19 Sep 2017

Chronic needs 'fall between the cracks' in mental health

3:30 pm on 19 September 2017

Community care is failing those with chronic needs, a woman calling for a return to a more institutional approach - whose adult son suffers paranoid schizophrenia - says.

Henry accessed Evolve Youth Service in the past.

(file photo) Photo: RNZ / Rebekah Parsons-King

Sue Wilson's son was diagnosed with paranoid schizophrenia when he was 17.

Now 36, he is in a monitored home with four others, where he is supposed to look after himself.

Ms Wilson said he cannot hold a rational conversation, shop, prepare meals or shower himself. She said staff had complained he was difficult to look after and questioned whether he was in the right place.

"Where he is - I agree with the staff - is not ideal.

"But the alternative is an unsupervised boarding house where I don't want him to go or myself, 69, getting in a caregiver, renting a three-bedroomed house and trying to look after him," she said.

Ms Wilson said he needed to be in an institutional-type environment, like an acute hospital ward.

"When he's left to his own devices, he will just lie on his bed, staring at the ceiling, or ringing me up four or five times a day looking for money for cigarettes," she said.

Psychiatrist Mark Lawrence said community care was designed to help people live independently safely.

But Dr Lawrence said there was a small group whose needs were more challenging.

"There would be a small group of cases where the level of need and support can't always be met in a supported accommodation provider and it does raise challenges, because they sort of fall between the cracks in some respects," he said.

Trish, who RNZ has agreed not to name, is a nurse in an acute inpatient ward in Auckland.

She said, as in many acute wards around the country there were a number of patients who end up staying on long term because there was nowhere else for them to go.

More money needed for people in community care - advocate

Supporting Families in Mental Illness national coordinator Fiona Perry said often community mental health services were stretched in areas where housing was tight, like Auckland, but she said the system also was not geared towards those with chronic illness.

"Our system is set up for people to integrate back into the community, but whether there are adequate supports to meet everyone's needs ... is another question," she said.

Ms Perry said the answer lay in more money for people in community care, so patients received treatment from well-trained, understanding and caring staff who worked in conjunction with families for the best outcome.

"So the people who need support have adequate hours of access to support people, not just one or two hours a week, but someone on a more regular basis.

"Someone who they can develop trusting relationships with, someone who can support that person to meet and explore the things that they want to do," she said.

Ms Perry said mental health support workers were struggling to do that because of issues around pay equity.

Read an investigation by RNZ's Insight programme about New Zealand's mental health services here.

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