The NZ depression website self-test

Today I found depression.org.nz. It’s the official NZ government National Depression Initiative website. I was . . . less than impressed.

The website has the initial problem of being spectacularly ugly, and is not particularly well designed or intuitive. But, I decided that it was probably worth a look around. The first thing I found interesting, in the first tab, was a depression self-test. Whee! I decided to give it a go.

I filled it out honestly first, with what I had experienced in the last couple of weeks. Then, I asked for my results. You know what I am? 13 out of 27, that’s what I am. Not ‘possibly depressed’, or ‘mildly depressed’ or whatever. Just 13 out of 27. What does that even mean? Who knows?

The advice under it was ok, I guess. I was told that if I was feeling suicidal or wanted to self-harm, I needed to talk to a professional straight away. Good advice. The I was given some information – the Depression helpline number (available 8am-midnight – because we all know depression never causes problems in the night – that’s a rant for another day), to call 111 if I feel in immediate danger, the details for contacting Crisis Assessment and Treatment Teams, and to go through a bunch of self-help videos and things featuring John Kirwan (a former All Black – pretty much NZ royalty – and depression sufferer).

I see some problems here (dear government, you should hire me to find the problems in all your mental health publications). The Depression Helpline is good advice, even if it is closed during the witching hours when things can crash down on an untreated depression sufferer’s sleepless head. It’s non-threatening – I mean, it’s just a helpline after all, I can hang up if I don’t like what’s going on. It’s confidential (or at least I assume so – maybe that should be emphasised if it really is). It’s something that a reluctant or unsure depression sufferer can do without feeling overwhelmed.

Calling 111 is the total opposite of all that. It’s dramatic – to the point of being over-dramatic. It’s scary. There’s this feeling that no matter how bad you’re feeling, it’s a bit over the top. The way mental illness has been treated since forever means that mental health emergencies are just not treated the same as physical health emergencies, and there’s a real aversion to calling emergency services for something that’s ‘all in your head’. Additionally, emergency services often have not the foggiest idea of what to do with a suicidal person. In some places you’ll be sent an ambulance, who will transport you to hospital as quietly or not as you make it. They may treat you well . . . they may treat you as a crazy, or worse, as an attention seeker who’s wasting their time. And in many places, they cost money – something that many people can’t really afford. Alternatively, you might be sent some very very confused cops who have even less of a grip on how to treat a suicidal person than an ambulance does. They will also take you to hospital – usually – but it’s not a good experience all round. One that, if you’ve done it before, you may swear to never do again.

Contacting a CATT is another thing that just seems over-the-top. Most people don’t know what a mental health crisis is, or what it might look like. They’re not likely to identify themselves as being in crisis – it’s ‘all in your head’, after all. CATT is likely to be seen as the sort of thing that you call when someone is having an acute psychotic episode, not something you call for low mood, even if the mood is so low that suicidal thinking has started. New Zealanders simply don’t acknowledge the seriousness of depression.

Finally, there’s the advice to use the website resources. That’s pretty good advice, and it’s likely to be followed because it’s non-threatening, because no-one needs to know, because it’s John Kirwan. But it admits itself, it’s self-help tools for people who are feeling ok – it’s not much use for someone who’s seriously unwell. We’ll come back to this in a moment.

There’s no advice to see a GP – something that I would have thought would be common advice, and certainly advice I would give to start with. They’re not perfect, but they tend to be good at assessing how unwell you are and referring appropriately. There’s also no reference to other services that may be able to help – other health lines that are open more hours, or other websites, particularly ones that might be more culturally appropriate for various grouops like Maori or Pasifika people. There’s a tight focus on the government’s initiative, without looking to other excellent resources that might help others. I think that’s a weakness.

So, I decided to see what it would tell be if I presented as severely unwell. Feeling suicidal every day, not sleeping at all, and so on. I thought it would have some relatively strong suggestions to see someone RIGHT NOW. Surprise! It didn’t. In fact, it gave exactly the same answers – including ‘go ask JK, he’s pretty awesome’. This, I feel, is a major failing. It’s not communicating to severely unwell people that they are unwell and really need to seek help – at a time when they’re asking what they should do. The NDI is yet again failing to most unwell among us.

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