 recommendations aimed at addressing the key issues. Dr Erik Monasterio, a forensic psychiatrist with nearly 30 years experience, worked at the then-Canterbury District Health Board (CDHB) for 25 years. He was the Clinical Director and Director of Area Mental Health Services for the Canterbury Forensic Service between 2015 and 2021. Speaking to RNZ, Dr Monasterio said his first impression of the report was how the recommendations were going to be "implemented and opreationalised" in a way that would lead to "improvement in functioning and a reassurance around patient safety and reasonable standards being met". Dr Monasterio said the inquiry's findings were "really concerning". Issues around governance identified in the report were "at the core" of difficulties that had arisen, he said. He said he wrote a letter in late 2016 which was co-signed by other clinical directors of the DHB's mental health services addressing "likely implications" of the change in leadership and governance structure that had been identified in the report. "I forewarned that this change in leadership structure was going to undermine the viability of the services and likely lead to adverse outcomes. "So it's very, very frustrating that those concerns were largely ignored. And some of the issues that have arisen, a significant component of the issues that have arisen, are as a consequence of that change in leadership and governance structure." Asked how unsafe Canterbury's Mental Health Services were in 2022, Dr Monasterio said a lot of very experienced staff had left. "The knowledge at every level of the institution was significantly watered down. "The processes had become watered down. So in the absence of good processes and good leadership, you just don't know what you don't know. But you know you're sitting in a situation which is potentially very risky." Dr Monasterio said he left his role over concerns he had about the "viability of the service". "To the extent that I felt I couldn't remain in the leadership position because I felt that there were acute risks, both to staff and patients and the community, and I could not enact a positive change from within the institution and as a Forensic Service at the highest level of seniority that I could achieve." He said Dr Crawshaw's report "paints a grim picture". "The issues that are identified therein, unless people can convincingly show that they have an initiative and a plan to change that, then I think it'll just continue to get worse," he said. "Unless you get this right there's going to be more adverse incidents. I don't think there's any doubt about that." Consultant forensic psychiatrist Associate Professor James Foulds, who worked at Hillmorton for seven years until 2023, told RNZ he felt the report was a "fair summary" of the problems in the mental health system. "I feel sad for the people who have been affected by the poor state of mental health services in Christchurch - not just the families of the two people who were murdered but also the many people with serious mental illness who haven't been able to get an acceptable level of care, and the health staff who have suffered from working in this environment." He said there needed to be "accountability" from senior mental health service management in Canterbury. "Some of the senior managers who were present at the time have already moved on, but there needs to be a change in the culture of the organisation and that starts at the top." Dr Monasterio agreed. "Unless you change that culture, nothing's going to change." 'Critical' staff shortages Dr Crawshaw said the "most significant and prevailing issue" concerned staffing in the clinical areas, especially the adult inpatient, community and forensic services. "In the inpatient areas, there were daily issues in ensuring minimum safe staffing levels." The divisional leadership team had "significant concerns" about the number of staff vacancies and the "relatively junior nature" of the clinical staff in some areas. There were "critical shortages" of staff in many areas of the service, particularly inpatient units. "Clinicians frequently used the phrase 'on numbers', referring to being deployed to an inpatient unit to bring up the numbers of staff on a roster to a perceived safe capacity. "The inspection team heard concerns that people were working overtime and double shifts, to meet the 'on numbers' expectation. While the magnitude of the issue was unclear, it was raised repeatedly by staff in interviews. Some staff stated that they no longer wished to do overtime and double shifts due to the level of personal stress and strain it caused them." Staff 'afraid to come to work' In relation to nursing staff, Canterbury, like other services across the country, had a challenge with a "missing middle" - nurses who were "competent and experienced but still have a long career in front of them". When the inspection was carried out there was a group of staff nearing retirement. They appeared "fatigued and were possibly experiencing burnout". Some of the new graduates had been placed in "unsafe situations". "For example, a newly graduated registered nurse spoke of arriving for a shift at the forensic mental health inpatient unit and being told that they would be the shift leader, a task they felt wholly unprepared for." Some nursing staff were "afraid to come to work" with an "unacceptably high rate" of assaults on nursing staff by patients. "Staff reports of experiencing the clinical environment as unsafe were particularly prevalent in forensic services. There, staff described how a number of senior staff had recently left, particularly from the acute medium secure unit. "This had left both a gap in staff numbers and a gap in expertise. Some staff appeared to be distressed by and angry at the situation; particularly those working in the acute medium secure forensic ward." 'Significant failings' Health New Zealand (HNZ) national director of mental health and addictions Phil Grady acknowledged the "significant failings" identified in the report. HNZ was "committed" to implementing the recommendations to "prevent the tragic events of 2022 and 2024 from happening again". "We recognise the loss and grief these families have and continue to experience and express our sincere condolences to them. We are deeply sorry for the failings in our systems. "We have reached out to these families to apologise and discuss Dr Crawshaw's report, and will remain in contact, if that is their choice, to update them on progress to implement actions from the report." HNZ accepted all of Dr Crawshaw's findings and had an action plan in place to implement the recommendations, which focused on the underlying issues related to governance, the care model, and resourcing. "We are focused on continuing to provide senior leadership oversight of planning for the service, building a framework, and ensuring there is sufficient staff with the right level of training and experience to safely and effectively deliver services." Grady said there had been "demonstrable progress" on key recommendations including establishing a clinical governance framework and increasing clinical staffing by 11 percent since 2022. Clinical decision making on patient leave was "consistent with policies" and there were weekly audits of compliance in place. "There are clear pathways both within the service and nationally within Health New Zealand to escalate and manage risk." 'We are taking action' Mental Health Minister Matt Doocey said in a statement Waka Tunidau's death was a "tragedy no family in New Zealand should ever have to experience". "The release of this report today is an important moment. It shines a light on the long-standing failings in Canterbury's mental health services, failings I've been assured, there is a robust plan in place to address. "I have been upfront that we must do better to improve the mental health system and improve outcomes, this has been my top priority from day one." He said the government inherited a "long-standing fragmented and underperforming mental health system". "And this report underscores the scale of the challenges we have been left with and continue to face." Doocey said public and patient safety "must always come first". "I have made it clear to Health New Zealand that the issues identified in this report must be addressed urgently, and that progress must be visible and ongoing. "We are taking action. I have prioritised committing additional funding for forensic services, strengthening regional accountability, and growing the mental health workforce. Because every New Zealander should be able to get the support they need, when and where they need it, and those around them should have faith that they will be properly looked after while in care."
Scoop
12-08-2025
- Scoop
Canterbury Mental Health Review Released
A formal regulatory inspection of Canterbury-based mental health services has set out a series of recommended changes for Health New Zealand and is continuing checks over the next 12 months. Ministry of Health Director of Mental Health Dr John Crawshaw, who undertook the inspection under Section 99 of the Mental Health Act, acknowledges the tragic circumstances prompting this work. He expressed his deep sympathy for the family mourning the loss of Laisa Waka Tunidau who was murdered by a patient on community leave from Christchurch's Hillmorton hospital in June 2022. The Ministry's inspection began the following month in July 2022. Sadly, there was a second tragic incident in 2024 involving a patient under the care of mental health services at Hillmorton – underscoring the urgency of addressing underlying issues facing the Canterbury service. Dr Crawshaw says the circumstances of both incidents were separately investigated by Health NZ and are not directly covered by the Ministry's report, which looked more deeply into the underlying issues related to governance, the care model, and resourcing. He says the report recognised the difficulties for mental health services brought by COVID-19 during the pandemic on top of a legacy of events in the region that have stretched mental health services and exacerbated existing systemic issues, and the findings of the review should be seen in that light. Dr Crawshaw says the goal of mental health services is to support, care for, and treat individuals affected by serious mental illness to keep both them and the community safe. Where there are serious service failures, such as in this instance, the legislation provides significant investigative powers to find causes, make recommendations and then monitor progress. The report makes 18 recommendations covering governance, the care model, and resourcing. The overall theme of the report is the need for better cooperation between service leadership and service delivery to prioritise service, enable staff to do their best, improve the models of care, and planning. 'There have already been significant improvements made by Health New Zealand in many areas.' Dr Crawshaw notes that the use of leave plans and leave protocols have been assessed and updated following an independent review. Safeguards now include a detailed leave procedure, an updated safety and risk assessment framework for leave, an amended missing person policy, and a review of the electronic clinical record system. As of next week, for patients under the Mental Health Act who are cared for in Hillmorton's forensic services (but are not special patients), all leave requests, which follow a very robust, carefully considered process, will also require final review by the Director of Mental Health. This arrangement will be in place while the report's recommendations are being implemented. Dr Crawshaw says Health New Zealand's work in quality improvement and progressing the report's recommendations will be carefully monitored over the next 12 months. He says this will help provide the public with a stronger degree of assurance that underlying issues are being addressed and progress continues to be made.
