‘Terrible Gaps’ in the Mental Health System for Youth and Children

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Many district health boards have longer waiting lists than adults for youth and children seeking outpatient mental health services. The Mental Health Foundation says it is an “absolute crisis” and the Children’s Commissioner says it is a violation of their rights.

Photo: RNZ / Vinay Ranchhod

More than 2,000 young people and children across the country are waiting for appointments for mental health assessments with District Health Boards (DHBs). They are 273 in Waitematā awaiting their first date, 189 in Southern, 164 in the Nelson / Marlborough area, 125 in Taranaki and a staggering 459 in Waikato and 463 in Canterbury. These are the young people whose references have been accepted. Many have seen theirs rejected, time and time again.

DHB say Covid-19 has led to increased demand and they are struggling to meet it. Wait times in Auckland have been further exacerbated by Covid-19 restrictions, with DHBs struggling to arrange clinical appointments by phone or Zoom. Manukau counties say young people are increasingly presenting “significant thoughts of self-harm and suicide”, further pushing back the wait time for “non-urgent” referrals.

Mental Health Foundation executive director Shaun Robinson said wait lists and waiting times are a symptom of a system that has been neglected for decades.

“I think people are faced with horrible decisions where to sort, they have to choose. They are so overwhelmed that they have to make decisions that they shouldn’t have to make,” he said.

“I am heartbroken for a lot of people when they ask for help and get caught up in these terrible loopholes in the system.”

The Children’s Commissioner’s office said it was a violation of a young person’s rights.

“Children and young people have rights, including under the United Nations Convention on Children, to the best possible health and access to care when they need it. This does not happen for everyone the mokopuna, ”a spokesperson said.

“We believe that denying young people the support they need to be mentally well is both a violation of their rights, it also hurts their chance to have a full childhood.”

Robinson said that the onset of many mental health problems occurs early in a young person’s life. They navigate their relationships, try to find a job, build a career and think about their future. The stress and anxiety associated with the pandemic, climate change and poverty are huge contributing factors, as are the impacts of colonization and racism.

“And then you add to that the scarcity of professionals for DHB services, and in particular the scarcity of pediatric psychologists, psychiatrists, professionals specializing in the care of children and young people, and that’s why you see this scheme.”

It is estimated, based on previous research and data, that about one million people per year face a significant mental health problem, Robinson said.

“It makes mental health the biggest health problem in the country with Covid-19. I don’t think it’s ever really recognized,” he said.

“I mean, I always have conversations with politicians, when they tell me ‘I find that hard to believe’. And it’s like ‘Well I think that’s the root of the problem, so, is not it ?’.”

Waiting for help

RNZ has asked every district health board in the country to provide it with the number of people on their waiting lists for outpatients, adults, youth and children.

The following people had longer waiting lists for youth and children

  • Canterbury DHB had 463 youth / children. No adults on the general waiting list, but 192 waiting for specialized services
  • Waikato DHB had 459 youth / children and 114 adults
  • Taranaki DHB had 125 youth / children and 58 adults (up from 85 and 45 two months ago)
  • Hawke’s Bay DHB had 16 youths / children and nine adults
  • Nelson / Marlborough DHB had 164 teenagers aged 13 to 17 and 100 adults awaiting psychology appointments
  • Waitematā had more young people / children than adults waiting for their second date

Others had similar figures, such as the Wairarapa / Hutt Valley / Kapiti Coast service which had 95 young people and 100 adults on its waiting list for outpatient consultations.

The only DHB in the country with a waiting list for inpatient youth mental health services was Canterbury, which has three locals and four from the regions on hold. All other DHBs said they either did not have anyone on the waiting list or did not have a waiting list.

Canterbury DHB Mental Health Services Director General Greg Hamilton said there was a growing demand for Child, Adolescent and Family Services (CAF), with 4,284 children and young people referred during the 12 months until the end of October.

“Staff have been working hard to meet the increased demand, but the average wait time for non-urgent cases has increased,” he said.

Of those referred, 80 percent received their first contact within three days, and over the past three months, the average wait time of those referred for their first face-to-face appointment was 26 days.

Taranaki DHB Mental Health Officer Wendy Langlands said one of the reasons her DHB had more young people / children waiting for help was because of the service model, with a team for young people / children and three for adults. They had recently obtained an additional employee for the youth / children department.

“We know there has been an increase in the prevalence of mental health problems among children and adolescents across New Zealand, in fact the rates have doubled over the past few decades,” Langlands said.

“There has been a lot of research and speculation on the contributing factors to this, but we have documented a combination of the following factors here in Taranaki: poverty, exposure to social media, concerns about global warming, and uncertainty about Covid-19. “

DHB also told RNZ that collecting information from family and school before assessments sometimes added to the delays. Patients are screened when referred to a service, and “the time and urgency to respond are determined accordingly.”

Invest in youth services

The health ministry said DHBs are responsible for funding and planning services to meet the needs of their local people, but working alongside them to increase funding and improve services.

The ministry said it has invested heavily in mental health services for young people since the publication of He Ara Oranga – Pathways to Wellness in 2018.

Investments included: expanding and improving school-based services, expanding services for higher education students, Rainbow youth, and funding digital and telehealth services.

In addition, funds were injected into primary mental health and addiction services in general practice, Kaupapa Māori and Pacific services under the Access and Choice program, and workforce development.

“In addition to broader health care reforms and the Access and Choice program, we are transforming Aotearoa’s approach to mental wellness so that all people are supported to stay healthy and have access to help. that works for them, when and where they need it. It requires a joint effort with many organizations, sectors, communities and people working together over time, ”said a spokesperson for the ministry.

“By intervening earlier through Access and Choice and mental wellness supports in schools, we want to reduce the number of specialized interventions required by young people. This is a long-term goal.”

Mental Health Foundation chief executive Shaun Robinson said he believed Labor was genuine when he said he wanted to improve things in mental health.

“But I think they picked up the rock of sanity and found so many issues underneath, it’s a lot worse than they imagined.”

Everything the government does is good, but it is not enough, he said.

“… And the whole response started so far behind the eight ball that everything the government does seems to come to naught, because the problem is so big.”

Where to get help:

Need to talk? Call or text 1737 anytime to speak to a qualified advisor, for any reason.

Safety rope: 0800 543 354 or SMS HELP to 4357

Suicide crisis helpline: 0508 828 865/0508 TAUTOKO (24/7). This is a service for people who are thinking about suicide or for those who are worried about their family or friends.

Depression helpline: 0800 111 757 (24/7) or SMS 4202

Samaritans: 0800 726 666 (24/7)

Youth line: 0800 376 633 (24/7) or free text 234 (8 am-12pm), or email [email protected]

What’s up: online chat (3 p.m.-10 p.m.) or 0800 WHATSUP / 0800 9428 787 helpline (12 p.m.-10 p.m. weekdays, 3 p.m.-11 p.m. weekends)

Kidsline (5-18 years): 0800 543 754 (24/7)

Rural support hotline: 0800 787 254

Health line: 0800 611 116

Rainbow Youth: (09) 376 4155

To present: 0800 688 5463 (6 p.m.-9 p.m.)

If this is an emergency and you feel you or someone else is in danger, call 111.

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