Health NZ wants to close a mental health facility, staff say more people need it
123RF
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.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Otago Daily Times
an hour ago
- Otago Daily Times
Dead teen's family told they had to get his body back to hometown
A teenager's death from complications after surgery revealed troubling gaps in complex care across the South Island at the time, the Health and Disability Commissioner says. The 19-year-old died in 2015 in circumstances where his family never had the chance to say goodbye. In addition, within minutes of them being told the teen was 'brain dead' they were asked if they would like to donate his organs. The teen's family was also told by a social worker that it was up to them to organise transportation of their son's body back to where they lived. A complaint to the coroner was referred to the HDC. In a decision released today, Deputy Health and Disability Commissioner Vanessa Caldwell found that Health NZ breached a section of the Health and Disability Services Consumers' Rights code, around gaps in information and delays associated with the air retrieval team. She was also critical of why alternative transport options had not been considered for the teen who had been taken to and from various hospitals for specialised treatment and care. Health NZ had sincerely apologised for its departure from the standard of care. Death unexpected The teen died unexpectedly after suffering complications related to a postoperative wound infection. He had undergone elective surgery at a South Island tertiary hospital for the removal of benign tumours from his nervous system. Caldwell said it was complicated by postoperative infection and meningitis which required further hospitalisations at a secondary hospital and later, another tertiary hospital. The postoperative infection was treated successfully, but the teen continued to suffer complications. He was later re-admitted to hospital with ongoing headaches and vomiting but a further lumbar puncture was not done because of concerns over how the teen was coping. A decision was made to send him back to the tertiary hospital where the initial surgery was done, to insert a shunt to drain excess fluid surrounding his brain and spinal cord. Because he was considered 'neurologically stable' and there were operational delays by the air retrieval team, a decision was made to delay the transfer for a few days. While waiting, he collapsed and had a cardiac arrest. The neurosurgeon's team rushed to the hospital where he was and administered critical care but he continued to deteriorate. He was transferred back to the tertiary hospital but certified brain dead after he arrived. Outcome linked to delayed transfer Caldwell said there was dispute as to whether he would have benefited from an earlier transfer. Caldwell acknowledged the family's concerns regarding the neurosurgical care provided but she considered that Health NZ provided him with a reasonable standard of care. She said the teen's poor outcome was attributed to the delay by the air retrieval team in transferring him. However, his care was triaged and prioritised appropriately based on the information available to the team at the time, Caldwell said. An initial referral was made at 6pm and triaged by the flight coordinator with input from a senior medical consultant. Because he was considered neurologically stable and the air retrieval team was scheduled to return from another job, a collective decision was made to depart the next morning, with an expected arrival back by early afternoon. The air retrieval team stated that this was the nature of prioritisation under a resource-constrained environment, Caldwell said. On the morning of the scheduled transfer, a further delay occurred because a flight nurse had to stand down for rest after attending an overnight retrieval. Efforts were made to contact other flight nurses and intensive care nurses who were not on the roster, but none were available. At the time, the air retrieval team had been experiencing increased demands but nurse staffing levels had not increased, Caldwell said. She said between March 2015 and March 2016, there were 60 occasions when a second retrieval had been requested but could not respond. An expert's advice was that road transfer could have been considered as an alternative option but the surgeon disagreed. He said that in his experience, moving patients by road had led to a negative outcome, because of the lack of ambulance staff and inability of the ambulances to cross boundaries between healthcare districts at the time. List of changes made since The air retrieval team had since made a comprehensive list of changes, including additional nursing staff, and has introduced improved communication and operational guidelines. Caldwell said a 'significant number of changes' to the health sector had since been made. She said the amalgamation of the 20 district health boards into Health NZ had created better service integration, sharing of resources, and communication between treating teams. Health NZ Southern and Health NZ Waitaha Canterbury districts were asked to provide a formal written apology for the breaches identified in the report. Tracy Neal, Open Justice reporter
1News
an hour ago
- 1News
Dying teen transferred, family told to arrange return of his body
The family of a teenager who died from complications after an operation never got the chance to say goodbye. They were further distressed by being told they needed to organise his body's repatriation to his hometown. A complaint about the 19-year-old's care was referred to Health and Disability Commissioner by the coroner. The young man – who died in 2015 – had undergone an operation in January that year related to his type 2 neurofibromatosis – a genetic condition that causes benign tumours to develop on nerves, particularly those in the skull and spine. There were complications due to a post-operative infection and meningitis, which was treated successfully at a secondary hospital. ADVERTISEMENT The man – who was referred to in the commissioner's report as Mr B – continued to suffer from fluid building up around the brain and required regular release of cerebrospinal fluid through lumbar puncture. He was admitted to hospital with ongoing headaches and vomiting in April. A decision was made to hold off on further lumbar punctures due to concerns it could cause a hernia and to transfer him to another hospital via an air retrieval team. The transfer was delayed due due to staffing issues and a lack of an available air ambulance. Deputy commissioner Dr Vanessa Caldwell said Mr B was neurologically stable at the time and his transfer was scheduled for the next day. However, while waiting he collapsed and his heart stopped. He was then urgently transferred to another hospital, but his condition deteriorated and at the second hospital he was declared brain dead. ADVERTISEMENT Mr B's family told the commissioner they did not understand why he was not transferred by road when the air retrieval team was not available, and they did not understand why he was transferred to another hospital when his prognosis was poor. The transfer meant they did not have a chance to say goodbye to him before his death. The family also said they were asked if they would donate his organs only minutes after being told he was brain dead, which left them little time to consider their options. They were also told by a social worker it was up to them to organise transport of his body back to where they lived, even though he qualified for travel assistance. Health NZ apologised for the distress caused by the discussion related to organ donation and the miscommunication regarding transporting Mr B's body. Dr Caldwell said the care provided to the man was at an appropriate standard and decisions, such as the air transfer, were made appropriately based on the information available to the team at the time. Incorrect and minimal information was provided to the family once the man died and this had been particularly distressing for them, she said. ADVERTISEMENT She also had concerns about the communication between the air retrieval team and the teams treating Mr B. Health New Zealand breached the patient's right to information under the Code of Health and Disability Services Consumers' Rights, the commissioner said. A number of changes had been made since the young man's death, including the establishment of Health NZ, Dr Caldwell said. The morning's headlines in 90 seconds, including wintry blast on the way, Gloriavale leader in court, and Liam Lawson picks up points. (Source: Breakfast) "I am also mindful that providing recommendations at this stage for errors that happened some time ago is likely to have limited practical benefit." She recommended Health NZ Southern and Health NZ Waitaha Canterbury provided a formal written apology for the breaches identified in the report within three weeks.
Otago Daily Times
2 hours ago
- Otago Daily Times
Teen's death exposed gaps in South Island healthcare: HDC decision
A teenager's death from complications after surgery revealed troubling gaps in complex care across the South Island at the time, the Health and Disability Commissioner says. The 19-year-old died in 2015 in circumstances where his family never had the chance to say goodbye. In addition, within minutes of them being told the teen was 'brain dead' they were asked if they would like to donate his organs. The teen's family was also told by a social worker that it was up to them to organise transportation of their son's body back to where they lived. A complaint to the coroner was referred to the HDC. In a decision released today, Deputy Health and Disability Commissioner Vanessa Caldwell found that Health NZ breached a section of the Health and Disability Services Consumers' Rights code, around gaps in information and delays associated with the air retrieval team. She was also critical of why alternative transport options had not been considered for the teen who had been taken to and from various hospitals for specialised treatment and care. Health NZ had sincerely apologised for its departure from the standard of care. Death unexpected The teen died unexpectedly after suffering complications related to a postoperative wound infection. He had undergone elective surgery at a South Island tertiary hospital for the removal of benign tumours from his nervous system. Caldwell said it was complicated by postoperative infection and meningitis which required further hospitalisations at a secondary hospital and later, another tertiary hospital. The postoperative infection was treated successfully, but the teen continued to suffer complications. He was later re-admitted to hospital with ongoing headaches and vomiting but a further lumbar puncture was not done because of concerns over how the teen was coping. A decision was made to send him back to the tertiary hospital where the initial surgery was done, to insert a shunt to drain excess fluid surrounding his brain and spinal cord. Because he was considered 'neurologically stable' and there were operational delays by the air retrieval team, a decision was made to delay the transfer for a few days. While waiting, he collapsed and had a cardiac arrest. The neurosurgeon's team rushed to the hospital where he was and administered critical care but he continued to deteriorate. He was transferred back to the tertiary hospital but certified brain dead after he arrived. Outcome linked to delayed transfer Caldwell said there was dispute as to whether he would have benefited from an earlier transfer. Caldwell acknowledged the family's concerns regarding the neurosurgical care provided but she considered that Health NZ provided him with a reasonable standard of care. She said the teen's poor outcome was attributed to the delay by the air retrieval team in transferring him. However, his care was triaged and prioritised appropriately based on the information available to the team at the time, Caldwell said. An initial referral was made at 6pm and triaged by the flight coordinator with input from a senior medical consultant. Because he was considered neurologically stable and the air retrieval team was scheduled to return from another job, a collective decision was made to depart the next morning, with an expected arrival back by early afternoon. The air retrieval team stated that this was the nature of prioritisation under a resource-constrained environment, Caldwell said. On the morning of the scheduled transfer, a further delay occurred because a flight nurse had to stand down for rest after attending an overnight retrieval. Efforts were made to contact other flight nurses and intensive care nurses who were not on the roster, but none were available. At the time, the air retrieval team had been experiencing increased demands but nurse staffing levels had not increased, Caldwell said. She said between March 2015 and March 2016, there were 60 occasions when a second retrieval had been requested but could not respond. An expert's advice was that road transfer could have been considered as an alternative option but the surgeon disagreed. He said that in his experience, moving patients by road had led to a negative outcome, because of the lack of ambulance staff and inability of the ambulances to cross boundaries between healthcare districts at the time. List of changes made since The air retrieval team had since made a comprehensive list of changes, including additional nursing staff, and has introduced improved communication and operational guidelines. Caldwell said a 'significant number of changes' to the health sector had since been made. She said the amalgamation of the 20 district health boards into Health NZ had created better service integration, sharing of resources, and communication between treating teams. Health NZ Southern and Health NZ Waitaha Canterbury districts were asked to provide a formal written apology for the breaches identified in the report. Tracy Neal, Open Justice reporter
