TThey call it a last resort, but for people held in mental health units in New Zealand it can seem like the beginning of a nightmare. “Seclusion” itself is something of a euphemism, a soft name for locking someone in a room for an average of 27 hours straight. It is meant to be a last resort to prevent people from hurting themselves or others, but the practice itself can be traumatizing. A woman, remembering his experience of isolation, describes how, even now, you don’t like the sound of the keys. It reminds her of being locked up, she says, of feeling desperate, scared, and alone.
“Being confined is absolutely terrifying, terrifying and overwhelming.”
New Zealand has been lauded for its response to the Covid-19 pandemic and for a more humane kind of politics characterized by a focus on ‘well-being’. But the country has been repeatedly denounced by the UN and human rights groups for high rates of confinement in its mental health facilities. Maori are five times more likely to be subjected to the practice than people of other ethnic groups. The increasing use of seclusion also acts as something of a canary in the coal mine, suggesting that units that have already expanded may lack the resources to handle a growing number of acute cases. Some health boards resort to having people sleep in seclusion rooms due to a shortage of beds, somewhat the chief ombudsman pointed out last year as a violation of a UN convention on torture.
During the course of my reports on mental health, I had the opportunity to visit inpatient units. Many facilities are decades old, run-down, and despite the best efforts of staff to improve them, bleak and institutional. A balance of hospital buildings conducted in 2019 found that 15 of the 24 mental health units were rated poor or very poor based on nine design principles. Maintenance within 70% of the units was poor, including leaks and holes in the walls. An official once confided to me that eliminating seclusion was not practical without better, less crowded, and more therapeutic facilities.
New Zealand’s Ministry of Health is led by the personable public health physician, Dr. Ashley Bloomfield, a minor celebrity in the country due to his steadfast handling of the pandemic. Last week, the agency finally released a long-overdue monitoring report showing that seclusion use had actually increased in 2018 and 2019, despite an ambitious goal of eliminating the practice by 2020.
The recoil was quick. Shaun Robinson, director of the Mental Health Foundation, said the figures showed that the mental health system was in worse shape than when the Labor Party led by Jacinda Ardern first came to power in 2017. Ardern had announced that health Mental was a major problem when broaching the subject. his first choice, promising to reform the ailing system and make sure it worked for everyone.
In the four years since then, the government has held mental health research and invested a record NZ $ 1.9 billion in mental health and wellness. Most impartial observers, including former mental health commissioner Kevin Allan, have praised authorities for their renewed focus on the issue. But the fast-paced rhetoric and initial investment, which has often developed slowly, has not translated into substantial change, and people are legitimately frustrated. Being told that things will get better eventually is cold comfort when you can’t walk in the door now.
To its credit, the government has invested money in repairing or replacing some of the worst buildings I have ever seen. Nor do I doubt that there are good and committed people in the Ministry of Health working to improve access to mental health services. But what’s bothersome is the disconnect between rhetoric and reality, and how, in an attempt to disguise flaws and push forward a particular narrative, crucial information appears to be buried or obfuscated.
When it was finally released, the new monitoring report was slimmer than its previous editions – key metrics had been removed, including wait times and the number of people accessing services. The ministry claimed that the delay was due to Covid-19 and that it was modernizing the way it presents data. But removing things and posting them elsewhere only makes the reports more fragmented and less transparent. It becomes more difficult for journalists and advocacy groups to hold the government to account. Reporting for things Emails discovered among officials who delayed the release of the report. The documents paint a picture of an agency that is sometimes more concerned with avoiding bad coverage than with disseminating information. One wanted to look at it with a “risk lens” before publication, while another expressed concern about the large amount of “negative data and statistics” presented without sufficient context.
It is natural to want the media to focus on your positive achievements. But when governments become obsessed with image management instead of focusing on the problems in front of them – mentally distressed New Zealanders locked in empty rooms – they have lost sight of what’s important.
George is Digismak’s reported cum editor with 13 years of experience in Journalism