Navigating NZ’s mental health system: tips from nine years in the maze

if you have any tips you think should be added let me know in the comments section.

NOTE: I am not a professional. Please keep that in mind. I do not wish to speak for anyone, this is just my experience and what I have learnt over the years x

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I first entered the mental health system at 15-years-old. When trauma from an ancient event made itself apparent — combined with a fun dose of anxiety — I was fast-tracked to the Waikato youth mental health branch. There, I had six sessions of Cognitive Behavioural Therapy (“imagine a nice beach when you feel distressed”). I was popped on Prozac and sent my merry way. Six years later, at 21, I re-entered the system. This time I was suicidal. I’d been looking for help before then but I wasn’t bad enough… until I was beyond the point of bad enough.

I do quite a few stories on mental health — it’s therapeutic. I still haven’t had counselling since those six CBT sessions nine years ago but I like learning from others who understand the world in all its ugliness and find ways to push past that. Edit at at June 2018: currently having therapy through the public system. There can be hope (it’s made a huge difference), but the wait list is long.

A side effect of reporting on mental health, however, means lots of strangers contact me — either asking for advice or just unfolding their thoughts. While I love helping out where I can, it’s important to remember I’m not a professional and have my own issues going on. In the depths of depression it can be hard to a) read some of the things I get sent and b) remember to reply to them. This subsequently leads to feelings of guilt (and emails two months later with the subject line “I am SOOOO SORRY!!” and hoping the person is still alive). I struggle to reply to emails at the best of times but what I am good at doing is writing mental health stories. I can’t do that if I’m burning myself out by trying to be an angel for everyone (and it’s hard because I know how it feels to be another number on a waiting list).

So I’m writing this guide to the system in the hopes I can email it to people who contact me on days when I am either too busy or not mentally well enough to fully engage. I love that people connect to my writing and feel they can reach out. This isn’t any form of abandonment but rather a handy hug of advice. Print it out, wrap it around you. Know that I care.

Come here if you’re feeling slightly anxious, fully-fledged suicidal, if you’re worried about a friend or loved one. Diagnosis is only the start of the journey but that journey can be halved if you know where to go. Below is a bit of context regarding the system but if you want to go straight to the tips just scroll past it.

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The first step is to contact the Community Mental Health Team in your area (you can be referred by your GP). This is the public mental health service run by the DHB — it’s free to access but incredibly difficult to get into as the minimal resources are outweighed by overwhelming need.

New Zealand hasn’t had a dedicated psychiatric hospital for a few decades. A big deal was made of shutting down mental health hospitals from the 60s through to the 90s and in-patient units were integrated into general public hospitals. The Community Mental Health Teams (CMHTs) provide out-patient services where the majority of those in mental trouble will be treated.

The CMHTs are run as part of the public health system but are not located next to hospitals. They are divided up by location (e.g. the Taylor Centre in Ponsonby, St Lukes Community Mental Health Centre and so on) and provide access to psychiatrists, psychologists, nurses, and social workers who work together to provide care.

St Lukes Community Mental Health Centre — my old haunt circa 2013 and 2014. Photo from Google Maps (legit)

Since the CMHTs are divided by regions if you move a lot it can be a mission to get counselling — in 2013 I moved from Ponsonby to Kingsland so had to change which centre I went to (about a three month wait) and was put on the waiting list for counselling (about 3–6 months). Then I moved in with my parents when I was suicidal so had to go on a whole new waiting list to get into that area’s team (and then I moved to Grey Lynn, three months later when I got a job). It’s convoluted as all hell and I wish I knew about services like Youthline back then.

Being admitted to an in-patient ward or unit (such as Hamilton’s Henry Bennett centre) is a huge thing and not something you can generally just rock up and do (although voluntary admissions are possible).

This page lists contact phone numbers for Mental Health Crisis teams at each DHB. Find your DHB on that page and call them for help. Alternatively here’s a list of helplines in NZ like Lifeline, Depression helpline and others. There are support groups and more resources are available in the Get Help section of the Mental Health Foundation website.

Where to go when you start feeling unwell but aren’t deemed serious enough to access the CMHC teams

Go private if you are fortunate enough to be able to do that. The waiting lists for CMHTs are lengthy and the consistency in care is near non-existent, especially if you have to move. When you stop being a huge threat to yourself/others they will discharge you pretty quickly. This means issues have time to fester without being addressed until suddenly you have a new crisis on your hands. Private counselling normally costs more than $100 an hour so it’s sadly not a reality for many New Zealanders.

Accessing a counsellor (low cost or free)

• To find low cost or free counselling in your area, search the Family Services Directory, or contact your local CAB.
• The Winz Disability Allowance goes towards 10 initial counselling sessions (it can be extended). The current income threshold is $629.04 per week (before tax) for someone over 18 who is single and with no children. If you do qualify it only pays a maximum of $61.69 a week (so realistically you could see a psychologist once a fortnight or once a month). Here is a link to more info and an application form. You don’t need to be receiving a benefit to apply, nor do you need to pay it back.
• Raeburn House in Auckland run low cost group and individual counselling, have a free app with a directory of social services in Auckland and offer creative and holistic forms of therapy (like music therapy)
• Most GPs are part of Primary Health Organisations (PHOs) that run Government funded mental health programmes − often you can access free counselling sessions (typically 4–8 sessions) through these.
• If you are in paid employment you may be able to access free confidential counselling through your company’s employee assistance programme (EAP)— talk to your employer. I have a friend who clicked with her counsellor so much that she continued to see her privately.
• If you’re in Christchurch, Petersgate does sliding scale counselling as per your income. If you earn less than $20,000 a year it is $25 per one hour session and if you earn $80,000 or over it’s $110 per session (typical private counselling price).
• Free Youthline counselling for youth aged 12–25 years and their families. Adults can also get free phone counselling and in-person counselling on a sliding scale basis. Every time I’ve directed someone there I’ve heard glowing feedback about how quickly they respond.
• Evolve is sort of like Wellington’s version of Youthline. They offer free counselling for those aged 10–24.
• If you have experienced sexual abuse or assault ACC may be able to pay for therapy with a clinical psychologist or psychotherapist: 0800 735 556. Ask your GP about making a Sensitive Claim.
• If you are enrolled at a university you are usually eligible for free or low-cost counselling. Massey, Auckland University, AUT, Vic Uni and Otago Uni are the universities I know of that either offer free counselling or give heavily discounted or free psychology/psychotherapy sessions when you see a supervised student clinician. Again, wait lists vary.
• I’ve been told this website is really helpful for mother’s experiencing mental illness (it has a nationwide map you can click on to find free or low-cost support): http://www.mothersmatter.co.nz/Support/default.asp

Accessing a counsellor (general)

• Yellow Pages — look under Counselling Services, Psychotherapy & Psychology
• Talking Works Directory of counsellors, psychologists and psychotherapists
• Healthpages to find private psychiatrists practicing nationwide

Immediate Psychiatric Help

If someone is in a psychiatric emergency — experiencing delusions, psychosis, mania or is suicidal — go to this page https://www.mentalhealth.org.nz/get-help/in-crisis.

Usually the first port of call is to ring your local CAT (Crisis Assessment & Treatment) team.The above link provides a drop down menu of the regional phone numbers. CAT provide 24/7 assessment and short-term treatment services for those experiencing a serious mental health crisis as well as a treatment plan to support the person in crisis and their family/ friends.

Legal Help

Having someone put under the Mental Health Act is a scary and often isolating time. But there are advocacy groups to help families and people under the Act deal with the process. Legally, you are allowed to request a visit from a district inspector who will advise you of your rights and the review process. The Mental Health Foundation recommends this chapter on rights under the Mental Health Act.

The Wellington Community Law Centre has an online manual, Chapter 19: Health, Disability and Mental Health is particularly useful. Local Community Law Centres provide legal advice and Auckland’s specialist Disability Law Service includes mental health.

Oranga Ngakau — Getting the Most Out of Mental Health Services: A Recovery Resources for Service Users was published in 2014 and contains useful information on the rights of mental health consumers.

I’d personally recommend contacting Changing Minds — a peer advocacy group in Auckland who provide free legal help and will meet with family members to explain what is going on (family members often feel very out of the loop in the whole process due to Privacy Act constraints).

They also published this brochure, The Mental Health Act and You http://changingminds.org.nz/wp-content/uploads/2014/07/MENTAL-HEALTH-ACT-AND-YOU-BROCHURE-FINAL.pdf.

Here is a copy of the mental health act so you can see how the time frames for assessment and treatment can work. Start from section 8 and read through from there.

Helplines

• Lifeline — 0800 543 354 for counselling and support.
• Depression Helpline — 0800 111 757 to talk to a trained counsellor about how you are feeling or to ask any questions.
• Suicide Crisis Helpline — 0508 828 865 (0508 TAUTOKO) For people in distress, and people who are worried about someone else.
• Healthline — 0800 611 116 for advice from trained registered nurses.
• Samaritans — 0800 726 666 (for callers from the Lower North Island, Christchurch and West Coast) or 04 473 9739 (for callers from all other regions).
• Youthline — 0800 376 633, free text 234 or email talk@youthline.co.nz. For young people, and their parents, whānau and friends.
• What’s Up — 0800 942 8787 — for 5–18 year olds; 1 pm to 11 pm.
• Kidsline — 0800 54 37 54 (0800 KIDSLINE) — for children up to 14 years of age; 4 pm to 6 pm weekdays.
• OUTLine NZ — 0800 688 5463 (0800 OUTLINE) — provides confidential support for sexuality or gender identity issues

Help for families

http://www.supportingfamilies.org.nz/

Online tools

• SPARX — an online self-help tool that teaches young people the key skills needed to help combat depression and anxiety.
• The Journal — NZ based self-help programme designed to teach you skills that can help get through mild to moderate depression more effectively.
• Mood Gym — is an interactive web program designed to prevent depression.
• Big White Wall. Free for Auckland DHB residents. A UK-based professionally facilitated, peer support community of people who are experiencing common mental health problems

Tips

• Remember to find a counsellor that suits you. Don’t feel bad if your personalities clash and you want to ask for someone different
• If you’re in the public system you are entitled to any notes they have about you. Ask at reception and they will send them to you. If the notes have skipped something important you are able to update them so that if you get into further mental distress they will have accurate notes on what helps calm you down and what the context is behind your breakdown. UPDATE: you can do this with private counselling as well under the Privacy Act.
• If you run out of medication pharmacies will generally give you an “emergency supply” that will last around three days

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