Anyone following the story of the Hawke’s Bay District Health Board over the past eight years will understand that the organization has experienced tough times. Chief executives have come and gone. Managers have come and gone. The board itself has come and gone, and come back again. From a personal viewpoint it’s great to be back! But this time it’s without the distressing media headlines of a year or two ago. With the prospect of a brand new chief executive to join us in a couple of months we look forward to a fresh start.

However, the current economic climate has put a damper on many of the initiatives the board would like to have progressed. The Ministry of Health’s national capital committee has put plans for the Hawke’s Bay hospital campus redevelopment on hold due to lack of funds. While some parts of the campus have had a recent revamp, there are parts that are well overdue for demolition.

In particular, the mental health inpatient unit is top of the list. This outdated relic of the 1970’s is a blight on a vastly improved mental health and addictions services landscape. These services have made monumental progress following major reforms started in 2001. The regular coats of paint and ad hoc decoration of the old building have made some cosmetic improvements. But the whole building is well past its use-by-date.

High hopes were held that the sale of the old Napier hospital site would provide capital for a full rebuild. The tragedy is that the sale fell through and hopes for the new mental health facility fell over with them. Other health boards have had the luxury of new mental health inpatient units based on a design of best practice, whereas Hawke’s Bay continues to struggle on with the old institution-style building.

Mental Health has traditionally been the poor relation when it comes to health funding. But the last decade has seen quite a turn around in priorities. The ring fencing of mental health dollars has prevented funds from being skimmed to prop up medical and surgical services. Nation-wide campaigns to de-stigmatise mental illness have made a huge impact on public attitudes toward mental illness. At last, the voices of mental health consumers and their families are being listened to when new and innovative services are being developed.

Hawke’s Bay has been a national trendsetter in a number of areas of mental health services. We have won praise and awards for ideas such as the “friendly landlord” scheme, “knowing our people” project and the consumer driven organizations such as “Whatever It Takes” and “The Lighthouse”.

The average person on the street wouldn’t have a clue what these services involve. But for thousands of Hawke’s Bay people suffering from a mental illness, these services provide the support they need to live in the community free from risk to themselves or to other people. More importantly, hundreds of people who would have previously been destined to spend long periods living in the inpatient unit are now living at home. Many have real jobs and now take their place in the community.

However, no matter how responsive the services in the community are, the reality is that sufferers of severe mental illness will have episodes where intensive treatment is required. There will be times when their world falls apart and they need to be stabilized in a hospital setting. This is the time when they most need an environment that is safe, welcoming and nurturing. Anyone who has been to Hawke’s Bay’s inpatient unit will agree that the building is far from this ideal.

The renowned Fred Hollows performed amazing ophthalmologic procedures in sub-standard third world conditions. In Hawke’s Bay, our skilled and dedicated mental health staff are putting up with these same third world conditions right here.

Waitakere and Waikato hospitals have new up-to-date facilities. Our neighbours in Palmerston North have a new inpatient unit complete with a “Garden of Tranquility”. The public outrage would be deafening if our accident and emergency centre looked like the mental health unit, but acceptance of these sub-standard conditions for mental health sufferers tells us we have a long way to go in advancing community attitudes to mental health inviting the same outraged response.

The plans are already drawn up, everyone from consumer advocates to medical specialists has agreed upon the design. We just need the big tick now from the national capital committee. In many respects, it is up to the wider community to help the District Health Board fight for better mental health services needed in this region.

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4 Comments

  1. Awful analogy Diana… the cataract surgery performed by Fred Hollows enabled many to see again, and also that this procedure could be achieved at a mere fraction of the cost of what was involved performing the same operation within 'rollsroyce' surrounds … like the olde Napier Hospital environs. I am not sure the transfer of all services to Memorial Hospital resulted in more, better, or cheaper cataract surgery being performed at all?

    I am sure that having a baby in the back of a taxi is probably somewhat better than in the back seat (?) of a porsche though.

    Further, I am not sure that a prime function of psychiatric institutions is to offer an 'environment that is safe, welcoming and nurturing.'

    Traditionally, the 'Hawke’s Bay has been a national trendsetter in a number of areas of mental health services,' not necessarily all have had a sound empirical base nor been durable over time.

    One has to wonder if those 'up to the moment facilities' in Waitakere and Waikato hospitals and the “Garden of Tranquility”. in Palmerston North offer increments in treatment effectiveness over the 'sub-standard third world conditions' in Hawke’s Bay … somehow I would doubt it. I would have thought that this would enter the equation somewhere though.

    I am sure that it is this strength of feeling, this embarassment about the facility, that has led to the planting of a hedge along the Orchard Road boundary … to shield it from public view(?).

  2. Morton, of course you are entitled to your views but have you even given any thought that you never know one day you might end up visiting a much loved family member who has been admitted to the unit. Should that happen I am sure you would exoect the environment offered is "safe, welcoming and nurturing" for your family member. The experience of being admitted is not only traumatising to the person concerned but also to their immediate and wider families. It is during this time that family is vital for successful treatment and if they too can be included in best practice management of their family member then hopefully a timely discharge will result.

  3. Rosemary are you aware Morton is a psychologist at the DHB so he does actually understand what the unit is like and what happens in there, unlike Diana who gets paid for sitting on a board, Morton gets his hands dirty and helps people with mental illness

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