Promises: Mental Health in crisis

Tracey Holden

In New Zealand, a total of 36,684 referrals were made for people needing mental health crisis assessment during the 2015-16 financial year. Nearly 13,000 referrals were made for people needing an overnight stay – some patients being referred multiple times.

Yet there are just 590 beds in acute mental health wards nationwide for people in crisis.

Recently I felt compelled to sign a petition on actionstation.org.nz  calling for a National Inquiry into Mental Health Services. Up until then I had been like the silent majority of New Zealanders who have glossed over stories about how our mental health services are in crisis.

Solidarity comes when our stories align.

My story started on my mother’s death bed when she made me promise to “look after” my older brother. He’s a farmer in the deep south on marginal land he can hardly ever leave. I’m a physiotherapist in a big city. My “looking after” has existed largely over the phone.

From the age of sixteen he learned to look after himself, and the value of working hard on farms. With little help, he realised his dream of owning his own farm. On the outside he’s your stereotypical southern man. He can hold his liquor. He can work from dawn to dusk, crutching, shearing, mustering. Even with a broken leg, he can shoot a deer and haul it onto the tray of his ute.

He always has a good story.

He knows how to talk.

Our calls were one-sided affairs where he listed all the chores he’d tackled that day, bellowing down the phone as if he was calling the dogs from the back paddock.

Recently, after our dad died, the shape and tone of the conversation changed. The bellowing quietened and he would stop mid-sentence ….

I’d be left hanging …  while he was sinking, sinking in those long pregnant silences.

Nothing is ever cut and dried.

What becomes a catalyst for the sinking?

Poorly controlled diabetes; a gall bladder removed early in the year; a fall from a quad bike metres down a ravine (after which ACC blamed the wear and tear changes that showed up on X-ray and not the bike fall); no weekly wage; no rain and tinder dry paddocks stock that no one wants as the price of shearing them is more than you’d get at the works.

Sometimes your dream becomes your prison.

He’d been there before.

He was recognising the not being able to get out of bed in the morning. Bed felt safe but there was no sleeping. Nowhere to escape the endless chatter inside his brain that caused a searing pain that burnt across his temples and made him throw up every morning.

Promises tie us to each other.

I had made him promise that he would never do anything.

That he would ring.

We’d never enlarged on what that meant but we both knew.

He had never asked for help from anyone.

This phone call was eerily quiet and desperate.

I need you to come.

I’m only ringing because I promised you.

I flew down.

He had made another call that day to mental health services and they had offered him an appointment in a week’s time. If he had fractured his skull or ruptured his spleen, help would’ve come from an accessible chain of contacts through a life saving process and onto physical healing.

The mental life saving process is fraught with road blocks. A counsellor stated, “you are too bad to see me”. Ten minute appointments with a series of  different GP locums. Starting your story every time to a new stranger. Cries for help from a southern man need continuity.

I booked a long appointment with a new, empathetic GP. He told me to take the keys of the gun cupboard. He put my brother on a sickness benefit. To get a sickness benefit you need an appointment with Work and Income. To get an appointment you need an email. To get an email, you need to access and know how to use a computer. If you don’t, you can’t get in the door which is carefully guarded by two security guards. If you do get inside, you have to get on a computer to log in to the account you set up via the email. Too hard for a computer-illiterate, suicidal beneficiary.

There was no shortage of empathy on this journey. The kind man in WINZ  could read our pain and so, against company policy, he produced 40 printed pages called a Jobseeker Support Questionnaire. Questions that made my brother’s head hurt so much he didn’t know the answers. He wasn’t a jobseeker, but he needed support. We left an hour later.

Too many unanswered questions. The $150 a week was out of reach.

Rural Services were stretched so the psychiatrist appointment was via Skype. A tear-stained face loomed down on us from a computer screen saying that mental health funding had been cut and there were 18 beds and 22 patients already on the ward.

The system relies on having family and friends.

Daily phone calls from the hospital to check he was not going to end his life were truly the ambulance at the bottom of the cliff.

The on-call health worker told me that with two new mums and screaming babies on the ward, my brother was probably better off where he was. But they didn’t know where he was, and what if he didn’t have family or friends to support him, and what if he did? The promises in this story come from a family who have lost a family member already to suicide.

Mental health dollars spent on TV advertising to educate on depression and mental illness encourage people to reach out for help. This is poorly conceived if the promises of help are empty.

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Tracey Holden is a physiotherapist working holistically with clients with chronic pain. She holds an Arts degree In English, Creative Writing and Film from Auckland University. Her honours thesis from AUT looked at  physiotherapy moving from a model of illness to a model of wellness.

A short story by Tracey,  based on an uncle committing suicide in the 1950s, was published in Spectrum 3, published by Auckland University and edited by Witi Ihimaera.

Support this  discussion on Mental Health  on actionstation.org.nz