Erica Hume, a 21-year-old student at Massey in Palmerston North, died in May 2014 in Ward 21 (the mental health unit) at Palmerston North Hospital. Her file reads as a train wreck of rejection from services she desperately needed and of inadequate care when she finally received ‘help’.
How do you end up dying in what’s supposed to be a safe place for mental health patients to recover? These are the questions that surround her care in the unit, and how things went so horribly wrong there, but the thing is, Erica could have lived, without even needing her last hospitalisation, if she had received adequate care. She could have lived a good life if she had received good care.
She was referred from Bay of Plenty DHB, so someone at her home DHB evidently thought that she needed care, and they weren’t wrong. But MidCentral DHB said she didn’t meet criteria, and turned her away.
Hold the line. She was directly referred from another DHB, and MidCentral said, ‘Sorry, she’s not sick enough’. What are we saying about MidCentral’s level of care here? Oh wait, I know exactly what we’re saying. MidCentral was the DHB that “cared” for me while I was at Massey, as well as some of my friends while I was living in the area, and they are a downright failure. They are, without question, the worst mental health team that I have ever had the privilege to have to deal with.
I’m not saying that there’s anything wrong with the staff there, or at least not systematically. There are always the odd less-than-ideal staff member at any service, and I don’t hold that against them. No, what’s wrong is the systems and the resourcing of the service there. The systems are a failure and the resourcing is so inadequate that you have to laugh at it – otherwise you’d cry over it. At times I’ve done both.
Suicide attempts are so far out of what they have the resources to deal with that they’re sent home after talking to an assessor with a vague promise of a follow-up, one that is never chased up if it is missed (as is possible if they have the wrong address for you – no phone call to check, no nothing). I’m sure that if they thought you were an imminent threat to yourself or others that they would hospitalise you . . . wait, no I’m not sure. They are so under-resourced that I have no faith in their capability to do such a thing.
In Erica’s case, she was seen in the emergency department more than eight times. MORE THAN EIGHT TIMES!! I cannot underline enough how bad that is. She was capable of killing herself – there’s some pretty convincing evidence of that. But more than eight times she was seen for self-harm, and could have been helped, and just bloody wasn’t! That’s a massive failing. She was also hospitalised at least once for self-harm and overdose. How did this not trigger intervention? Because MidCentral DHB mental health team has either so few resources or has their resources so poorly focused that they simply cannot care.
It was recommended more than once that Eric receive DBT*. But DBT, a core treatment for many mental illnesses, was not available. Whether they were missing the staff or the funding doesn’t matter. What does matter is that here was one girl who might still be alive if that treatment was available, and more people that would be experiencing a better quality of life.
Erica’s care was characterised by responses to crises, rather than any coherent plan. This is not surprising, in a place that has plans only for the most seriously unwell. She was not falling through the cracks. She was hanging out in the massive pits in the care coverage of MidCentral DHB’s mental health team.
Maybe the experiences of my friends and I, and Erica, are not typical of MidCentral’s care. But I rather doubt it. The pattern seems fairly consistent across all the people I know who have been cared for at Palmerston North Hospital. They fail people, and in this case, Erica Hume died because of it. Well done, MidCentral District Health Board Mental Health Services.