Blueprint II was launched on the 13th of June and the mental-health sector has been largely silent in response. This is likely because Blueprint II is an epic 52-page document.
An Executive Summary on pages 6 and 7 of Blueprint II provides a summary of what goals need to be achieved, but does not outline how to achieve them. This leaves the reader with a lofty set of ideals and little practical perspective of what implementation involves.
In order to get the full picture of Blueprint II, one must read the entire document and it’s 102 page companion document. Notably, the assertions likely to make the most significant impact on service delivery are saved for the final chapter and the appendices of the companion document.
While Blueprint I set out to clearly define what was needed in the mental-health service sector and how to get there, Blueprint II makes calls for better, more effective services while supporting a drive for reduced funding and greater efficiency.
Oddly, the Blueprint II Companion Document makes the assertion that problems of inaccessible and under-resourced services have been resolved and that the future strategy should be focused on efficiency and productivity.
The document provides no evidence to back up this assertion that services have improved and can now focus on efficiency and cost-cutting. Presumably the authors have simply believed the marketing material of mental-health services without establishing whether their rhetoric is realised in action.
Blueprint II is a missed opportunity for the Mental Health Commission to influence government to increase the resources available to the mental-health sector and prevent further cuts to a sector that can ill afford them.
Staff at Engage Aotearoa have been supporting individuals currently residing in Auckland’s acute psychiatric wards across the previous two weeks and can confirm that although the Blueprint II authors state that services are now accessible, family-focused and person centred, this is not the case. Family members are currently left without information, nursing staff do not have time to talk to service-users, service-users are given extended periods of unsupervised leave without a single member of their family being informed, service-users have no access to the clinical psychologist on staff, even when specifically requested. There is clearly no room at the acute service for any form of budget cuts or loss of FTEs. Anecdotes from service users in the community suggest waiting times for a funded therapist can extend upwards of six months. In our community mental-health centres, only those in the top 3% of severity can be seen. At Engage Aotearoa we have heard stories about suicidal people seeking access to a key worker to keep themselves safe and being turned away. We have heard stories about service-users being discharged from their community mental-health centre over the phone without being reviewed due to demands on the service. Access to unfunded therapy is limited to those who can afford the fees.
A number of NZ newspapers recently ran a story about an unwell man who murdered his flatmate: while many people were worried about him in the days leading up to the incident, no one knew to call the Crisis Team or police to get him help. Everyone knows where they can buy an iPhone, but no one knows where to go when someone is a risk to themselves or others.
It seems clear that mental-health services in NZ continue to be under-resourced and difficult to access. Some of the most crucial services are so under-resourced that they cannot even make the public aware that they exist, let alone actually provide their service to all who need it.
Despite its push for better, more effective services, Blueprint II advocates reducing the number of services and making those services do more with less. An environment of competition for scarce resources pits services against each other at the same time that they are asked to work together in collaboration.
This is unlikely to result in positive changes for New Zealanders seeking improved wellbeing, the people they live with or the professionals who work to help them.
