One of the most important things for many psych patients is the relationships they form with their mental health workers. These relationships are part of their therapy in a way, as they learn to trust the people trying to help them. And it’s an area that the NZ system fails in.
The fragmentation of the system – the separation of crisis management, community mental health, and acute inpatient care – makes continuity difficult. A patient starts to trust the crisis team, but they’re handed off to the community team. Then, if they get very unwell and are put into the ward, they see yet another team. Every time the care team changes, history has to be taken again, trust has to be built, and an often already battered patient has to jump through new hoops. It can be frustrating and demoralising.
Staff inconsistency also contributes to a lack of continuity – not only does scheduled time off require different workers for periods of time, but the rapid burnout of mental health workers means that a patient can be shuffled around fairly often.
The therapeutic relationship is so important for so many psych patients, and to have it disturbed so often is detrimental to these vulnerable.