Think for a moment about the worst motel room you’ve ever stayed in. Dingy. Too hot or too cold. Cramped. Poor light. Outdated furnishings.

Now think about how your immediate surroundings affect your mood. They can inspire and lift you up … or pull you down. These things matter, don’t they?

If you’re reading this article, you’re probably relatively comfortable, and in a reasonably positive and stable frame of mind.

Which means you – fortunately – are not in DHB’s Mental Health Inpatient Unit.

The Inpatient Unit is where our community’s most mentally ill are cared for. And they are well cared for by a committed, able staff directed by Mike Connolly, Clinical Leader of the Mental Health Inpatient Service. There’s no problem with the quality of clinicians and caretakers.

But take a walk through the physical facility, as I have, and you must conclude that patients are being helped despite their surroundings. As Mike says, “People recover here in spite of the environment.”

The Inpatient Unit is a 22 bed facility. Five beds are in a secure wing, to care for those representing a significant danger to themselves or others. The Unit generally operates at 80% to full capacity, with the typical patient staying an average 18 days.

Patients might be referred from community mental health care providers, the hospital, brought in by the police, or simply appear on the doorstep. Over the course of a year, typically 360 admissions would be made to the Unit. Forty percent of these will be first presentations, the balance repeat admissions. This compares with roughly 2,000 patients who are seen in an average month by the Bay’s community health providers, mostly NGOs.

Out of DHB’s total annual budget of some $32 million for mental health and addiction services, $5.8 million is spent on inpatient and intensive care services. While overall mental health spending includes addiction programmes, the Unit’s patients are not there for addiction treatment, though addictions might be part of their profile.

The first section of the Inpatient Unit was built in the early 1970s. Time has taken its toll. However “state of the art” the building might have been thirty-some years ago, it is seriously deficient now … well beyond its “use-by” date.

The physical layout makes it difficult to segregate patients who should not be intermingled or to provide privacy – for example, separating living quarters for men and women, or providing a suitable environment for a young woman, with infant, suffering from post-partum depression.

The facility has leaky roofs and the stained carpets to prove it. Fresh paint is needed … with more inviting colours. Maintaining comfortable temperatures – instead of too hot in summer, too cold in winter – is virtually impossible. In short, modernization all around is required.

The most appropriate fix, given the outmoded nature of the facility, would actually be a complete re-build. And this is precisely what the DHB wants to do, at a cost of $18 million. A capital expenditure of this size far exceeds the capital pool normally available in the HBDHB budget, hence a proposal must be submitted to the Ministry of Health’s National Capital Committee, where it will compete with applications from other DHBs. This investment is in fact the top capital priority of our DHB.

At one point, local health officials had hoped that proceeds from the sale of the Napier Hospital site, which might have netted $14 million or so out of a $20 million sale price, would have sufficed to move the project forward. Of course, that deal has fallen apart and is the subject of litigation.

And so, unless a philanthropic “angel” steps forward in Hawke’s Bay, the fate of the Inpatient Unit lies in the hands of Wellington’s bureaucracy. All the more reason for concerned citizens in our community to make their views known to MPs Foss and Tremain.

Meantime, the best the Bay’s mental health caretakers can expect in the foreseeable future is a cosmetic bandaid here and there for the Inpatient Unit.

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