Mental healthcare moves out of hospital
Horror stories have been attached to Hillmorton Hospital, formerly Sunnyside, for decades, and Canterbury mental health professionals want the stigma to end. Georgina Stylianou reports.
Olive Webb started working as a nurse at Sunnyside Hospital in 1969 and has seen how the health system failed mental patients in the past.
"It was stigmatised and segregated and all of that," she said. "A small amount of the stigma will always be there as long as you have a place where people are taken when they are mentally unwell."
Patients are now called consumers or service users because having a mental illness does not always mean a hospital admission.
Webb said Canterbury's focus on developing mental health services in the community was the "best and only way forward".
"People get well best where they get sick," she said. "If they are removed from their environment and taken to hospital, which is necessary sometimes, you still have to reintegrate them into that place, which is always going to be challenging."
The Canterbury District Health Board (CDHB) has just released its transition plan on the long-term recovery of the health system after the Canterbury earthquakes.
For the mental health sector, the plan includes making alcohol and drug-addiction services less hospital-based and developing a better system for people who need to move between inpatient and community services.
It focuses on developing alternatives to hospital care and seeing more health professionals visit people in their homes.
The board also wants to develop health hubs and family health centres around Canterbury, and mental health services "would definitely be included", Webb said.
At a CDHB meeting this month, board members, including Webb, talked about the stigma attached to the hospital and to mental health in general.
Board member Aaron Keown said even the name of the hospital "had bad memories for a lot of people".
Specialist mental health services general manager Sandra Walker trained as a nurse at Sunnyside in the early 1970s and said "nothing is like it was then".
Renaming the hospital "wouldn't make a difference", she said, but the names of some buildings, such as the old inpatient building, called the Fergusson block, "might benefit from a change".
"People have this fear of the unknown, but this is a hospital campus, not a mental asylum," she said. "We have sports teams that play on the field, consumers, staff and visitors all use the same cafe, we have training, dental services and people who come and go. It's not this dark, scary place."
The board had pledged $7.5 million to upgrade the Fergusson building. It will house quake- displaced mental health staff from community-based services in the central city.
"Teams are working on top of each other in pretty cramped conditions, so the upgrade will be great, and it will allow for people to be based in the same place on campus, and then obviously teams head out and about throughout the day," Walker said.
It was hoped the project would be finished by the end of the year, but "we think it's going to take a little bit longer than that".
The inpatient wards were also due for an upgrade but there were no plans to increase inpatient capacity "because it simply isn't needed", she said.
"We're building capacity in the community because that's where we need it and that's where it should be," she said.
Having mental health services in the health hubs and family health centres would "make mental health more normal and less segregated", she said.
Nurse consultant Craig Cowie said there would "always be challenges involved in change".
"But the changes are very positive because it's about the person's needs, not the system's needs," he said.
In the past, people had "bounced from service to service".
"Now there's one treatment plan and you stay with the same team from the start to the end," he said. "If you need a short inpatient stay, now it's much more flexible and easier to leave and go into community services."
Partnerships with non- governmental organisations created choices and ensured people could be looked after in their communities, Cowie said.
The new systems would also help reduce readmissions to Hillmorton Hospital because care would continue once a person left.
Quality manager Barbara Wilson said quake-related anxiety and depression "have made mental health a lot more real for a lot of people".
"Not too long ago, many people didn't believe these issues were mental health issues, but since the earthquakes people have come to realise that it's OK to feel that way and it's OK to do something about it," she said.
Wilson said "every single person who works in mental health" was aware of the stigma attached to the hospital.
"Staff can often experience stigmatising language and behaviour and they are trained to deal with that . . . We're very aware of some public perception, but that's just not how it is," she said.
Allied Health professional leader Rose Henderson said the changes would "bring Canterbury's mental health sector in line with what is going on nationally and internationally".
"Pills and pillows are just not the answer," she said.
- © Fairfax NZ News
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