The country's largest District Health Board has hired a lawyer and brought in a senior nurse from another area to investigate concerns about senior management in a mental health unit.
Late last year an open letter expressing no confidence in the Director of Nursing for mental health at the Auckland District Health Board, was signed by nurses working at mental health unit Te Whetu Tawera.
The nurses at the 58-bed unit near Auckland City Hospital – are being represented by the Public Service Association.
A PSA spokesman said he understood a decision around senior nursing leadership would be made in the next couple of weeks.
The PSA would not be releasing the letter as the investigation had not been completed.
A, ADHB spokesman confirmed there was an independent review into "potential workplace issues raised by staff."
"Auckland DHB has commissioned an independent review to see if there is any substance regarding claims of workplace issues raised by staff.
"To confirm specific details before this process would breach Auckland DHB's responsibilities to its staff and management and breach the confidentiality of the process and the persons involved," he said.
"Auckland DHB takes the claims made seriously and has appointed a lawyer, advised by a senior nurse adviser from another DHB to carry out an independent review of the human resources issues to see if there is any substance to them."
The review started in March.
The spokesman said the issues raised in the review are not about clinical safety, practice or care and that the review's focus is on workplace issues.
He would not provide figures on the number of patients who had died subsequent to treatment at Te Whetu Tawera over the past 18 months but said the unit would have treated and discharged 900 to 1000 patients over this period.
He would not confirm when the review would finish apart from saying they expect the reviewers to "complete their task as promptly as possible".
To date no one has been stood down as a result of the investigation.
Te Whetu Tawera has been plagued by problems for several years - a Health Ministry review in 2008 said the service suffered "a lack of appropriate leadership in medicine, nursing and management" and said problems had been occurring "over some years, and no effective action has been taken".
- Stuff
Sunday, April 26, 2015
NZ DHB CALLS IN LAWYERS
Friday, April 24, 2015
NZ GOVT LIES TO UNCAT
22 April 2015
The Committee against Torture today concluded its consideration of the sixth periodic report of New Zealand on its implementation of the provisions of the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment.
There had been no prosecution for an act of torture brought under the
Crimes of Torture Act, said a delegate. As to whether there had been any
redress or compensation under the Act, the delegate said a conviction was a
pre-requisite and as there had been no prosecutions there had been no awards
of compensation under the Act. Yes true only because police refused to
prosecute and legal aid not made available or help to proceed with one
there had been no civil claims brought against the New Zealand Government or
the New Zealand Police which had resulted in any award of damages or out-of-
court settlement in respect of an allegation of torture as defined in the Convention
against Torture. same legal aid refused to do this
victims who participated in the Confidential Listening and Assistance Service had
been provided with access to counselling services and advocacy support,I was
offered 10 hours of general counselling of which i had already had over 1000
hours of. What i needed was specialised trauma counselling to get over the
torture i was put through I was not offered any thing i needed to recover and no
advocate so another lie by NZ Delegates and another outright lie was
the New Zealand Police which had resulted in any award of damages or out-of-
court settlement in respect of an allegation of torture as defined in the Convention
against Torture. same legal aid refused to do this
victims who participated in the Confidential Listening and Assistance Service had
been provided with access to counselling services and advocacy support,I was
offered 10 hours of general counselling of which i had already had over 1000
hours of. What i needed was specialised trauma counselling to get over the
torture i was put through I was not offered any thing i needed to recover and no
advocate so another lie by NZ Delegates and another outright lie was
The police are constantly working to maintain high levels of public trust and
confidence, so that communities and victims felt encouraged to report domestic
violence and sexual violence to the police, said a delegate. Other initiatives
included the provision of better support to victims through the court process to
encourage them to pursue their claims and the ‘It’s Not Ok’ campaign focusing on
family violence, which had led to a greater increase in reporting.
confidence, so that communities and victims felt encouraged to report domestic
violence and sexual violence to the police, said a delegate. Other initiatives
included the provision of better support to victims through the court process to
encourage them to pursue their claims and the ‘It’s Not Ok’ campaign focusing on
family violence, which had led to a greater increase in reporting.
one word ROASTBUSTERS
and when we had a win this is what the NZ Government did
WELLINGTON, NEW ZEALAND--The New Zealand Ministry of Health said Tuesday that it would appeal a court's order to pay $34,000 that had been withheld from a $114,000 compensation package for former Lake Alice Hospital patient
The payouts were also ex gratia, not proper compensation and merely settling an out of court civil action against the Government. One group that stood up and fought for justice got punished as they lost half of their payout in legal fees the others coming in behind got twice the payout where is the justice in that
NZ Delegates said The practice of seclusion for persons with intellectual
disabilities in mental health facilities was only used when necessary, never for the purposes of discipline, coercion or staff convenience. yea right Emma lives with her dad, is interested in politics and plays piano. Her favourite composer is Chopin. She studies maths and psychology at Wellington’s Victoria University.
disabilities in mental health facilities was only used when necessary, never for the purposes of discipline, coercion or staff convenience. yea right Emma lives with her dad, is interested in politics and plays piano. Her favourite composer is Chopin. She studies maths and psychology at Wellington’s Victoria University.
Two years ago, aged 18, she tried to kill herself and was placed under the Mental Health Act in Wakari psychiatric ward near Dunedin. During her stay she says she was diagnosed with depression, forced to have seven rounds of electroconvulsive therapy (ECT) and injected with sedatives.
Nothing was working; she was tired of being away from home and tried to kill herself again.
Emma (not her real name) says she was then pinned down by nurses, stripped naked and locked in a small room – part of a practice called seclusion – inside the forensic ward; the general psychiatric seclusion rooms were full. They had also run out of gowns.
Nothing was working; she was tired of being away from home and tried to kill herself again.
Emma (not her real name) says she was then pinned down by nurses, stripped naked and locked in a small room – part of a practice called seclusion – inside the forensic ward; the general psychiatric seclusion rooms were full. They had also run out of gowns.
On the hard floor there was no mattress or pillow, she says, despite these being mandatory items for patients in seclusion. Emma used a blanket to cover her body from nurses routinely peeping through the observation window.
She rested her head on the cardboard bedpan she’d been given to use as a toilet and relieved herself on the floor, she says.
At its birth, 22 years ago, the Mental Health (Compulsory Assessment and Treatment) Act of 1992 was radical. New Zealand had finally rid itself of the “loony bins” of Janet Frame’s era following a de-institutionalisation movement in the 1970s. Lobotomies and screaming patients chained to chairs were yesteryear. Seclusion replaced padded rooms and straitjackets. The future of humane psychiatry was now.
We charged forward but somewhere along the way our commitment to adequate mental health care faltered, say experts, including the ombudsman and our disability commissioner. In fact, things are so bad they’ve gained international attention. The United Nations Working Group on Arbitrary Detention visited last year, urging the Government to review the Mental Health Act and dubbing seclusion a form of torture that violates human rights law, particularly when mental illness or intellectual disability is concerned.
Advocacy groups have tried repeatedly over the past decade to ban electric shock therapy.
“We’re witnessing knock-on effects from a government that’s doing as little as possible to help mental health, including cutting back on funding and getting rid of the Mental Health Commission in 2012,” says Sarah Gordon.
She wrote a paper calling for the Mental Health Act to be reformed to avoid discrimination and it was published in the New Zealand Medical Journal last year.
The number of people on the jobseeker’s benefit due to psychological or psychiatric conditions has more than doubled since 2000 and there’s been a significant rise in police calls about attempted or threatened suicides.
“These interactions are complex and time-consuming, taking on average two to three hours to resolve,” says Assistant Police Commissioner Dave Cliff.
Police respond to almost 500 mental health jobs a week on average.
In a bid to help staff deal with this the Royal NZ Police College recently rolled out new mental health training for recruits.
“We’re witnessing a worsening epidemic that’s not only significantly affecting health services but a whole range of other agencies. Until we address it, the result – other than human misery and disability – is an overburdened health service and economic loss.”
The Southern District Health Board says Emma should complain to the board, not the media, so it can investigate her claims.
Emma isn’t comfortable with that: “There’s always the worry that since you’re the mentally unwell one, no-one will believe you.”
Despite Emma waiving her right to privacy and her claims being relayed (as asked) to the DHB, it wouldn’t confirm whether they were true or comment, saying: “For the integrity of any investigation process it is important that we avoid discussion on the matter.”
The DHB did agree to answer general questions around seclusion in email format.
Dr Brad Strong, the clinical leader of the Southern DHB, says people being put into seclusion are provided with basic necessities, a bed with bedding and a pillow.
“They also have access to drinking water, toilet facilities and a hand basin. Reading material or music can be offered depending on the clinical needs of the person. Most people are able to remain in their own clothes or they can change into hospital-supplied pyjamas.
“It is considered a temporary and infrequently used approach that can allow clients to calm and recover their emotional balance in a low stimulus environment.”
Research proves otherwise, says Disability Rights Commissioner Paul Gibson.
“For many people, seclusion has a detrimental effect and for those in permanent seclusion – there’s five people in New Zealand who’ve been locked up for a year – that’s even more detrimental.”
A range of patients who had been locked up under seclusion were spoken to for this article. Many were fearful of speaking openly.
The overall feeling was one of helplessness – “You’re virtually stymied in every way. It’s what I assume it feels like to be in prison but the irony of it is it’s not a crime to be mentally ill yet we end up getting treated like blimmin prisoners,” says Suzy Stevens, who experienced seclusion last year.
Stevens, who suffers from bipolar affective disorder and bouts of psychosis, was admitted into a psychiatric ward after her partner raised concerns about her behaviour and policemen “frogmarched” her straight into a seclusion room.
After six hours, a friend who worked for the DHB was alerted to Stevens’ seclusion and visited. At her behest, Stevens was given food and subsequently released.
In a former job, Stevens worked in the mental health sector and this made for an unsettling experience when she came under the act.
“People knew me, the manager of the unit knew me. It was like I’d stopped being who I was and was wearing the garb of a patient and therefore didn’t exist.”
Stevens left her mental health job – finding it too stressful – and now runs a cafe in the Bay of Plenty. What helps her come down from an intense high or balance out a depressing low is yoga, going for walks and aromatherapy. “I’m stuck in the world of psychiatric drugs but when I’m well I try and have that inner calm.”
There are alternatives to seclusion but they involve more resources. New York State has outlawed seclusion – nurses sit with those in agitation and distress.
Other hospitals have invested in sensory modulation – using sight, sounds, smells (essential oils), movement and items like weighted blankets and rocking or massage chairs. These help people learn self-soothing techniques and how to change their emotional and behavioural responses to stressful situations in positive ways.
We have to be cautious about being too quick to eliminate seclusion, says John Dawson, an Otago University professor who specialises in mental health law.
“The concern is that other means such as the over-medication of people may be used in critical situations as the alternative. Other approaches more harmful than seclusion could take its place.”
Director of Mental Health Dr John Crawshaw says he is aware of this in working towards ultimately eliminating the use of seclusion.
“Part of the challenge is you don’t want any perverse outcomes,” he explains. “We actually want to reduce the drivers that lead to seclusion and improve the outcomes for people who have significant challenges with mental health and addiction problems.”
In Janet Frame’s autobiography, An Angel at My Table, the author recounts her discharge from a mental hospital after more than 200 applications of ECT in the 1950s. She describes them as “each the equivalent, in degree of fear, to an execution, and in the process having my memory shredded and in some aspects permanently weakened”.
Today things are different.
Modern-day ECT is given “just like any other hospital operation”, says Crawshaw.
Administration is ongoing, usually twice a week, and patients are wired up so an electrical current can pass through the whole brain causing a brief intentional seizure.
The reason it works – although the claim that it works is hotly contested – remains a mystery. There are multiple theories such as that the seizure causes alteration of certain chemicals in the brain. Another suggests it adjusts the stress hormone regulation in the brain which affects energy, sleep, appetite and mood.
But passing a jolt of electricity through the brain isn’t without risk and many doctors think the side effects – permanent memory loss, confusion, disorientation – can outweigh any possible benefits.
Steve Green, the executive director of the Citizens Commission on Human Rights, has been petitioning for New Zealand to completely ban ECT – one petition which nearly went over the line in Parliament was to stop it being forced on pregnant women, the elderly and children. “Some people say it works as a last resort but how do you define that?”
In 2013, 253 people had ECT, according to the Director of Mental Health Annual Report, and 2341 treatments were administered – about nine per patient.
Of this number, 60 were deemed as not having the capacity to consent and were involuntarily treated. Another six were seen as having the capacity to consent but were still involuntarily treated.
Emma was involuntarily given ECT and says it was the most invasive treatment she had against her will. She was made to have it when she was suicidal and refusing medication. As is legally required, two psychiatrists had to agree it was in her best interests.
In her discharge sheets the hospital stated: “an improvement in physical depressive symptoms was objectively identified” and that “she also intermittently acknowledged some subjective improvements in feeling better in herself for short periods after ECT”.
“It’s terrifying to know someone is going to give your brain an electric shock and make you have a seizure,” Emma says. “I got used to it, though. It was twice a week. Basically you can’t eat the day you get it until after you’ve had it because you have to go under a general anaesthetic. You’re asleep while it actually happens. I did get pretty bad headaches afterwards and the first few times I threw up when I woke up . . . I experienced some memory problems . . . and I tend to assume any memory problems I have today, over a year later, are because of the ECT.”
Have you, a friend or family member experienced seclusion or ECT? Email jess.mcallen@fairfaxmedia.co.nz.
– Sunday Star Times
and many more examples on my blog
Sunday, April 12, 2015
FOR CHILD ABUSE VICTIMS, THE HURT GOES ON INTO ADULTHOOD
DEENA COSTER
Last updated 05:00, April 11 2015
Fairfax NZ
The clock ticks loudly on the wall while he talks.
While time is meant to heal wounds, it can also bring bad memories back to the surface.
"I have days when I think about it. I'll be out mowing the lawns or something and it just pops in your mind and you just can't get it out."
For this north Taranaki man, his experience of abuse while in state care at the age of 15 has cast a long, and sometimes ugly, shadow over his life.
He admits he pushed the boundaries as a youngster, experimenting with drugs and alcohol and running away from home, but the decision made by his family and social worker to put him into temporary care started him down an even darker path which he still struggled to understand.
"I was real outgoing. You couldn't stop me as a kid. Now it takes a lot to get me to go out," he said.
While the first glimpse of the New Plymouth home he was placed into in 1990 came as a "shock," by day two of his stay, he realised it was going to be very different to what he expected.
"Things started getting quite heavy."
He was the victim of a group beating, where other young people took turns kicking and punching him.
"It was not full blows, knock you out, kind of thing but it was a hiding." The bullying and intimidation continued as did
his use of drugs and alcohol, something which was either overlooked or condoned by the caregivers.
By the time he went back home two months later, things had changed forever.
"I was pretty bent and twisted. I'd seen another side of life."
At 21, he tried to commit suicide.
"I basically just aimed my car at a power pole and put my foot down to about 100kmh."
While still affected by the injuries from the crash, he now considered himself lucky. He said at least two people he met while in care had killed themselves.
Their stories were the main reason he decided to file a historic claim against the Ministry of Social Development (MSD) for what happened to him as a teenager.
His was one of 569 claims settled by MSD between January 2004 and December 2014. According to information released under the Official Information Act by the department, there are still 1113 outstanding, with payouts so far totalling more than $8 million.
While his application resulted in an apology letter and small pay-out, the 39-year-old said it had provided him with a chance to stand up and be counted.
"It wasn't really about the money. It was about giving a voice for people who aren't able to talk."
One thing that still grates is the fact no action was taken against the people involved in his case.
Although he has the option of private prosecution, it was not something he could afford or had the energy for.
But he still gets angry, an emotion stoked especially when he sees people who were involved in his care out in the community.
"You see them and you wonder if they remember you. I'm not a small guy and stuff but I kind of feel quite small when I see them."
Life had taken a turn for the better in the past decade.
A stable partner and job meant he was able to leave behind the "rollercoaster" lifestyle he had lived previously.
However, his well thumbed file - a collection of letters and case notes about his time in care - was a reminder not only of how far he had come, but how much other people might have suffered.
"There are people out there who would have had it a hell of a lot worse than me."
For lawyer Sonja Cooper, stories like this make up the bulk of the work she manages everyday from her Wellington chambers.
She has about 600 clients on her books who have made historic claims against the state, a number she thinks will only grow.
"I think, sadly, it will be an ongoing issue."
While many of the claims settled so far by MSD related to the period between the 1960s and 1980s, this did not mean abuse complaints were confined to the past.
Cooper's youngest client is 17 but she said research suggested it took on average 22 years before a person reported abuse.
She said the issues which led to the abuse went beyond "the few rotten eggs" scenario but resulted from systemic failures.
But a royal commission inquiry, which another abuse victim Grant Mahy has started petitioning for, was not the answer, according to Cooper.
She believed an independent panel was needed instead and if set up, would go a long way to show how seriously the Government treated the issue.
"New Zealand is very good at talking the talk but not good at walking the walk," she said.
Earlier this month, Social Development Minister Anne Tolley announced a complete overhaul of Child Youth and Family (CYF), which she said was lagging behind other countries in terms of how it operated.
One who supports this move is Lynnette West, centre manager and counsellor at New Plymouth's Young People's Trust.
She said challenges CYF social workers faced, including high and complex caseloads, meant they were often too busy to spend quality time with their clients.
But she did believe there were better mechanisms in place now to deal with abuse as well as active campaigns which encouraged people to speak up.
She said there were more targeted services available to step in, but they were often at capacity and waiting lists meant people were not getting the help when they needed it most.
Another trend West had noticed with young people she worked with was their higher tolerance for hurt and harm.
"What I see here is an acceptance of abuse."
She described it as a "oh, so what" attitude which meant they were often oblivious to what was safe or risky behaviour.
"The baggage that those young people carry around is huge," she said.
A rally will be held on Saturday, April 11 at 11am outside the New Plymouth District Court as part of a world-wide protest against child abuse.
A BETTER UNDERSTANDING
Trying to break the cycle of abuse is often at the forefront of intervention with families and research often plays a big part in finding out what does, or does not, work.
Two Taranaki woman are currently involved in projects which are seeking to develop a deeper understanding of how abuse affects people and how society can learn from their experiences.
Dr Leonie Pihama has been involved in a five-year long project headed up by Te Atawhai o Te Ao, a Whanganui-based Maori research unit.
Known as mifHe Kokonga Whare: Maori Intergenerational Trauma and Healing, she said the project aimed at increasing understanding about why and how violence is used in New Zealand, with a particular emphasis on Maori society.
Pihama has also worked alongside Tu Tama Wahine o Taranaki staff to understand the impact sexual abuse has on whanau relationships.
About 70 interviews had been conducted with abuse survivors in an effort to understand what helped them recover.
Pihama said findings from the full research project will be released in October and key recommendations passed onto Government.
New Plymouth woman Tiffany Apaitia-Vague's Phd project is also focussed on how abuse victims have turned their lives around.
Her project, supervised through Massey University, looks at how people who have been involved with Child Youth and Family (CYF) view sexuality and relationships.
She said the research participants, who had spent time in CYF care, also spoke about how they managed to cope with the abuse.
"These are just not stories of trauma, they are stories of resilience," she said.
Anyone interested in being part of Apaitia-Vague's research can either visit nzstatecarestories.com or send her a private message via Facebook.
The NZ Govt: Make the Confidential Listening and Assistance Service Findings Publicly ... https://www.change.org/p/the-new-zealand-government-make-the-confidential-listening-and-assistance-service-findings-publicly-available?recruiter=253071081&utm_source=share_petition&utm_medium=twitter&utm_campaign=share_twitter_responsive …
Fairfax NZ
The NZ Govt: Make the Confidential Listening and Assistance Service Findings Publicly ... https://www.change.org/p/the-new-zealand-government-make-the-confidential-listening-and-assistance-service-findings-publicly-available?recruiter=253071081&utm_source=share_petition&utm_medium=twitter&utm_campaign=share_twitter_responsive …
Saturday, April 4, 2015
QUESTIONABLE MEDICAL PRACTICES IN NZ
Fran O'Sullivan: Questionable 'medical' practices not confined to overseas horror stories
5:00 AM Saturday Apr 4, 2014
The "Zombie Ward" - that's what the young female nurses, of which I was one, used to call the locked mental health facility where women prisoners were treated with the now-infamous "deep sleep therapy".
I've wrestled again with that uncomfortable experience from 40 years ago over the past couple of days since news broke about the lawsuit that more than 750 Guatemalan victims of a US-Government-sponsored experiment to infect them with syphilis and other sexually transmitted diseases had launched against Johns Hopkins University and the Rockefeller Foundation.
What the hell did the US Government think they were doing?
This "ethically impossible" research - as an Obama-appointed commission has damned it - took place from 1946-48, the same time the Western world was still recoiling from the revelations of the unconscionable medical experiments that Dr Josef Mengele performed in the Nazi Germany death camps of World War II.
But instead of offering US Government reparations - a step that Barack Obama, if he had a conscience, would take - the victims are having to slug it out in the courts because the US government cannot be held responsible in an American court of law for any action committed in another country.
The videos of the victims' stories are of course hideous.
When I was a 20-year-old trainee nurse in Dunedin in the early 1970s, the then-mental health institutions still contained a number of patients who suffered from neurosyphilis dementia or general paralysis of the insane.
Some had been committed by relatives for immorality (in the case of the women). Their misfortune was to have been born far too early to receive the penicillin medical treatment that later became available for those infected with syphilis - which the Guatemalan guinea pigs and their children have been denied.
There have been questionable "medical" practices here as well.
And they have still to be properly confronted.
So, to the modified - or "deep sleep" - therapy that was meted out to some Dunedin women prisoners at Cherry Farm Hospital before Christchurch Women's Prison became the sole correctional facility for women in the South Island in 1974.
In the early 1970s, the hospital - like others - used electro convulsive therapy or ECT as standard practice. But putting people under deep sedation for days on end was in a different order again when it was introduced as a voguish new treatment by a foreign doctor at a time when it was starting to be roundly condemned elsewhere.
It carried risks. The women patients had to be woken up from weeks of deep sedation and walked to prevent the risk of deep vein thrombosis. We had to turn them in bed every few hours or so to avoid problems.
In other villas - for men - similar "treatment" occurred.
No one questioned psychiatrists much back then. They were gods. Even when we nurses stepped up when we nearly lost one large patient during ECT because an incompetent doctor had not taken account of a prior cardiac condition, the higher-ups would not countenance questioning of medical staff.
I often worked in the women's secure villa where the violent patients or those on suicide watch were incarcerated.
We were taken aback when we were asked to prepare for new arrivals - female prisoners from Dunedin prison - who we were told would also undergo deep sleep or narcosis therapy in an especially locked-down unit of the villa.
It has never been made clear just who gave the approval for the prisoners to be taken to Cherry Farm Hospital for this controversial treatment.
It wasn't clear either from the later inquiry the Department of Health commissioned from Graham Mellsop and Michael Radford in September 1990 whether they were even aware that prisoners were among those subject to a treatment which by the mid-1970s was discredited. If so, they chose not to highlight this.
The departmental inquiry came about after Scientologists forwarded documents and affidavits to the authorities which could not be ignored.
Mellsop and Radford did a good job. But in retrospect, the Department of Health did not take up their recommendation to look more closely at Cherry Farm, where they said the amount, nature and varieties of drugs used were in their opinion not consistent with sound clinical practice. The report is understated but the cut-through is there. Cherry Farm was the hospital to use deep sleep therapy most; many patients were not given optimal treatment; the specific application of modified narcosis was inappropriate and applied to a large number of patients up to 1978.
They noted that by the 1970s, standard psychiatric textbooks either did not mention the topic or noted that it was no longer a respectable form of treatment. By 1980, the Australian and NZ College of Psychiatrists had denounced the continuous use of deep sleep therapy.
The disgraceful reality is that files were missing - including half those containing nursing notes; there was no evidence of systematic monitoring.
The two medical reviewers found the amount and nature of drugs used were not in their opinion consistent with sound clinical practice. "It is our opinion that a more extensive inquiry into the events at Cherry Farm would be required to fully elucidate the quality of care of the patients ... and to draw formal conclusions as to benefits versus harm and responsibility and accountability."
That never happened.
• Fran O'Sullivan was a trainee nurse at Cherry Farm for two years in the early 1970s.
Read more by Fran O'Sullivan Email Fran O'Sullivan
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