Engage Aotearoa

Category Archives: Human Rights And Legal Issues

Information and updates on human rights and legislation issues related to mental health.

Celebrating the end of conversion ‘therapy’ in NZ

I breathed a massive sigh of relief last month when the government revealed plans to bring forward the ban on conversion ‘therapy’ in New Zealand and announced a timeline to have legislation in place before the middle of next year.

I want to take a moment just to send a huge congratulations and an even bigger thank you to all the LGBTQI+ advocates, activists and allies who have worked in so many ways, big and small, to get this safeguard underway. The Green Party’s Rainbow Spokesperson, Elizabeth Kerekere, quite rightly describes conversion ‘therapy’ as “torture for our rainbow community”.

If you would like some insider knowledge on what it is like to receive conversion ‘therapy’ and what it can actually look like in practice in New Zealand, check out Sherry Zhang’s article in the Spinoff and Trinity Thompson Brown’s first person account about surviving conversion therapy over at Re:News.

To be clear, conversion ‘therapy’ is not really a therapy at all. A therapy should be therapeutic, meaning it should have a net benefit effect on the person participating in it. Torture is never therapy. A therapy should resolve problems not invent them. Finding problems where there are none is not therapy. Discrimination, shaming, rejection, and ostracism are never therapy. These are forms of social control and coercion.

Zhang sums up what conversion ‘therapy’ really is for us when she writes, “Conversion therapy is a pseudoscientific technique that attempts to change or suppress someone’s sexual orientation or gender identity through shaming, emotional manipulation and/or physical trauma. The practice is primarily used within religious communities and has been linked to severe mental health issues, including depression and suicidal ideation.” Altogether now: this. is. not. what. therapy. looks. like. Full stop.

Here’s looking forward to 2022 when people subjected to this traumatising experience will have recourse in the law.

The Royal Commission of Inquiry into Abuse in Care: Stories from survivor advocates and how to get involved

Right now, New Zealand is carrying out a Royal Commission of Inquiry into Abuse in Care. This is an opportunity for people who have experienced abuse as children, youth or vulnerable adults in the care of faith-based or state institutions between 1950 and 1999 to shine a light on what happened to them, so this can be formally acknowledged, learned from, and hopefully better prevented in future. This invitation extends to people who have experienced abuse themselves and their supporters. The scope of the inquiry is broad and the commission is interested in all kinds of abusive experiences across all kinds of state care settings including social welfare, education, corrections, disability, health and mental-health settings.

Please take a moment to check out the Abuse in Care website to find out more how to get involved. www.abuseincare.org.nz/survivors/how-to-get-involved/

Another good reason to visit the Abuse in Care website is for the short films where survivor advocates share their stories and their hopes for justice and change. Each video is just a few minutes long but you will meet some remarkable people with a lot of wisdom. If you are a survivor of abuse in NZ institutions, you might find a bit of hope in seeing these stories being given voice and being heard – do think about getting involved if it feels right for you. You can do this in person or in writing, in private or as part of a public commission hearing. Nonetheless, these are difficult experiences to revisit and retell. There are lots of ways to support this kaupapa if it doesn’t feel right for you to participate yourself: it is also a big help to spread the word and help raise awareness. This is something we can all do, whether we are survivors of abuse in care ourselves or want to be an ally to those who are. You never know who is carrying a story that is ready to be told.

The commission is interested in hearing about experiences of “physical, sexual, and emotional or psychological abuse, and neglect” including “inadequate or improper treatment or care” and abuse “by a person involved in the provision of State care or care by a faith-based institution.” The commission recognises that “a person may be ‘involved in’ the provision of care in various ways. They may be, for example, representatives, members, staff, associates, contractors, volunteers, service providers, or others. The inquiry may also consider abuse by another care recipient.” While the inquiry is specifically focused on historic experiences of abuse that took place from 1950 to 1999, they may consider experiences of abuse that took place before or after this period.

The commission defines state care as follows: “State care means the State assumed responsibility, whether directly or indirectly, for the care of the individual concerned”. This can be as a result of “a decision or action by a State official, a court order, or a voluntary or consent-based process including, for example, the acceptance of self-referrals or the referral of an individual into care by a parent, guardian, or other person” and “the State may have assumed responsibility ‘indirectly’ when it passed on its authority or care functions to another individual, entity, or service provider, whether by delegation, contract, licence, or in any other way.”

The inquiry can consider abuse “by entities and service providers, including private entities and service providers, whether they are formally incorporated or not and however they are described.” These may be residential or non-residential settings and may provide voluntary or non-voluntary care. For the purpose of the inquiry, ‘State Care’ includes the following settings:

  • Social welfare settings, including: (A) care and protection residences and youth justice residences: (B) child welfare and youth justice placements, including foster care and adoptions placements: (C) children’s homes, borstals, or similar facilities.
  • Health and disability settings, including: (A) psychiatric hospitals or facilities (including all places within these facilities): (B) residential or non-residential disability facilities (including all places within these facilities): (C) non-residential psychiatric or disability care: (D) health camps.
  • Educational settings, including: (A) early childhood educational facilities: (B) primary, intermediate, and secondary State schools, including boarding schools: (C) residential special schools and regional health schools: (D) teen parent units.
  • Transitional and law enforcement settings, including: (A) police cells: (B) police custody: (C) court cells: (D) abuse that occurs on the way to, between, or out of State care facilities or settings.

The inquiry may consider abuse occurring in any place within the above facilities or settings and in the context of care but outside a particular facility. For example, abuse of a person in care, which occurred outside the premises, by a person who was involved in the provision of care, another person, or another care recipient.

Here is that link again:
www.abuseincare.org.nz/survivors/how-to-get-involved/

New study highlights stories of successful withdrawal

My latest paper has just been published in the open access journal, Therapeutic Advances in Psychopharmacology, as part of their special collection on discontinuing psychotropic medication.

You can read the full text free here: Service-user efforts to maintain their wellbeing during and after successful withdrawal from antipsychotic medication (Larsen-Barr and Seymour, 2021).

Abstract

Background: It is well-known that attempting antipsychotic withdrawal can be a fraught process, with a high risk of relapse that often leads people to resume the medication. Nonetheless, there is a group of people who appear to be able to discontinue successfully. Relatively little is known about how people do this.

Methods: A convenience sample of adults who had stopped taking antipsychotic medication for more than a year were recruited to participate in semi-structured interviews through an anonymous online survey that investigated antipsychotic medication experiences in New Zealand. Thematic analysis explored participant descriptions of their efforts to maintain their wellbeing during and after the withdrawal process.

Results: Of the seven women who volunteered to participate, six reported bipolar disorder diagnoses and one reported diagnoses of obsessive compulsive disorder and depression. The women reported successfully discontinuing antipsychotics for 1.25–25 years; six followed a gradual withdrawal method and had support to prepare for and manage this. Participants defined wellbeing in terms of their ability to manage the impact of any difficulties faced rather than their ability to prevent them entirely, and saw this as something that evolved over time. They described managing the process and maintaining their wellbeing afterwards by ‘understanding myself and my needs’, ‘finding what works for me’ and ‘connecting with support’. Sub-themes expand on the way in which they did this. For example, ‘finding what works for me’ included using a tool-box of strategies to flexibly meet their needs, practicing acceptance, drawing on persistence and curiosity and creating positive life experiences.

Conclusion: This is a small, qualitative study and results should be interpreted with caution. This sample shows it is possible for people who experience mania and psychosis to successfully discontinue antipsychotics and safely manage the impact of any symptoms that emerge as a result of the withdrawal process or other life stressors that arise afterwards. Findings suggest internal resources and systemic factors play a role in the outcomes observed among people who attempt to stop taking antipsychotics and a preoccupation with avoiding relapse may be counterproductive to these efforts. Professionals can play a valuable role in facilitating change.

Auckland Pride Festival on now

Auckland’s annual Pride Festival kicked off this week with a dawn ceremony at Maungawhau on the 3rd of February and runs right through to February 28th. You can check out the full 2021 calendar of events on the Pride Festival website at https://aucklandpride.org.nz/category/events/.

There are hundreds of events and heaps of them are free. You’ll find things like a Spoken Word Showcase on Feb 17th and 25th, the ICON exhibition from Same Same but Black from Feb 3rd – 28th, a workshop on Accessing Trans Healthcare on Feb 10th, lunchtime yoga at Ellen Mellville Centre on Wednesdays, and the Pride March from Mt Albert Park on Feb 27th.

Stuff article puts spotlight on psychologist shortage

On Tuesday, Stuff published an article by Helen Harvey highlighting the ongoing issue of access to psychologists in New Zealand. You can read the whole article here if you missed it.

In a nutshell, there still aren’t enough of us to go around, wait-times are too long, and we have far too few funded options. Dr Malcolm Stewart of the NZ College of Clinical Psychologists hits the nail on the head when he says, “The whole mental health system needs an overhaul. I don’t know if the system has ever really met the need.’’

We went on strike for a whole year trying to advocate for an increase in our workforce numbers so we could create the conditions we need to meet demand, but all we got was a pay-rise and a working group. No real change. None of us are in it for the money of course, so we keep leaving. The official story is always one of moving on to greener pastures, and we usually are. But that’s not usually the whole story. We aren’t allowed to talk in public about what happens in the pastures of DHB-land. It’s a bit like joining Fight Club that way. So it is good to see a journalist taking this up in the media again.

Harvey writes, “Following on from Like Minds Like Mine, a Government funded public awareness campaign, there has been a lot more acceptance of mental health issues and more people seeking out psychological assistance, Stewart says. “And more and more people are seeking non-pharmacological ways of dealing with issues. Good therapy, amongst other things, often helps people to hold onto hope and to believe that change is possible. This can be very protective of life and helps people believe that they can be part of changing their own lives. It is often harder for people to feel this optimism and agency if their treatment is mostly just medication.’’ One in five New Zealanders live with mental illness and/or addiction each year, Health and Disability Commissioner figures reveal. And it is estimated that nearly half of the population will live with mental distress and/or addiction at some point during their lifetime. The system is creaking under the weight and many are blaming years of inaction in the area of mental health.”

Read the full article here:
New Zealand’s Psychological Crisis Putting Lives at Risk
Helen Harvey, Stuff, 26 Jan 2021. https://www.stuff.co.nz/national/health/122695066/new-zealands-psychological-crisis-putting-lives-at-risk

British Psychological Society releases position statement on psychologists with lived experience

The British Psychological Society’s Division of Clinical Psychology released a position statement on clinical psychologists with lived experience of mental health difficulties on the 19th of August.

The document opens by stating, “The Division of Clinical Psychology publicly recognises and supports the unique and valued contribution that lived experience of mental health difficulties brings to individuals working within clinical psychology.”

It goes on to recognise how many therapists with lived experience there are among the profession, the diversity of these experiences, the complexity involved in making decisions to disclose these experiences, the impact of stigma, and the value these experiences bring to the work and the field as a whole.

They close by writing, “Overall, this statement wishes to make clear that lived experience of mental health difficulties does not have to be a barrier to training or practising as a clinical psychologist. On the contrary, people with lived experience are an asset to the profession and make a significant contribution to it”.

As a therapist with lived experience myself, it is a wonderful thing to see these points written down by such a well respected group. I look forward to the day that the professional bodies here in New Zealand take similar steps. I am incredibly grateful to the good folks at In2Gr8 Mental Health for the hand they had in making this a reality.

Read the full position statement here www.bps.org.uk/news-and-policy/statement-clinical-psychologists-lived-experience-mental-health-difficulties


Towards Restraint Free Mental Health Practice

In case you missed it, Te Pou have launched a new resource called Towards restraint free mental health practice: Supporting the reduction and prevention of personal restraint in mental health inpatient settings. This resource is the latest in a suite of work from Te Pou that is aimed at reducing and preventing the use of seclusion and restraint in New Zealand mental-health services. According to the Te Pou website “Every mental health inpatient unit in New Zealand is engaged in some form of practice based activity that promotes least restrictive practice.” This latest resource is intended to assist services to put ‘least restrictive practices’ in place and reduce the use of seclusion and restraint.

Find out more and download the resource here

 

Te Pou: Towards restraint-free mental health practice

Te Pou is pleased to launch Towards restraint free mental health practice: Supporting the reduction and prevention of personal restraint in mental health inpatient settings. This resource is the latest in a suite of work aimed at reducing and preventing the use of seclusion and restraint. Services can use this resource to plan and identify best practices that support a least restrictive approach to service delivery.

Contact:
Te Pou
Level 2, Building B, 8 Nugent Street, Grafton, Auckland 1023.
Telephone: +64 9 373 2125www.tepou.org.nz

New Ministry of Health guidelines for COPMIA

The Ministry of Health will soon release the national COPMIA guideline, currently in draft.

This guideline will outline the responsibilities all mental health and addiction services have to the children of parents with mental illness and or addiction (COPMIA) and their families and whānau. For some, this is going to mean a big shift in the way that services operate. The guideline envisions a mental health and addiction sector that is inclusive of family and whānau, focusses on strengths, and promotes and protects the wellbeing and rights of children. It promotes early intervention in the lives of children to support resilience, offering evidenced based and culturally appropriate ways of working, and across sector partnerships to meet the needs of children and their families and whānau.

For more information click on this link to Te Pou.

Or contact Mark Smith at Te Pou
Phone number: 07 857 1278
Mobile number: 027 687 7127

Synergia Report -Think Differently, Ministry of Social Development

Think Differently, led by the Ministry of Social Development, is a social change campaign that seeks to encourage and support a fundamental shift in attitudes and behaviours towards disabled people.

It works across community and national level activities to mobilise personal and community action, to change social attitudes and beliefs that lead to disabled people being excluded, and to increase people’s knowledge and understanding of disability and the benefits of inclusive communities. To support this work, Think Differently commissioned a review of the published and grey literature to understand the factors that cause disabled people to be socially excluded. The review is designed to inform the further development of the Think Differently Campaign. This summary focuses on understanding social exclusion and its key drivers. The methods and a more detailed analysis of the key concepts are provided in the main body of this report.