Union Condemns Mental Health Programme Changes Amid Safety Concerns

The Public Service Association (PSA), representing over 95,000 workers across various sectors, has condemned recent changes to the Mental Health Response Change Programme implemented this week. The union argues that these alterations create unacceptable gaps in both worker and patient safety, particularly concerning the assistance provided by police during mental health crises.

Under the new Phase Three of the programme, mental health workers now face a higher threshold for seeking police assistance when dealing with unwell patients. Additionally, a new process has been established for patients who abscond from facilities. PSA National Secretary Fleur Fitzsimons expressed concern, stating, “We have been consistent on this since the Mental Health Response Change launched: these changes are dangerous and will cause harm.” Fitzsimons urged Health New Zealand to carefully assess the level of support required following the police’s withdrawal from crucial aspects of this work.

In Wānaka, local health facilitator Kate Murray of Community Link voiced hope that the changes would not negatively impact police assistance when the new threshold is met. She emphasized the importance of maintaining a strong relationship with local police. The revised procedures indicate that staff can only engage police when there is an imminent threat to life or property, which raises concerns about the safety of both healthcare providers and patients.

Mental health professionals often operate in precarious environments, dealing with individuals who may act unpredictably. Fitzsimons highlighted that “mental health nurses and healthcare assistants work in what can be quite dangerous conditions,” and emphasized the necessity for a direct line to police support.

Earlier this year, NZ Police acknowledged shortcomings in their response to a December 2024 incident in Wānaka involving two mental health workers and a male patient with a history of violence. The patient, who was on leave from an inpatient clinic and had a documented history of assaults, was reported by the workers as a potential risk after carrying knives. Inspector Paula Enoka admitted that certain aspects of the police’s interaction with the patient could have been handled better, especially after the workers were advised to manage the situation without police assistance.

Following the incident, the man was released due to safety concerns. He later escaped from a motel, prompting a search and rescue operation before he was eventually located in a hut. This situation underlined the challenges faced by the Mental Health Response Change Programme, particularly regarding the transfer of individuals detained under the Mental Health Act while in police custody.

Assistant Commissioner Mike Johnson pointed to discrepancies in interpreting Section 109 of the Mental Health Act 1992, especially concerning the handover of detained individuals in hospital emergency departments. Fitzsimons reiterated that mental healthcare staff prioritize both their patients’ well-being and their own safety, cautioning that the new procedures overlook critical “what-ifs” that could jeopardize care.

Despite these concerns, Johnson stated that both Health New Zealand and NZ Police are committed to ensuring the changes are implemented safely, aiming to provide appropriate care for those in mental distress while protecting healthcare staff. “We are determined to get this right and have been taking the time to ensure the plan for phase three and its implementation will be safe and clear,” he said.

As Phase Three rolls out nationally across all police districts, feedback from district teams has been incorporated to streamline the non-emergency request process. Johnson noted that non-emergency requests for assistance will now be assessed against updated guidance that evaluates immediate safety risks and potential future harm.

Karla Bergquist, Director of Specialist Mental Health and Addiction at Health New Zealand, emphasized that the safety and well-being of both patients and staff remain paramount. She acknowledged that the detailed planning for phase three has identified numerous scenarios that cannot be managed by health practitioners alone, necessitating police involvement in certain cases.

The ongoing dialogue surrounding the Mental Health Response Change Programme reflects the complexities of providing adequate support for mental health crises while ensuring the safety of both patients and healthcare providers. The response from the PSA and other stakeholders will likely continue to shape the implementation of these critical changes.