Cantabrians are still struggling with mental health problems associated with the devastating earthquakes of five years ago, health professionals say.
Canterbury District Health Board chief executive David Meates said they were seeing about 500 more adults a month in specialist mental health services than before the quakes, and close to 100 extra children.
He said they were managing well, but everyone was tired.
"You don't have to scratch far beneath the surface to see a kind of irritability, that sense of actually this is getting really, really hard. The challenge we have again is how we keep people engaged and motivated and that sense of actually it has got an end point, this is going to get better."
Read and listen to a full Insight investigation into the mental health problems following the earthquakes on Sunday morning.
Toni Burnside is principal of Banks Avenue School which is on the edge of the red zone, and she worried about younger children.
She said there were signs of social and emotional turmoil in children, with more than a few "bouncing off the walls" without much warning.
She said five-year-olds were coming to school with poor language skills, with attachment disorders and problems with bed-wetting. The after-effects of the quakes were stressing families and undermining children's learning, she said.
"I do think it's a time bomb. I think it will be one of those things we'll look back on and say, 'what else could we have done better?'"
Mental health teams, including six health board staff, are working with 107 schools throughout Canterbury.
But Dr Harith Swadi the District Health Board's clinical director of child, adolescent and family services said there was more to be done.
"No, it isn't enough, we have another 103 schools to go."
District Health Board clinical director of community mental Peri Renison was seeing problems among young adults.
"We're increasingly in our community teams in the adult service seeing 18 and 19-year-olds frequently presenting in crisis with very low resilience to stress, and that does seem to have been impacted by what's been going on over the last five years."
And Mr Meates said for hospital staff the pressure was also unrelenting as they were caught up in not only the quake aftermath, but the rebuild and a major hospital redevelopment project.
"To have surgeons on the end of a walky-talky to contractors saying: "Actually, we really do need you to stop drilling now because we're about to make an incision."