‘Forgotten’ hospital abused ask for apology - NewsWire.co.nz

‘Forgotten’ hospital abused ask for apology

FORGOTTEN HISTORY: The old Porirua Lunatic Asylym, where former patients allege abuse took place.

MANY of New Zealand’s old psychiatric institutions now stand derelict, surrounded by weeds, unnoticed by passers-by.

However, hundreds of former patients say the walls of these old buildings once hid physical violence, sexual abuse and cruel punishments.

More than two decades since the last of the old “bins” closed, a group of Wellingtonians is fighting for those patients whose stories of trauma are a forgotten chapter of New Zealand’s history.

Mental health advocacy team the Phoenix Group has launched a petition to have the Government formally acknowledge Te Āiotanga: The Report of the Confidential Forum for Former Inpatients of Psychiatric Institutions, which contains the accounts of almost 500 patients and their families.

The Forum was convened in 22 locations throughout New Zealand between 2005 and 2007, and heard testimonies from 493 people affected by their time in the “bins”.

Its report was presented to former Labour health minister Pete Hodgson, who declined to offer an apology or an acknowledgement of the suffering.

The current petition was initiated by Phoenix Group member Anne Helm, who sat on the panel of the Confidential Forum for two years, listening to the patients’ personal stories.

“[The institutions are] a period in our history that needs to be acknowledged,” says Ms Helm.

“The report said that a public apology would make [the patients] feel valued and respected, and bring them closure.

WARRIOR WOMEN: Anne Helm (left) and Eileen McAtee

“The Government can apologise for the Poll Tax [on Chinese migrants in the early 20th century], and the Ministry of Social Development can run a process for people abused as wards of the state. But, for the people in the institutions, there’s been no response.

“Everyone knows about the Ballantynes fire, but hardly anyone talks about the fire at the Seacliff asylum, which killed 39 people. We need to tell them this should never have happened. It will make that closure concrete.”

With regard to formal acknowledgement of Te Āiotanga, Dr John Crawshaw, Director of Mental Health at the Ministry of Health says the report has been shared with the appropriate government agencies.

Dr Crawshaw says a number of historical complaints about abuse in psychiatric facilities before 1992 have been referred to the ministry by the Confidential Listening and Assistance Service.

“These complaints can include a request for compensation or an apology. There is an established process in place for addressing and, where appropriate settling, these claims.”

Ms Helm is not convinced of the effectiveness of the Confidential Listening and Assistance Service to help resolve complaints.

“The Confidential Listening and Assistance service … is mandated to listen to stories in much the same way as the Confidential Forum was, with the exception that this process has no formal reporting abilities.

“In other words, what they hear will never reach the light of day.”

The Phoenix Group’s petition, posted on international social justice website Avaaz.org has generated 54 signatures and interest from overseas.

Another Phoenix Group member, Eileen McAtee, is hopeful that, as well as gaining official recognition, the petition will raise awareness of mental illness in New Zealand.

She says the petition was partly inspired by the United Nations Committee Against Torture.

“Many people don’t know about this time in our past. When people find out about it, they will be shocked and know it’s not okay,” says Ms McAtee.

“The things described in Te Āiotanga that those people went through were torture.  Also, some of the things described in the report are being brushed off as historical practices.

“People in the mental health system are still being put in seclusion. ECT is still being used without patients’ consent. These things are too neatly being put into the past.”

Ms Helm and Ms McAtee have both experienced mental illness, and Ms Helm spent time in psychiatric institutions between the ages of 19 and 28.

She underwent deep sleep therapy – in which a patient is rendered unconscious by psychiatric drugs for a period of weeks – at Cherry Farm in Dunedin, and recalls traumatic experiences at Lake Alice in the Manawatu.

Because of her past, she says her time on the Confidential Forum panel was “exceptionally difficult”.

Testimonies heard by the Confidential Forum included reports of physical abuse by staff, sexual assaults, solitary confinement, heavy doses of medication given as punishment, taunts against transgendered people and women with eating disorders, and ECT given to young children.

“I had to work on all my own Pandora’s boxes at the time,” says Ms Helm.

“I had to learn not to be distressed. I had a beautiful embossed bag with me in the room – and I’d touch it to remind myself there were still beautiful things in the world.”

The final report, Te Āiotanga, was presented to former Labour ministers Michael Cullen, Pete Hodgson and Rick Barker.

At the time Te Āiotanga came out, according to Ms Helm, then health minister Pete Hodgson’s response was: “We have to be very careful of what we’re apologising for.”

She says: “I think there was a fear of financial accountability, and of opening a can of worms.”

Further interest was sparked in Te Āiotanga was sparked last year.  Kiwi filmmaker Jim Marbrook (right) made Mental Notes, a documentary about former patients’ and staff members’ experience in the “bins”.

“We thought we’d use the publicity from the film to generate interest in the petition,” says Ms McAtee. “Consciousness was already being raised. People following the Mental Notes Facebook page have expressed their support.”

Mental Notes tells the story of five New Zealanders – including Ms Helm — who were incarcerated in these institutions, including Lake Alice. The latter was the centre of a police inquiry resulting from claims of child abuse at Tokanui Psychiatric Hospital, Porirua Lunatic Asylum and Lake Alice.

“I was horrified to hear some of those stories,” says producer and director Mr Marbrook.

“We’d be terrified of the bins, even as children. The legend in the Waikato was that you turned right to Tokanui if you were mad, and left to Waikeria [prison] if you were bad.

“It’s important to record and preserve this history that’s not in our official archives. The buildings themselves are falling down. Lake Alice is getting knocked down in 10 years’ time, and there’ll be just a pasture left. And then who’s going to know what happened?”

Human Rights Commission Disability Commissioner Paul Gibson is supportive of the petition’s goals.

He says the commission wants to “slow cook” a national conversation about the old psych  institutions by making people in the disability sector and beyond aware of the human rights abuses that took place.

“I am using the notion of saying sorry at public speaking events [for the commission], and comparing it with processes such as the South African Truth and Reconciliation Commission [restorative justice following apartheid], the ‘Stolen Generations’ [process] in Australia, and Treaty [of Waitangi] reconciliation in New Zealand,” he says.

“The physical, emotional and sexual abuses against disabled people needs national acknowledgement. Everyone in our communities needs to know what happened, acknowledge it and learn from it.”

Even though she is aware the process will be slow, Ms Helm says she will continue to speak out against the mistreatment she and many others received.

“I believe I have the responsibility to the people I was in Lake Alice with. They are my people.

“I will stand for the recognition of Te Aiotanga until they put me in my grave.”

HORRIFYING STORIES: A still from Jim Marbrook’s “Mental Notes”.

Photos:

Top image: http://www.poriruahospitalmuseum.org.nz

Jim Marbrook: http://2010.spark.net.nz/

Bottom image: http://worldcinemashowcase.co.nz/

Electric shock therapy in the modern day | Stuff.co.nz

Electric shock therapy in the modern day

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.

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

Amped up against ECT | Stuff.co.nz

Amped up against ECT

AMY CHILDS

From left: Rangimarie Bosma, Frances Louis, Rob Kent and Kevin Owen.

Rotorua Review

A mental health patient at Rotorua Hospital set fire to her room in a failed bid to avoid another round of Electroconvulsive therapy (ECT), according to anti-ECT campaigner Frances Louis, prompting her crusade to have the controversial treatment banned.

ECT is the administration of an electric current to the brain via electrodes placed on the head in order to induce seizure activity in the brain and is used in the treatment of certain mental illnesses, especially severe depression.

The group fighting against ECT is led by Frances Louis and plan to hold weekly ECT protests on Pukeroa Hill each Saturday at 2pm.

Mrs Louis said she is campaigning against the treatment after being approached by a "terrified" patient.

"The patient said she set fire to her room because she was so scared about getting another round of treatment. But for this behaviour, another ECT was what she got," said Mrs Louis.

"She wanted me to come and help her talk to the psychiatrist as she has had three rounds of ECT and said she couldn't take anymore. She is deprived of food and drink for nine hours before her treatment and does not want to undergo anymore of this."

Mrs Louis said she was moved by the terror in the patients eyes and knew she had to help her and others in her position.

"She is going to be a lifetime customer of the mental health system and she knows it."

She said patients also suffer from side effects such as memory loss and trauma.

"I want this treatment banned from Pukeroa Hill. This land was given to Rotorua by the tribe for healing, but the way I see it, ECT is not healing, it's torturous control.

"I have grave concerns for the patients who refuse to undergo ECT and the ability the psychiatrist's have to override the consent of an adult. It is a violation of human rights."

Rotorua MP and associate Health Minister Todd McClay defended the treatment, saying it was an effective way to deal with various types of mental illness including depression, mania, catatonia and other neuropsychiatric conditions.

He said it was also effective when medication failed.

Mr McClay also said he would be happy to meet with anyone who had concerns over ECT treatment.

Lakes DHB chief executive Ron Dunham said he had received a letter from the campaigners which had been put before the DHB board.

"Lakes DHB is currently reviewing its processes around ECT," he said.

- Rotorua Review

Electrical parameters and threshold discussion - YouTube

Electrical parameters and threshold discussion - YouTube

ECT 'It has ruined my life':

'It has ruined my life': Woman who underwent electro-shock therapy in the 1980s now campaigns against the practice

A woman who was administered controversial electroconvulsive therapy (ECT) is campaigning to ban the mental health treatment.

Jacqueline Dunn, 47, of Sutton, wants to ban the treatment she said has ruined her life and left her suffering with memory loss and other problems.

The treatment is still offered by South West London and St George's mental health trust (SWLStG), which covers Kingston, Merton, Richmond, Sutton and Wandsworth.

Formerly of Ormesby, near Middlesborough, Miss Dunn was diagnosed with paranoid schizophrenia when she was a teenager, but believes she suffered from bi-polar disorder and depression.

She said: "I got really ill and I thought I was Jesus in the time leading up to the ECT treatment. I dressed up as him and everything, I really believed I was him and became very religious.

"It got to the point where I even baptised my feet in the toilet."

When she was 17, in 1985, Miss Dunn was taken to the now-demolished St Luke's Hospital in Middlesborough and underwent ECT in hope that it would improve her condition.

ECT was first used in the 1930s to treat patients with severe depression. The patient is first given anaesthetic and muscle relaxants before putting in a mouth guard to stop them from biting their own tongue.

Promoted stories

Dr John Read, from the University of Liverpool, believes the treatment will eventually be consigned to the "rubbish bin of historical treatments".

He told the BBC: "It's not in any way addressing the cause of their depression. It's systematically and gradually wiping out their memory and cognitive function."

But an SWLStG spokeswoman said: "Electroconvulsive therapy is an evidence-based, NICE-approved treatment to be used under specific circumstances and can have benefits for certain patients, particularly for people with severe depression who have not responded to other forms of treatment.

"We follow NICE clinical guidance on the use of ECT, and its use in the trust is accredited by the Royal College of Psychiatry."

The Mind charity says ECT "can be an effective treatment" for people with severe depression, for whom no other treatment has worked.

Mother-of-two Miss Dunn added: "I remember being taken into a room on the ward and being given a needle in my hand. Something was put in my mouth before they anaesthetised me.

"When I woke up I had a horrible headache and that has never gone away.

"I had so much going for me before I had the treatment and really loved doing the smaller things in life.

"My big passion was walking, I did it every day, but since the shock therapy I don't have the drive to do it and that's really upsetting for me.

"I'm horrified that this is still being done on people. It has ruined my life."

The Awakening - YouTube

The Awakening - YouTube

watch a shock doctor in court say ECT causes memory loss 

Redress, including compensation and rehabilitation, for victims of torture

19.      While welcoming the commitment of the state Party to provide compensation to victims of historic claims of abuse, the Committee is concerned at the fact that victims have not  been  awarded  with  full  redress,  including  compensation  and  rehabilitation,  as prescribed by general comment No. 3 (2012) on the implementation of article 14 by States

parties. The Committee further notes that the Prisoners' and Victims' Claims (Continuation and Reform) Amendment Act 2013 restricts the circumstances in which the courts are able to award compensation to prisoners victim of acts that amount to torture and ill-treatment.

Recalling its general comment No. 3 (2012), the Committee recommends the State Party to amend the provisions of the Prisoners’ and Victims' Claims (Continuation and Reform) Amendment Act 2013 that might be inconsistent with the aim of the Convention. The State party should establish the legislative and structural framework necessary for ensuring that all victims of torture receive redress, including medical and psychological assistance, full compensation and the means for full rehabilitation.

Withdrawal of reservation to article 14

20.      While  noting  the  explanations  provided  by  the  delegation,  the  Committee  is concerned that the State party has maintained its reservation to article 14 of the Convention, which leaves at the discretion of the Attorney-General of New Zealand the right to award compensation to torture victims, is incompatible with the letter and spirit of the Convention, as well as with its obligation to ensure the rights of victims of torture to a fair and adequate compensation including the means for as full rehabilitation as possible. (art. 14)

The Committee reiterates its previous recommendation (CAT/C/NZL/CO/5, para. 14) and urges the State party to consider withdrawing its reservation to article 14 of the Convention and ensure the provision of fair and adequate compensation through its civil jurisdiction to all victims of torture.

Paid $25,000 and told to stay silent | Stuff.co.nz

Paid $25,000 and told to stay silent

JOHN SELKIRK/The Dominion Post

Tracie Nichols outside the former girls' home in Hamilton where she was abused.

EXCLUSIVE: A woman dying of anorexia was paid hush money by Child Youth and Family after accusing one of their managers of molesting her in a state-run girls home. 

Hamilton woman Tracie Nichols, 33, says she was abused and betrayed by the CYF manager, who was paid to keep her safe. She was in the Hamilton Girls Home to escape a serial paedophile who had earlier abused her.

A confidentiality clause in the $25,000 settlement - made two years ago - silenced her from talking about the manager's abuse.

CYF historic claims manager Garth Young told The Dominion Post that the agency had apologised to Ms Nichols for the abuse. CYF also confirmed it would not pursue her for breaching the confidentially clause attached to her secret payout.

Mr Young said confidentiality clauses were "standard legal procedure" two years ago but would not be used today.

"We have learnt a lot ... we do not want claimants to believe that we are restricting their ability to speak about what happened to them.

"We know that claimants want to be heard; they want an acknowledgement of what happened to them."

However, the abuse by the CYF manager was only one in a series of blunders made by the agency in its care of Ms Nichols.

She was made a state ward at the age of 12, when she complained of abuse by a man who subsequently confessed to CYF. The agency also knew he was a serial paedophile because he admitted to preying on other children.

But - within a year of becoming a state ward - Ms Nichols had been placed in a foster home where the abuser was able to get at her again.

At the time, CYF described the blunder as "regrettable".

When she was 14, Ms Nichols was put in Hamilton Girls Home to escape the serial paedophile. It was here the CYF manager of the home abused her over about six months. He has since died.

Documents obtained by The Dominion Post show that, also while in the home, CYF planned an experiment of secretly "stepping up" contact between Ms Nichols and her first abuser.

"Tracie is not aware that this will be happening," the documents said.

In 2001, Ms Nichols complained to CYF of her abuse by the manager and asked why police had not been told of a complaint she made while resident in the home.

CYF, at the time, said her complaint was "extremely serious" and it would be pursued in "an open professional manner".

But, in 2005, CYF said it wanted the complaint settled secretly. It denied all liability but paid $25,000 to settle.

Ms Nichols' aunt and spokeswoman, Lisa Kenny, has criticised the confidential CYF settlement.

"For abuse to carry on, it has to be hushed up. By hushing it up they were being perpetrators of it," Ms Kenny said.

"They tried to cover it up and shut my niece up."

Ms Kenny was abused by the same serial paedophile who first molested Ms Nichol. He was convicted in 1998 of abusing them when they were children and was sentenced to periodic detention. The Dominion Post, with the consent of the two women, has successfully applied to lift a court order suppressing their identities.

Ms Kenny says Ms Nichols is anorexic and doctors have said she will die. Both women believe sexual abuse is the cause of the disease.

The Ministry of Social Development now has a Historic Claims Unit and Mr Young urged anyone else with allegations of abuse to make contact.

"It is extremely important to get this right. Not only to protect the rights of claimants, but to ensure that the rights of those subject to allegations is respected," he said.

- The Dominion Post

Napier polytech counsellor had relationships with former clients | Stuff.co.nz

Napier polytech counsellor had relationships with former clients

A polytechnic counsellor who had relationships with two former patients behaved "unprofessionally and unethically", the deputy Health and Disability Commissioner says.

Stefan Thevessen was employed by a medical centre with the contract to provide counselling at Napier's Eastern Institute of Technology (EIT). He began a relationship with one woman two weeks after their counselling relationship ended in 2005, after he had counselled her eight times. 

Their personal relationship ended in around June 2006, at which time Thevessen began a personal relationship with another women, whom he had been counselling for three years. Their personal relationship began within a month of their last counselling session.

His relationship with the second woman ended in 2012. In late 2013 the women complained to the NZ Association of Counsellors. The association chose not to pursue a formal complaint against Thevessen after he resigned his membership of the association. Instead, the association referred the complaints to the Health and Disability Commission.

The women also complained to the medical centre that employed Thevessen and following an internal investigation he resigned in March last year.

The commission released a report on each patient's complaint this week, but did not identify Thevessen.

Deputy commissioner Theo Baker found that Thevessen had acted "unprofessionally and unethically by failing to maintain appropriate boundaries and engaging in a personal relationship" with the women.

Baker said the medical centre had been unaware of the relationships and was not liable for Thevessen's breach of the Code of Health and Disability Services Consumers' Rights. 

Baker noted that Thevessen had retired from practising and did not intend to return. She recommended he provide an undertaking to register immediately with the association if he recommence practising.

She had not recommended that he apologise to the women as both had advised the commission they did not want an apology.

One of the women, speaking on the condition of anonymity, said she did not believe Thevessen should practice again.

"The other woman and I have become good friends since all of this started. We both say we'd never have had a relationship with him if we hadn't been so vulnerable when we saw him. It should never have happened. He's harmed enough people and we want to make sure it doesn't happen again," she said.

Thevessen said he knew he had erred and he was sorry.

"I have quit my job and quit my profession as a consequence [of my actions]. I have offered my apologies. I am still unemployed. I have accepted the verdict of HDC," he said.

"I accept responsibility. I have accepted the consequences and I have paid for it. I will never, ever work in any related profession again. I don't know what else I can do".

EIT said it had not employed Thevessen. He had worked for a medical centre that was contracted  to provide student health services that include counselling and nursing health professional services for 40 weeks a year.

 - Stuff

Govt urged to act over delays in settling abuse caims | Nine To Noon, 9:09 am on 10 February 2015 | Radio New Zealand

Govt urged to act over delays in settling abuse caims | Nine To Noon, 9:09 am on 10 February 2015 | Radio New Zealand

Electro Shock - ECT 1 - Patients Rights Advocacy

Electro Shock - ECT 1 - Patients Rights Advocacy

Electroconvulsive therapy endures - national | Stuff.co.nz

Electroconvulsive therapy endures

Margaret Parry cannot remember anything about her childhood. "I used to try desperately to remember, because I didn't want to lose my memory, but you couldn't stop it," she says.

Parry, 74, was 18 when her mother first took her to Porirua Hospital to try to straighten her out.

"I was a troubled teenager and I had a bad home life and I didn't have the love I needed as a child. My mother didn't know what they were going to do with me.

"I did need help, but not that kind of help."

She needed to talk to a therapist, but they weren't really around in the 1950s, so 45 courses of electroconvulsive therapy, or ECT – by which an electric shock, or a stream of electrons, is sent through the brain to evoke a seizure – were forced on her.

She is one of several people to have filed claims against Porirua Hospital for abuse, but says the courts would not look at the use of ECT on her "because it's allowed".

"It handicapped me. Before I had it, I felt normal, like everyone else, and afterwards I didn't feel whole, completely washed out. I was incapable of doing anything and couldn't talk to anybody any more."

Parry, who now lives in Waikato, has recovered enough to marry and have three children, but, since having ECT, she has always struggled with memory and concentration.

"I've never met anybody who said it helped them, and I've met dozens of people who have had it. They all said how terrible it is.

"I can't believe it's still happening today. I'll never be happy until it's banned."

Rae Chalmers, of Wellington, says the treatment she received 20 years ago helped her get over her depression when she was at a critical stage, "but it would only last a day, and then I'd have to have it again".

Chalmers, 75, says it helped her on the road to recovery, but medication had kept her on the steady path.

The women's experiences are reflective of a continuing debate about the need for the treatment, with clinicians and experts also divided over the merits of ECT.

Psychiatrist Pamela Melding and psychologist John Read are on opposite ends of the spectrum when it comes to the therapy.

They do agree on one thing: that clinician inclination (whether your psychiatrist is a fan) plays a big part in who gets the treatment.

Of the 200 people who have an average of between four and 12 courses of ECT each year, between 40 and 60 are in the Canterbury region, with only five from Auckland. Canterbury is followed by Otago, Waikato and Waitemata.

The number of patients has fallen by about a third since consent became compulsory in 2006, but 15 to 20 per cent of those who have ECT are deemed too unwell to consent, so the decision is made on their behalf, with input from psychiatrists, family and the Ethics Committee.

Women receive ECT nearly twice as much as men do, and elderly women receive the most. Reasons for this could include loneliness and isolation, specialists say.

It is given to patients who are suicidal, not eating or drinking, chronically depressed and who have sometimes tried several courses of antidepressants and therapy.

Dr Melding believes the results far outweigh the adverse effects.

ECT is used more often in the South Island because there are more beds and "there's a lot of clinician interest", she said.

Smaller district health boards (DHBs), such as South Canterbury and West Coast, which do not perform ECT, refer patients to the Canterbury DHB.

Melding administers ECT through the Waitemata District Health Board, where she works.

Auckland does less ECT because of a "clinician factor", she says.

Read, an Auckland psychologist and researcher at Auckland University, says the geographic differentiations are important.

"They've been there for a long time and they're huge. So that tells you that in any district health board it only takes one or two psychiatrists who are very keen on ECT.

"Your chances of getting this quite dangerous and ineffective procedure are quite arbitrary."

Auckland DHB confirmed the difference was because of "the prescribing practices of individual clinicians who refer patients to us, rather than any capacity issues".

Dr Richard Potter, of the Canterbury DHB, says it is unfair to compare the rates of ECT use throughout the country.

"Administering ECT is based on clinical needs and patients choosing to have it. It also depends on how often it is offered, which depends on a patient's clinical history."

ECT has survived attempts to have it halted altogether. A petition calling for it to be banned in the late 1990s sparked an independent review which led to the government adopting several recommendations.

THE Health Ministry began to issue annual reports on ECT and decided the treatment would no longer be given to people who did not consent, apart from those deemed too unwell to do so.

"It makes sense, doesn't it?" Melding says. "Why are you going to treat people with ECT when a pill is going to fix it?

"But there are some patients where you're not going to wait, because it's too dangerous to wait. These are patients whose depression is so severe they're catatonic, melancholic – they can't eat or drink or do anything."

It is a short-term solution and is often followed by a course of antidepressants, which can take weeks to work.

A stream of electrons is sent through the brain to evoke a small seizure to shock the patient, a practice that Dr Read says "burns out the brain cells".

Cognitive therapy is the best therapy for depression and it is much safer than ECT, he says.

"None of the follow-up studies [on ECT] that follow people for a week, month or a year show there is any benefit, and that wouldn't matter if there wasn't a horrendous set of adverse effects."

Psychiatrists who administer it acknowledge memory loss is possible, but say it usually comes back.

But others claim they were not advised of the way ECT could affect their memory before they were given it and say whole chunks of their childhood were missing after treatment.

Read says he knows many people, like Parry, who have had ECT, found no benefit from it and then "discovered there are chunks of their lives missing".

"If you tell people there is a pretty good chance you're going to have parts of your life missing, then who is going to sign up for it?"

But Melding says many patients consider it the lesser of two evils. "We have patients who say it's choice really: `If I've got a little bit of a memory problem as opposed to depression, then I'll take the memory problem'.

"It does shake your memory around and it's logical that it does, as ECT releases neuro-transmitters and those neuro-transmitters are not only important in mood, eating and drinking, but they're also important for your concentration and memory. But depression itself knocks those things around."

Memory returns within six weeks after treatment for 95 per cent of patients, but "it might take a bit longer" for the other 5 per cent, she says. The greatest risk was to people with cardiovascular problems, but this was monitored and considered before treatment. Muscle pains, ringing in the ears, headaches and nausea are other adverse effects.

Melding says ECT has changed dramatically since the late 1930s, when it was invented. It was widely used throughout the 1940s and 1950s, when there were few alternatives. Patients weren't given anaesthetic or muscle relaxants and the dose of electricity they were receiving could not be measured.

Patients now sleep during the procedure, which involves sending up to 540 millicoulombs of energy through the brain, and the process is over within minutes.

"In the old days, before we used muscle relaxants, people used to break bones and teeth," she says, "but now they're relaxed."

The treatment is controlled by a computer, as opposed to a machine with dials and wires.

The ministry's acting director of mental health, Susanna Every-Palmer, says there are historical cases of ECT abuse, including it being used as a punishment.

The number of people receiving ECT has declined and it is typically given only to those who consent.

"Someone who wouldn't be able to consent is the type of patient who is mute, unable to communicate and unable to engage. Anybody who can say `Yes, I hear and understand what you're saying' – that person basically has capacity."

Every-Palmer says New Zealand's rate of ECT is relatively low compared with other countries, such as Australia and Britain, which have about five times the amount of use per person.

Melding says the treatment works for 70 per cent of patients, which is "as good as the best treatments in medicine".

The only reason it is still being used is "because it works", she says.

Read disagrees and believes its decline is a signal that it will be gone in 10 to 15 years.

"We will look back on ECT as we now look back on lobotomies."

* Clarification: Due to an editing error, Margaret Parry was referred to as Margaret Perry in an earlier version of this story.

- Stuff

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Electric shock therapy in the modern day | Stuff.co.nz

Electric shock therapy in the modern day

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.

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

LOTS OF BULLSHIT FROM MINISTERS ON BOTH SIDES OF THE HOUSE

Former National Health Minister Bill English expressed horror in 1997 at the claims and said it had to be cleared up quickly, 

Judy Keall: Why has this matter taken so long to resolve? Hon. ANNETTE KING: The issue has taken so long to resolve mainly because of the previous Government. In July 1997, when Bill English was the Minister of Health, he said that the Government could not be seen to be hiding behind a wall of legal complexities. He did nothing for 2 years. When he became the Minister of Finance, he decided on 23 February 1999 that the claims would be litigated. He was strong on words and weak on action. The money does not go half the way to healing the violence that occurred. They could have come with an apology," Mr English said I seek leave to table two documents. The first document is a press release dated 9 July 1997 from the Hon. Bill English when he was Minister of Health, in which he said: ``The Government cannot hide behind a wall of legal complexities.'' The second document is a health report to Wyatt Creech and Bill English on the Lake Alice Hospital claim. Sue Kedgley: Does the Minister agree that it is unacceptable that people can still be compulsorily treated with electroconvulsive therapy against their wishes; if so, what is she doing to stop that practice? Hon. ANNETTE KING: Electroconvulsive therapy is not administered without a person's consent.  BULLSHIT Annette it can and is forced on people without there consent was in lake Alice and also on me again in 1999 in Aucklands conally unit

A Video Overview of Electroconvulsve Therapy - YouTube

A Video Overview of Electroconvulsve Therapy - YouTube

Raped and tortured: A New Zealand childhood

2004-0306 - Manawatu Standard - Raped and tortured: A New Zealand childhood

The Manawatu Standard
March 6 2004

Raped and tortured: A New Zealand childhood 
by Lee Matthews

The demons of Lake Alice still haunt the people who lost their childhoods there. 

Lee Matthews talks to a survivor. 

"We were doomed people in Lake Alice because nobody helped us. We soon learned not to complain. We knew nobody would listen." 

Stephen McMahon * is a survivor. From age 13 to 16, he says he was raped and tortured. He was also injected with gut-wrenchingly painful paraldehyde and put through unmodified electroconvulsive treatment--shock treatment with no anaesthetic. 

Routinely. To punish him. To modify his behaviour, because he seemed to live in a world of his own. 

This happened not because Mr McMahon * needed psychiatric treatment but because he was a boy with no place to go when he was 13, back in 1973. For family reasons, he needed a place in a boys' home, but there was no place. He ended up a ward of the state at Lake Alice Hospital's open child and adolescent unit, villa 11. 

He's spent the past 30 years thinking about what happened to him and brothers-in-suffering at Lake Alice. He was part of the group that in 2001, after 15 years of trying to make people believe what happened, received a public apology and a share of $6.5 million in government compensation. 

Mr McMahon *, now 45, is tall and quietly spoken. Horror seeps into his eyes when he talks of Lake Alice. He has health problems: muscle cramps, migraines, night terrors, other damage to his body. Right now he's in acute pain, a side effect of withdrawing from the morphine prescribed by Australian doctors. He also has depression problems. 

"I know I need to do serious work to overcome what has happened to me. Coming back to Palmerston North is the first step," he said. "This is fresh-start time." 

The first time he went to Lake Alice was in March 1973. His affidavit for the class action court case records what happened. 

On his first day, he was taken to villa 11 and into a day room where there were about 15 boys, all his age or younger. They were crying. 

"I asked one of them why and he said, `You'll find out.' There was screaming coming from upstairs and I was confused. I didn't know what was going on." 

What was going on was unmodified electroconvulsive treatment. Mr McMahon * was called upstairs, told to lie on a bed and electrodes were slid onto his temples. 

A rubber gag was wedged into his mouth, then unit head psychiatrist Selwyn Leeks "played with the dial" on the ECT machine. 

"They told me I wouldn't feel anything. All of a sudden I got hit with a sensation like a sledge hammer. I can't put the pain into words. Absolutely nothing compares with its intensity. Dr Leeks turned the dial down low and then up high. 

"It was like having little sledge hammers and then big sledge hammers hitting my head." 

Mr McMahon * woke up in a warm bath. One of the other residents was playing with his genitals. 

A diary was kept at the unit. Anyone caught smoking, answering staff back or committing any other trivial transgression had their names put in the "blue book". Then, on Fridays, those transgressors got unmodified ECT. 

Sometimes the youngsters had to help set up the ECT equipment. When this happened, Mr McMahon * tried to convince himself he was just a helper and that he would not be shocked--but generally the helpers got ECT. 

"Normally the smoke doors were kept closed (between the day room and the shutter cell room in villa 11, where ECT took place), but when Dr Leeks performed his ECT sessions, the doors were left open. 

"This was so the boys downstairs could hear the screaming and muffled cries of pain from the boy being tortured upstairs. 

"We were all terrified for each other. We were controlled by this fear. We just sat in the day room and waited," Mr McMahon * says. 

The staff used that fear. 

"The words they used for it were to `ride the thunderbolt', `the national grid' and `the zappidy zap'." 

He was also given unmodified ECT in the left shoulder by Dr Leeks, who said it would help Mr McMahon’s * asthma. This made Mr McMahon * too frightened to get his inhaler and medication from the office. 

Shock treatment was also administered during the week by other staff to the boys' knees, buttocks and testicles. One boy was shocked as he lay in bathwater. These staff also gave paraldehyde injections as a punishment. 

Paraldehyde is a psychiatric drug used to subdue out-of-control patients. It hurts as it is administered, leaving a feeling like hot, burning acid. It has a foul smell and leaves a sickening taste in the mouth for several days. 

Sometimes staff would "harpoon" the boys, throwing paraldehyde syringes at the their naked buttocks from across the room. 

Sexual abuse was also common, not only from staff but from some of the residents themselves. Some staff threatened that raped residents would get the thunderbolt if they complained. 

After residents complained about one resident, Dr Leeks set up a punishment session where the complainants were told to administer unmodified ECT to the abuser. 

Mr McMahon * was also beaten and kept in solitary confinement while at Lake Alice. On one occasion it was for refusing to scrub a floor with a toothbrush. 

Mr McMahon * left Lake Alice in 1975 and says his release and "rehabilitation" were typical. He was given his medication as usual that morning, then taken to Wellington, where a staff member booked him into a YMCA hostel and jacked up a labouring job at the old cigarette factory. Mr McMahon * was then given $100. 

End of rehabilitation. 

The job didn't last long. Co-workers taunted him about coming from the nuthouse. He was also cold-turkey withdrawing from medication and had no idea how to be responsible for himself. 

"One minute I was at Lake Alice, woken up in the morning with an air raid siren, being told what to do every minute of the day and being governed by fear, and now I found myself suddenly expected to fit into the workforce." 

He ended up jobless and homeless, sleeping in a Courtney Place bus shelter. A homosexual transvestite picked him up. Eventually, Mr McMahon * fled to Australia and to England. 

"To this day, I wake up crying, with nightmares about Dr Leeks and Lake Alice," he says. "The situation has not improved over time. It irritates me immensely that I just can't seem to get Lake Alice out of my life."n 

-------------------- 

Fear at first sight 

-------------------- 

The first sight of the old water tower rearing out of trees makes Stephen McMahon * shiver. 

"I hate the sight of that thing," he says. "It's so ugly. It used to be the first thing you'd see coming back after a weekend's leave. It meant you were going back there." 

Mr McMahon * was a ward of the state at Lake Alice Hospital's open child and adolescent unit from 1973 to 1975. He was 13 when he arrived. 

He went back last Friday for the first time in 30 years, to the place where he was tortured and raped while staff either participated or turned a blind eye. 

Driving there, he talked quietly of what has happened to him since Lake Alice, how the experiences there had shattered any chance of joy or a happy life. 

"I've got to go back there. I'm having a lot of difficulty dealing with this. I tell you, if it wasn't for my family, I would have taken my life over this," he says.

"I know the place is all closed down now. I know that, but I don't believe it. 

"I've got to go back there and make sure that those people aren't still torturing children in those rooms. 

"I've got to be able to walk through those rooms without feeling scared." 

The remains of Lake Alice Hospital sit a bare kilometre off the main road between Bulls and Wanganui. The hospital closed in 1986 and the national secure unit closed in 1999. Services shifted to Auckland. 

What's left now lurks behind locked gates and warning signs about guard dogs. Trees are overgrown and long grass invades the drive. Cows graze peacefully. 

Mr McMahon * goes to the caretaker's cottage. He quietly explains that he nearly died at Lake Alice as a child and he must see villa 11. His voice carries 30 years of conviction. 

The caretaker--who wouldn't let in the Manawatu Standard because it's more than his job's worth--warns that the place is wrecked. Vandals have got in. There's nothing left. 

This is what Mr McMahon * needs to hear. He also needs to see it. He goes with the caretaker. 

Half an hour later, Mr McMahon * comes walking back. He's carrying a cracked old wooden plaque-style sports trophy, recording the efforts of the Lake Alice bowling teams. 

"Look," he points out one of the little silver shields on the trophy. "S. McMahon *. 1974. That was me." 

There's a pause. He lights a cigarette, sits down. 

"I must have done something right while I was out here." 

His hands are shaking as he describes how good it felt to stand in villa 11, the place ruined and empty around him. Gutted. Reduced to a building nobody wants. 

"It's all covered in graffiti inside. Everything's broken. Even the toilets are broken. 

"It's a bit of a shock to the system, but I had to come here and see this, to be sure." 

The caretaker told him other survivors of his era have come back. It's not a pleasure trip for anyone. 

Mr McMahon * takes another look at the neglected grounds. 

"I've carried this place around the world with me, wherever I've been." 

He nods slowly. 

"That's all blown apart." 

But he says it has made him stronger to go back, to face the Goliath. 

"I will never understand why they did this to us." 

* Name changed on request