Today’s NZ Herald carried an article that is both hope and despair for the mentally ill of this country. A coroner has referred the deaths of two Tauranga men on to the Law Commission because of his growing frustration with the failures of the mental health system. There’s hope that maybe this might begin a path to change for the system, but despair that it is taking so long, and fear that this will just disappear into the wasteland of bureaucracy.
The cases he highlights are pretty bad. The first is that of young husband and father Brad Milne. He was transitioning between two psych medications, and appears to have been under the care of just his GP rather than a specialist. Medication transitions can be messy and dangerous, and I contend that they should be done under the supervision of a psychiatric team. Knowing about and being able to trust the local crisis team is another thing that I see as important during a transition. His family believe that he had no-one to turn to when the crisis came, which suggests that he did not know of or feel able to use the services of the crisis team.
The second case was awful in different ways. Eighteen-year-old Brendan Russell became depressed, and ended up self-harming. He was referred to the crisis team after seeing his GP, but he refused to see them. He was worried about mental illness affecting his career opportunities, and about how it would look to others if he was hospitalised. That’s just heartbreaking. The stigma of mental illness stopped a very unwell young man from accepting help. During this time, he made contact with other young people, telling them that he was going to harm himself. Finally, after telling a counsellor he was going to kill himself and being told to buy a notebook to write his feelings down (what? He threatened suicide! Warning bells, people!) he took his life.
These two cases are representative of too many New Zealanders, particularly young ones. They highlight some of the worst failings of our system, and our culture. The system fails us. It is understaffed and underpaid. GPs are trying to deal with complex mental illnesses as best they can, while waiting on the resources they desperately need. Resources that are stretched far too thin. There are too few psychiatrists, working too few hours, and they need to shuttle people out of the service as quick as they can, back to the GPs. The system fails us because we underfund mental health care, and we watch as people die because of it. Mental illness can be fatal, but with good treatment it doesn’t have to be. We just don’t have enough good treatment.
Our culture also fails us. The ‘toughen up’ attitude is so common that it’s not surprising that some people risk death rather than exposure as a mental health patient. We’re stigmatised. We’re treated as less worthwhile than normal people. We’re discriminated against in the workplace because of the chance that we might get sick and need time off. Even if we are stable and well, we still don’t get an equal shot. This is the truth of mental illness, and Mr Russell was not being unreasonable in his fears.
Perhaps this one angry coroner can stand up and change some of this. Maybe if people like him keep standing up, then their voices can be heard.