This says it all.
Awhile back on PA System there was a discussion of mental health service in New Zealand generally, and my main impression was that the mental health system here in Wellington, our capital, is in a word, woeful.
It angers me that a young man like Finn can “slip through the cracks” in a system that is supposed prevent the unnecessary deaths of bright young men. My own experience of Wellington’s system is that woeful is almost too weak a word, with it taking an expert outside the country to provide me with something like a diagnosis on the basis of reading this blog.
That makes me extraordinarily lucky.
Finn wasn’t anywhere near as lucky. He was new to a city with a useless, third-rate health system with poor communication, second-rate medical professionals, and a half-arsd approach to medical care.
It is nothing less than a disgrace that our Capital City continually fails people. It angers me, and it should anger you too. If any one of you reading this lives here in the Wellington region then you too could fall prey to the buffoons supposed to be taking care of us. And don’t give me the “but I had great treatment” line. If you had, think yourself lucky. Having sat in *a lot* of medical rooms and spoken to *a lot* of other people waiting for treatment, then clumsy mistakes and poor treatment is something of the norm here.
And in Finn’s case, it was fatal.
And what’s worse? There is absolutely nothing that you and I can do about. These fckers publish a report, slap each other on the wrist with a wet bus ticket, issue a weak, meaningless apology, and move on to their fat, fcking salaries… And I’m ANGRY. I’m sick of the excuses and I’m sick of hearing tales like this. I’m sick of waiting for someone to tell me something someone on the other side of the world could work out from 600 words on the internet.
Capital and Coast DHB you are FCKING USELESS. If there is ANYTHING that I’m thankful for, it is that I’m not as vulnerable as Finn was…
23 November, 2008 at 5:27 pm
It just keeps happening, again and again – the system fails people. What should be helping people is instead leaving them worse off.
It’s so frustrating.
23 November, 2008 at 6:48 pm
I was once told that Wellington health services are particularly bad because politicians are anxious to avoid accusations of favouring their local hospital. I don’t know to what extent that’s true.
I do know that many kinds of service in health need to be run like fire brigade – in other words, with spare staff hanging around so that they can deal with peak demand – but they aren’t. It’s easy to be first rate when you aren’t covering for someone who’s off sick because they’re stressed and used up all their leave and the roster is fucked up again and your mate just quit for a better gig in Australia and …
23 November, 2008 at 7:05 pm
Che, have you and Second Chef got a support crew lined up? Sister / mother / friend / whoever?
23 November, 2008 at 7:20 pm
@deb. no worries. sister there too. mostly so we can take a spell away if we need to!
23 November, 2008 at 7:22 pm
I’m impressed the Second Chef has worked out how to take a break! Wish I could have done that during the 32 hours…
24 November, 2008 at 12:40 am
Not just failed by the DHB and police, but by the last government who had *9 years* to invest more than they did in health services. And which could have invested even more if they hadn’t given into greedy demands for tax cuts and spent so much on building roads.
24 November, 2008 at 8:50 am
Having worked at a major Health ministry near most Wellingtonians I can say that money wasn’t normally the issue but where it went was – the IT Dept is well stocked with people, for instance, but how would they have been able to help Finn Higgins?
24 November, 2008 at 8:59 am
Wish I could have done that during the 32 hours…
Heh. That’s how I read that too.
I posted the following yesterday on PAS after Deborah linked to this post. It was partly a response to Che so I guess I should have posted it here as well, also in light of Mike’s comment – it may be convenient to talk about lack of money, and I’m all for more resourcing, but there are some indications we should do better for starters with the money there is.
I worked in the mental health service in my last year before leaving Italy, in the Veneto region that back in the seventies originated the reforms that led to the closure of asylums and the newly patient-centred philosophy which was later exported around the world. Then a few years after moving here I happened to do some interpreting for a group of visiting Italian psychiatrist who spoke in Auckland, Hamilton and Wellington, and it gave me a brief induction about the differences in the two systems. A strong element that emerged from those talks was the different kind of responsibility that befalls a branch of the mental health service in Italy when a patient is under their care, and I think it possibly addresses one of the points raised by Che in his post: namely, that here there seems to be little or no proactive duty of care, you can be seen to follow protocol and “do what you can”, stick to the rules and be minimally liable in the face of a tragedy.
Back home, once a person has sought help for a mental health issue, the local service has to take an active interest, do regular follow-ups, keep in touch, even talk to other DHBs if the patient happens to change address (it doesn’t hurt in this regard that Italy is much more of a police state). And the compulsory treatment option is taken VERY seriously, it can only proceed with the signature of the city’s mayor, who acts in this case as a guarantor of the health and the rights of the citizens. Fewer compulsory treatments and the obligation to care mean a much more proactive attempt to engage the patient in the voluntary forms of treatment, which alongside intensive and regular counseling (as opposed to the cheaper “throw drugs at them” option) is known to produce better outcomes. This is at least was what these visiting doctors reckoned, and it seemed to resonate with the locals. Whether that is the solution in an overextended and under-resourced system, I don’t know, but a change of philosophy could be part of the answer.
25 November, 2008 at 3:54 am
Hi Che, having read this posting i wanted to write and say thank you , its good to see some concern and anger being voiced over the circumstances surrounding Finn’s suicide. It would be great if people would direct that somewhere preferably at MoH level…Dr David Chaplow, New Zealand’s director of mental health[David_Chaplow@moh.govt.nz ]and Minister of Health[tony.ryall@parliament.govt.nz].
To help that along I would like to fill in some gaps that are missing at the moment and need to be addressed to prevent further avoidable deaths within mental health provision in NZ. ……………
A recent article describes Finn as ‘ suffering from depression and increased anxiety over the breakdown of his relationship with his partner.’
Over ten years Finn had learnt to identify and manage the issues that caused his recurring depression . In 2006 he came to suspect that the depression was linked to Asperger issues but he told no one[only later his partner] and sought no help. In early 2007 on relocating to Wellington he moved out of his familiar Auckland environment into an unsupported one where unemployment , debt and isolation resulted in a second severe depression. With assistance from his partner he recovered sufficiently to pick up work and life again . He put his concerns on the back burner whilst he spent the next twelve months financially and emotionally supporting his partner through her own crisis.
All this took its toll on the relationship and in January 2008 his partner talked of creating some space for them both to recover.
The thought of social isolation alongside work pressure and debt revived acute depression and that brought him ,unwillingly, to the attention of mental health services.
He refused to interact with mental health services and was dismissed by CATT[Wellington Crisis team] after accepting Citalopram to tackle the depression.
Despite warnings on the manufacturers website http://www.celexa.com neither Finn nor his partner were warned that there can be initial deterioration and increase of suicidal tendencies.
When Finn reacted , described by him in an e mail to us, no mental health worker reassured them about possible drug reaction, they simply added Clonazapan to the drug list.
His condition became too distressing for his partner too manage and CATT workers insisted he enter a voluntary respite centre for 48 hours until his sister arrived from the UK to take over his care.
Finn had told them about his connection with Aspergers and refused to leave his home ,where he felt secure to ,enter an unfamiliar environment with strangers.
Rather than accommodate home support , backed up by his family , CATT initiated sectioning so they could force him into a supervised situation.
During this interaction Finn had been very articulate about his situation and needs but it had taken some time and been very distressing to Finn. When CATT left him with his partner, whom ,by then ,he felt betrayed by ,Finn fled and attempted to drown himself in Wellington harbour. Heavily stung by jellyfish, he returned home to his partner and exhausted slept for 3 hours. Although his partner contacted the Crisis team and told them Finn was home and willing to talk to CATT no assistance came.
Instead a request was passed to the police that they escort him from his home to the police station. When Finn woke and realised he was facing removal from his home by police he ran to Mt Victoria and committed suicide.
Finn was quite open in identifying Aspergers as an issue with the CATT team. That was ignored then and since in the two CCHB reviews.
The only people with enough information to substantiate Finns conclusions about Aspergers are his family and his partner. We are all confident that he made a realistic analysis.
The treatment Finn received would have been distressing for any individual in that situation. For a person with Aspergers their experience and reaction would have been far more acute.
When faced with removal from his home he was articulate about his extreme fears and refused to go into an unfamiliar environment . This had been an issue for Finn since childhood. It should have been respected. The advice from his family in the UK , phone and home support in his home for 48 hours until his sister Zoe could arrive to take over should have been considered. If felt insufficient, mental health support could have been available in the home for 48 hours. That path of action was not taken and Finn’s suicide was the consequence.
Whilst self-diagnosis may be controversial if a person with Aspergers syndrome first presents as a crisis case then their analysis should be respected and they should receive appropriate treatment. The time to contest any diagnosis is after the crisis.
Virtually every action of the Wellington mental health team intensified the pressures and despair that was crowding in on Finn.
They demonstrated no knowledge or awareness of Asperger issues.
All in all it was inappropriate treatment for an Asperger person and would have infringed Finn’s rights under the Mental Health Act. We suspect this is why the CCHB continue to deny or enquire any further into that connection.
His treatment and the subsequent denial of Asperger issues by the CCHB bodes badly for others facing a similar situation in New Zealand.
It reinforces the need for the urgent implementation for the long awaited Autistic Spectrum Guidelines recently launched by the New Zealand goverment.
Reading through the material dealing with Finn’s death is difficult for Zoe[Finn's sister] and myself[Finn's mum] . The outcome, Finn’s death will remain distressing and painful for us but cannot be changed. The only potential result from our efforts will be a greater awareness that might prevent further avoidable deaths.
We are trying to do that through the website http://www.as-stories.co.uk which has just received its first submitted contribution. It would be good to see that publicised in NZ .
We can do little from the UK, even though we are NZ citizens, what is needed is others, like yourself , in New Zealand, flagging up and pursuing the issues .
All the best Dianne
25 November, 2008 at 7:02 am
[...] Tibby is justifiably angry in response, and there are some useful comments under his blog post, including one from Finn’s mother, [...]
25 November, 2008 at 12:11 pm
I’ve fallen through the cracks, too. It’s been more than four years waiting for a particular follow-up phone call and it’s become a running joke between my GP and me.
@Andrew: are you expecting the new govt to spend more? Roffle lamaow.
25 November, 2008 at 12:23 pm
By the way, there are some awesome hardworking people at CCDBH Mental Health Services. I think the problems highlighted by this and many other cases are more high-level ones… policy, strong direction, good management, organisation, coherence, yada yada
25 November, 2008 at 5:37 pm
diane, thanks for commenting, and thanks to RB for linking to the post.
this is such an awful situation i don’t really know where to go with it. the tragedy of losing bright young men like finn is something that haunts me, and strikes a very deep chord with some of my own family.
i agree that we should keep the pressure on the dhb to improve treatment of asperger people, and encourage anyone reading this post to write to the email addresses diane has provided.
this is two posts this week that i need to think more about.
i’ll get back to you all again when i feel less dismayed by my fellow man.
25 November, 2008 at 7:32 pm
@ drinks-after-worker: no, I expect them to spend less. I also think you’re probably right about the management issues, but it never hurts to have more expert staff on the front line.
20 May, 2009 at 2:16 am
My son is currently in a group ‘home’ which houses people with mental health problems. Since being there he is becoming an alcoholic, and is left to wander. No qualified staff attend and he receives little in the way of support to motivate him further. He is a bright, intelligent young man and I have witnessed him losing that.
There are too many managers/IT people/policy etc who talk alot and do little. There needs to be a different mindset to address the problem and it wont come from the current people – if you’re part of the problem you cant be part of the solution.
NZ doesnt give a damn about people with disabilities, physical or mental. Try and take a case under the HRAct and see how difficult that is in NZ….especially if youre already disenfranchised by Mental Health problems.
Labour was the government that fostered discrimination and socially engineered poverty and crime, to recruit more civil servants to vote labour, build more prisons and generally let the country fall behind many third world states.
I pray to God that Keys will take up the mantle and promote a better health service for everyone.