May 25, 2025 • 40 mins
A range of governments have flip flopped on mental health funding for years.
No matter how much is put into the sector, it always seems to end up in the wrong place - or not spent at all.
So where should the money be going?
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Speaker 1 (00:05):
You're listening to the Weekend Collective podcast from News TALKSB.
Speaker 2 (00:16):
You know I need someone anywhere these days. Well, we
thought we'd let that roll a little bit while I
(00:37):
found out why the choice of that song Wasn't it sad?
Of course that we as we do every every hour,
we invite our guests not only to come on our show,
but also they get the first pick of songs, and
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(00:58):
the Weekend Collective. We get each hour loaded up pretty
pretty quickly. Thank you, by the way for all the
feedback you got on the israelphin, which was not a
topic where where I was going to explore it anyway,
but I had a bit of time to make a
comment and the feedback has been significant. Thank you. Thank
you to most people, apart from you know, the ab
Hominem attacks, which always get a little bit tired tiresome. Anyway, right,
(01:20):
guess what it's time for a new hour. It is
the Health hub and we're gonna have a chat about
mental health. And there's been a range of governments have
flip flopped on mental health. And you've seen the headlines
about money, you know, so much money being allocated and
I think the reminding me of that story. I think
there was something about the labor government having allocated two
billion dollars and I just don't know do we know
(01:42):
where the money went? And so where should we be
spending our money in mental health? And it's a topic
that my my guest, who's well known to you all,
psychotherapist car McDonald, is kind of hot on right now.
Speaker 3 (01:56):
Coyle.
Speaker 2 (01:56):
How are you sure? Are you? Thank you? Yes? It's
are you keeping well? You're enjoying the slightly cooler temperatures
or are.
Speaker 4 (02:01):
You someone I like the change? I mean I love
some but it's nice that it's cooled down a bit.
Speaker 2 (02:07):
You can't be sporting a beard like that and not
like winter. I mean, that's the sort of beard.
Speaker 4 (02:11):
It's most Scottish ancestory.
Speaker 2 (02:12):
You need to go down to the South Island to
just hang out. You know, you probably get feature on
some sort of poster advertising Queenstown. This is that'd be
fun meet the locals visiting from Auckland. Now you've been
talking a little bit about this because there's been an
issue around the funding of one particular mental health institution
I think for one of a better word, tell us
about that.
Speaker 4 (02:33):
Yeah, So, Seeker House here in Auckland is a District
Health Board funded specialist mental health service. It's very dear
to my heart. I mean I actually trained there as
an intern back in two thousand and then was lucky
enough to work there for just under ten years from
about two thousand and five ish. And it's a service
it's been around actually as long as I have met.
(02:53):
It was born the same year as me, in years
nineteen seventy wow, and established by a very well known
psychiatrist actually for doctor Fraser McDonald who the psycho geriatric
unit here in Auckland is named after the Fraser McDonald's
you know. So it has a rich history and it's
always been I think it's fair to say, a bit
of a center of excellence. It's a specialist service that
(03:16):
over the years has had slightly different versions, but for
the last sort of twenty years has been an intensive
treatment service for people with borderline personality disorder, which for
people who haven't heard of that diagnosis. Essentially, it's people
who are extremely prone to getting very distressed, chronically suicidal
(03:36):
and can tend to self harm themselves as a way
to try to manage their distress. Often quite disabled obviously
by that difficulty, and often you know, the kind of
person who requires a lot of support, So you know,
from a resourcing point of view, they often use a
lot of mental health services, often calling and accessing crisis services.
(03:59):
You know, frequently require hospitalization in the in patient units
and s House is a program who specializes in providing
an intensive treatment, so people come in for sort of
four or five days.
Speaker 2 (04:12):
They come in in house four to seven for fou.
Speaker 4 (04:17):
Well, it used to be residential. We lost that funding
in about two thousand and six. There was a house
that people could live in and come into treatment. Now
it's a day program, so they come in for the
day and when people are in treatment, they're there four
or five days a week, attending multiple different groups and
all of the treatment sort of approaches are what we
call sort of empirically best treatment with other patients or
(04:40):
couple of therapists sort of six seven eight people in
a group, skills teaching around things like managing high levels
of distress a particular treatment approach called DBT or dialectical
behavior therapy. My field is full of acronyms, so it's
easy to get lost. Yeah, very nice.
Speaker 2 (05:01):
Wiw for what Sorry, let's see if we can throw
in a few acronyms during how many we can get
in there. We'll keep a score d.
Speaker 4 (05:09):
Yes, and so you know, trauma treatment in groups and
then also individual therapy, and then there's also a service
where they can access support out of ours as well,
so it's very much a wrap around treatment.
Speaker 2 (05:21):
Can you tell me, I mean, just as we dig
into this, because there's a punchline to this, which is
not a happy punchline. Yeah. What are the results you've
seen of the work that's done at Segerhouse.
Speaker 4 (05:32):
Yeah, so, as you can imagine, one of the things
about being a clinician and a service like this is
not a huge amount of time left over to do
lots and lots of research. But there has been research
done over the years, and I can certainly talk from
my own experience as well. When people engage and you know,
not everybody engages in treatment, but when people do engage
in treatment and make the most of it that they're
(05:52):
often leaving after sort of six, twelve or eighteen months
of treatment and often leaving mental health services all together.
So often people will leave a seger House program actually
be discharged and not require publicly funded mental health input.
They may go on to have private therapy with someone
like me in the community, which they are then able
(06:14):
to fund themselves because often they're moving back into work.
So when we think from a purely financial point of view,
the return on investment is quite huge when you take someone,
I mean, just to give you a number in patients
stay at the psychiatric unit here in Auckland is around
about two thousand dollars a day, and sometimes people would
come in to see your house and they may have
(06:34):
had stays of up to three months in the psychiatric hospital.
So you can you can very quickly see how if
you can get these people back on track and out
of the system altogether. The system is doing really well
in terms of finances. But also there's a bigger question here,
which is actually we're taking people who were barely holding
on to being alive and turning their lives around. So
(06:56):
the financial argument to me of closing the service has
never really stood up. But one of the problems, of course, Tim,
with health funding is if you're just counting bodies coming
through the door, yeah, and you're not actually counting outcomes,
then you're going to reach them pretty strange.
Speaker 2 (07:10):
So what's it? So when it's closing seeger house itself,
is it closing as a what's it? What does that
look like? Is it a is it a piece of
real estate where the building's doors are going to be closed?
But where are those services being subsumed or shifted elsewhere?
What does actually what does that actually look like?
Speaker 3 (07:29):
Yeah?
Speaker 4 (07:29):
Great question? So what is actually closing? So what the
proposal on the table is is the proposal proposal?
Speaker 2 (07:37):
So it hasn't happened.
Speaker 4 (07:38):
Yet, not that the service themselves has put a counterproposal
forward and there's going to be a decision made later
this week. And you know, it's one of those things, Tom,
I mean you would know what I mean here, when
when you sort of see a proposal process turn around
it so quickly with very little announcement, you sort of
wonder where there's been a predetermined outcome that they're just
sort of hammering the right process too. But nonetheless, the
(08:00):
proposal is that the three and a half full time
equivalent staff that are currently there funded for up to
six but they haven't been fully staffed for a variety
of reasons. Will be redeployed as the term and the
argument that the TEFA to Order is making that they
will redeploy the staff who are expert in this area,
and then people will just be able to access a
service at community level.
Speaker 2 (08:22):
So I'm going to, as I say often in the show,
I like to ask dumb questions that I'd normally be
nervous to ask. But is this Seeger House is a
particular location. It's a particular building, is it? This sounds
so trivial, but it's like we all have our favorite
we have favorite places to go as human beings. We
(08:43):
go to cafes. That's my regular this and that. Is
there something when you lose a physical piece of infrastructure,
so a place that is identified that patients recognize, people
in the mental health system recognize as providing a particular service.
I mean, because there be the argument, I imagine, well,
we're going to take these people, We're still going to
have those services. But the buildings closing's more than that.
Speaker 4 (09:06):
So I mean the building is relevant because one of
the factors that's in play here is that the least
for the service occupy that the service occupies the building
occupies it expires next month, and there is some question
as to whether that's actually what's really going on here.
So but nonetheless, what we've got as a service that
operates as a team of people operating together to provide
(09:28):
what's called a sort of a milieu or a therapeutic treatment,
therapeutic community.
Speaker 2 (09:31):
So the program itself is looking like that's going to
be correct.
Speaker 4 (09:35):
So if you scatter the clinicians, you no longer have
the program. They will see clients in the community, but
they will not be offered the same service. It's a
bit like you know, if you know, we looked at
GP's clinics and said, well, GP's clinics are understaff, So
how about we shut down the cardiac unit at the
Aukford Hospital and put those surgeons out into the community
and they'll just be able to see people with heart
(09:56):
problems out in the GP's clinic. And by the way,
GPS see a lot more patient So can we get
these cardiac surgeoncying more people?
Speaker 2 (10:04):
So where are we at with it?
Speaker 3 (10:06):
Then?
Speaker 2 (10:08):
Is it a lost course? From your point of view,
because I know you've been advocating strongly for keeping this
program as you won't be the only one, of course,
But where are we at with them?
Speaker 4 (10:16):
Well, it's not over until the opera singer things. So
I remain optimistic that whether it's too far to order
accepting the counterproposal from my colleagues, or whether it's actually
even the Associate Minister for Mental Health, Matt duc decides
to wade in and actually spend some of that money
that he's been spending on news services. You know, why
(10:39):
don't we spend some of that money on a service
that's been around for fifty years and has actually done
a tremendous job. And here's the thing, Tim, you would
know too. Once we lose these services, we don't get
them back, we will lose something that we will not
be able to access again, and it will cost people's lives.
Speaker 2 (10:55):
And be honesty, is there something fundamentally wrong with the
way where with the way we fund mental health services?
Because as I mentioned, you know, every time it comes
that money we spent I remember that headline. It was
a couple of years ago that about the two billion
dollars allocated for mental health and it didn't result in
a single mental health bed. Is there is there something
(11:15):
fundamentally wrong with the way where we're shuffling the money
around and what would you change about it? By the way,
if you're listening to this and you've got a view
on it, we'd love to hear from you as well,
whether you've I mean, I know if you've been a
patient of Seagar House and you may not want to
talk about it, but you are welcome to talk about
the outcomes you've had and why we should keep services
(11:37):
like this, But also on the way we spend money.
How would you be spending it if you were the
Associate Minister of Health? But carry on, sorry, kayle I
just jump in there and invite the calls.
Speaker 4 (11:46):
Yeah, no, absolutely. You know it's tricky because I think
the fundamental problem that we see across health is always
tricky to solve, which is we just don't have the
workforce in New Zealand.
Speaker 2 (12:00):
You know.
Speaker 4 (12:00):
One of the things that is true is that, yes,
there have been hiring freezers, and you know Seaga House
has not been immune to that. They've had vacancies of
their staffing that they haven't been allowed to fill. But
what's also true is they also have at times not
been able to find appropriate staff to actually come into
the roles. So that's the first problem that we have.
(12:22):
The second problem that we have is when a system's
under pressure, what we tend to do is we tend
to revert in mental health terms to what we call
a revolving door approach, which is people pop up when
they're a crisis, which of course we respond to. We
attend to that crisis, and then we patch them up
and we get them back out the door. An ongoing
treatment that actually gets people back on and even keel
(12:44):
and gets them back functioning at a higher level. It
tends to now be found much more in the private system.
Speaker 2 (12:53):
So where to from here for the Sea House Center,
you basically what you're about is lobbying advocating to try
and get because at the moment, this is a call,
it's been made by Tafar to Ora.
Speaker 4 (13:06):
I guess yeah, look it is. And if people want
to see if there's some actions that they can take,
they can jump on my website which is Psychotherapy dot Nz.
And if they have a look at my blog, there's
some details theory about how to write to the minister
for Mental Health Matt Doocy, but also some other coverage
of the story and a bit of background including the proposal.
But look, I remain hopeful. I think we've got a
(13:28):
week that deadline may even be extended. But I just
hope that the Futto Wader is engaging in good faith
at actually looking at how can we turn this around.
Acknowledging money needs to be saved. We all understand that
there's not enough money in house right now. But you know,
whether that's moving back to a hospital premise where the
costs are cheaper, whether it's seeing more patients. I think
the team really want to come to the party and
(13:49):
actually save the service.
Speaker 2 (13:51):
If it's a case of the leases out and they
can't actually renew the lease, I mean they can still
save the program, though, can't they? Because what we're talking about,
the program itself is under threat.
Speaker 4 (13:59):
You know, one of the things about therapy is all
we need is a chair in a room. We don't
need any expensive machines that go bing. You know, we
don't need bython fan, we don't need stayless steel tools,
we don't need anything costly. It's literally a couple of
warm bodies and a couple of cheers to sit in
and actually, when you think about it, from that point
of view, three and a half fts in a building
is an incredibly small amount of money in the context
(14:20):
of a health budget.
Speaker 2 (14:21):
FTA being full time employers. By the way, boofer, we'll
try and get on top of that asap. Now, sorry,
I couldn't not myself. What's the role of the minister
in this? And I realized that this health but we're
in a little bit of political realm here. What's his
ability to instruct a futt aora what to do on
(14:41):
specific things? Because there is that ministerial this is we
want you to focus on. Broadly speaking, this money is
for this, this money is for that, and you know,
you can't really tell the what can he do within
the cabinet manual in terms of it's like the crude example,
not the crewed example. An example would be the Minister
(15:01):
of Police cannot instruct the police commissioner on what to
do in it enforcing the law in the way police
is what can the minister do when it comes to
tafartu wura to saying I want you to preserve this project.
Speaker 4 (15:12):
Well, the police is a little bit different though wasn't
it because it's a constitutional matter. Yeah, okay, But I
mean I'm a bit cynical. It might surprise you to
hear t sim that I think that the ministers can
can trot out the old it's an operational matter when
they don't want to get involved. Equally, they can wade
in and save the day when they decide that they
want to. So I think it's all about what the
political decision is. One of the things that I think
(15:34):
is fantastic that the Minister has done in his time
is he has had a pot of money which he
has allocated to some tremendous new services. Just to give
you one example, peer support workers in the emergency department
in christ Church as a pilot, so people who've had
their own experiences of mental health. They're in the ed
to help support people who are in crisis. Great initiative.
(15:56):
But one of the things, of course is that also
governments like new things. They like to be able to
cut ribbons and roll out new programs. And if there's
a pot of money, then you know, why not throw
a bit of money to something that we know works
and actually is struggling to stay afloat right now? Money
is money, right, and yes it's tight, but it's not
a lot of money to.
Speaker 2 (16:14):
Keep a service like this going.
Speaker 4 (16:15):
How much money are we talking, Well, I don't have
the exact numbers, but we're talking you know, three and
a half to if it was fully staffed just under
seven FTEs you know, I mean a psychotherapist serve as
anywhere half a million for staffing, maybe a bit more
plus a building. It's you know, maybe two million dollars maximum.
(16:36):
It's not a lot of money in the health budget, right.
Speaker 2 (16:39):
We'd love to set your calls on this, and we're
also going to explore with cob just to tie it
into your own health health questions as well. As you've
heard the services that Seeker House provides it for people
who really, you know, the consequences for not getting the
right sort of help can be tragic, catastrophic, and we
(17:01):
know as we as you know Kyle is the psycho
three prist as well. But I'm quite keen to dig
on into the question. Of course, the last thing any
of us wants to have to do is to rely
on our mental health services, and so is there are
there ways that also you can look after your mental
health in such a way as to as to give
yourself the best chance of not needing the sort of
(17:22):
help of places that well, it's difficult. I've summed that
up very crudely because Sega House, a lot of these
problems can't be helped, I'm sure, but we do have
a chat about that as well. You give us a
call weight one hundred eighty twenty four past four new stalks.
He'd be.
Speaker 3 (17:38):
Going to help.
Speaker 2 (18:11):
And welcome back to the Weekend Collective. This is the
health happen. My guest is Carlin McDonald. He's a psychotherapist
as you know. Oh look it I should just say
we've got Carl McDonald in the studio. But we always
have new listeners Kyle, so it's always good to and
a host of the Nutters Club.
Speaker 4 (18:25):
Yeah, thank you. I must be it must have been
well behaved because I've got the second song choice as well.
Speaker 2 (18:28):
You did you have been? Now if you've been a
very very good boy, you might get how patronizing can
we be? Now? Hey, by the way, if people were
just on the Seeger House question around the funding, and
that's what we've been talking about just because it's a subject,
it's not a subject that's something else is a word
(18:50):
for it. It's a something that is close to Kyle's
heart as somebody who's worked there, and it is in
danger of being closed down. Now again, if people do
want to find out about this and support it, or
right to.
Speaker 4 (19:00):
The mast psychotherapy dot nz it is my website. Just
click on the tab at the top of this, says,
and you'll see a whole bunch of posts, including some
action you can take and easily right to the minister
to let them know.
Speaker 2 (19:09):
What psychotherapy dot ends. And you must have got on
early with that one.
Speaker 4 (19:13):
I did.
Speaker 2 (19:16):
Hey, look moving on onto people's personal callers as well,
but just on the on the whole mental health question.
Are there things we can do? It's we have Alex Flint,
for instance, who had who's a personal trainer, and and
we chat about, you know, ways to avoid you know,
your body aging and to look after yourself so you
(19:38):
don't have that heart attack. Are there ways that we
can look after ourselves with our mental health where we
can make certain choices or whatever to stop that mental
malaise or that problem, or that it might be it
might be just a little bit of creeping negativity which
leads to a bit more depression and are there ways
to stop to avoid And this is without judgment that
(20:02):
people who end up with problems have owned themselves to blame,
which I'm not saying at all, because there's a multitude
of physiological reasons and everything that people are the way
they are. But are therefore people who do encounter problems
with their moods and depression are things we can do
to look after our mental health to stop us heading
in that direction where you might need some more serious help.
Speaker 4 (20:25):
Yeah, it's a great question, and we do know a
little bit about what the sort of those pre existing
factors are. There does seem to be a strong role
for genetics, but genetics are not They're not a lie sentence.
So you know, if you have a family history of depression,
it doesn't mean you're going to experience depression, but it
doesn't crease your chances. We also know that trauma during
(20:45):
childhood is a strong predictor of mental health outcomes in adulthood,
and we also know an adulthood that trauma obviously is
a strong predictor of mental health outcomes. But when it
comes to the things across the board that we know works,
I'll give you the boring things. First are things that
everybody kind of knows, right, which is make sure you're
getting sort of six to eight hours sleep every night,
(21:05):
trying to stick to a routine when it comes to sleep,
and try to make sure that you get good quality sleep,
which means, god, I'm screwed. Not drinking, you know, making
sure you know you're not lying there all night, you know,
sort of in a light stay to sleep, exercise of course,
moving your body and whatever way works for you. And
diet's really important to and avoiding alcohol and drugs, which
(21:27):
doesn't mean mean you have to teetotal. If you haven't
had a problem with those things, you know, drinking every
now and then, it's fine, but it becoming a way
of coping with life stresses.
Speaker 2 (21:36):
Is when you run into trustee, I'm curious. I mean,
I don't want to get get into marijuana or anything,
but you know, there's people say often when people are
using marijuana, there's a form of self medication that's going on.
But are there's some drugs that you should definitely avoid
because you might think they're helping you, but they're just
going to make the problem worse. Well, excess alcohol being obvious, Yeah.
Speaker 4 (21:56):
Alcohol is by far and away the biggest in terms
of what's in New Zella.
Speaker 5 (22:01):
Now.
Speaker 4 (22:02):
Nicotine use is decreasing significantly, but we often forget about nicotine.
Speaker 2 (22:06):
But alcohol, in.
Speaker 4 (22:06):
Terms of drugs is by far and away the biggest
use and biggest problem. Look, it's about always about balance,
isn't it too? I mean, you know, some things have
a much higher addicted potential, like methamphetamine, for instance, is
generally not something you can dabble with and use lightly
or socially. But yeah, alcohol is by far and away
the biggest problem for most people. And then there comes
(22:28):
the slightly more subtle things that we know, which is
I often like to think in terms of connection and community.
So isolation, you know, and not necessarily that doesn't mean
not being around people, but it does mean not having
a connection with the people that you're around. So it
is possible these days to live your quite a lot
of your life disconnected, whether that be being able to
(22:48):
shop from home or work from home. We know that
actually that social connection with others is really protective. And
the other thing that we know that tends to predict
poor mental health outcomes or is a red flag for
people who are heading in this direction is what we
generally think of as avoidance. So you know, when we
have a tendency to retreat from the world and avoid
(23:08):
our problems, or we want to avoid painful emotions and
painful situations that might be going on in our life.
So for instance, you know, difficult conversations with the flatmate,
you know, conflict with our partner. If our first response
is to kind of keep retreating from that and not
talk about the issues, we know obviously that can cause
practical problems, but it can actually also cause emotional problems
because we start to ignore our feelings, avoid our emotional responses,
(23:32):
and become cut off from what's actually going on for
us feelings wise.
Speaker 2 (23:35):
Is that why sometimes you get people who are quite
out there and they vent very quickly, and they get
in arguments very quickly. But most of those people I've found,
they're actually quite happy. They can we invent to their
feelings all the time, and even if they're leaving a
bit of carnage in their.
Speaker 4 (23:49):
Way, everybody around them might not be always happy. But
I know what you mean, right, like, so sort of
better out than in. I mean, I think you know,
obviously everything has its downside, but generally I think people
who are able to more readily express their feelings. That's
a good example of the op of that kind of
emotional avoidance.
Speaker 2 (24:07):
Actually, how do you express I mean, this is where
people express themselves in a way that comes out violently,
which is I mean, how do you if you are
feeling those senses of rejection and anger and resentment and
all that sort of stuff, and there's it? I mean,
is there a way of physically exercising those demons?
Speaker 3 (24:24):
Off?
Speaker 2 (24:24):
I could use it, you know, sort of slightly heavy
metal analogy, But is there a way of dealing with
those violent impulses?
Speaker 4 (24:35):
Yeah, well it's a good question. I mean, you know,
in general and therapy, what we think about is being
curious and being able to observe without action. So you know,
it's kind of obvious in a way, but what gets
us into trouble is what we do, not what we
think and feel. So if we're able to observe what
we're thinking, observe what we're feeling, and make some sense
of it, even though the feelings often might be quite
(24:55):
big and may feel out of proportion, generally we can
understand what's actually led us to feel that way, and
then to address the real problem, which is, you know
what's triggered the feeling in the first place, Because there's
a question.
Speaker 2 (25:06):
I've got as a lay person. Again, I've just worked
out for myself as a guess the thing that I
worry about. It's one of the pet topics in politics
at the moment, is smoking vaping. But vaping the thing
that I'm worried about. You know this the popcorn lang
and all this sort of thing. But what I've said
to my daughters about it as well, I mean they're
not interested, hopefully that's what they say. And I don't
(25:29):
think there's any way they're going to be famous last words.
But the chief villain for me in vaping is introducing
young people to a substance which is addictive. And as
soon as is there something in avoiding substances which are addictive,
because it starts to train your body to like finding
(25:49):
something that gives you a high or that is addictive.
In other words, if you you know, if you if
you go through your three your life just eating you know,
meat and three vegi and fruit and all that sort
of thing. And there are some people as soon as
they hit an addictive substance, boomfer. That's the that's the moment,
and I'm very suspicious of anything that's main causes to
deliver an addiction.
Speaker 4 (26:10):
Yeah, it's a really good question. The answer is a
little bit complicated, but if we just zoom out a
little bit for a moment, the core problem with addiction
is often people who end up addicted to things are
trying to solve a sense of discomfort.
Speaker 2 (26:25):
So there's something else they're dealing with, yep.
Speaker 4 (26:27):
And wanting to avoid that discomfort. So it's why trauma
tends to set people up for addiction more readily than others,
because they're trying to solve the pain that they're in.
And then once you're locked into the cycle of addiction,
not being able to tolerate the pain of not doing
the thing that you're addicted to becomes the problem.
Speaker 2 (26:45):
Okay, before we go to the break, what is trauma?
Speaker 4 (26:50):
Any experience that overwhelms our capacity to cope and in
doing so, causes a sense of memory dysfunction where we
can't escape the memory of what's occurred, whether that be
through flashbacks, nightmares, or re experiencing it, and it keeps
us on some level locked in that state of distress
in ways that feel out of control, because I.
Speaker 2 (27:11):
Wonder where there are people who downplay what might be
the cause of their problems because they look at others
and think, well, no, no, I haven't been through trauma.
I can imagine that child there who was abused, you know,
or beaten as a young person, that's trauma. What I've
gone through is not trauma. So you know, I mean
imagine for some people the break up of a long
(27:31):
term relationship where your hopes and dreams have gone out
the door. That could be a trauma, but they might think, oh, look,
it's just a relationship, even though they are some part
of them as hemorrhaging.
Speaker 4 (27:42):
Well, check another acronym at you. There's a difference between
PTSD trauma with a big T and trauma with a
small tea, which, now in everyday language we kind of
used to describe distressing events rather than traumatic events.
Speaker 2 (27:55):
So where are we at with trauma then?
Speaker 4 (27:57):
Well, I think we have to acknowledge that sometimes things
in our past get in the way and the present,
and that's kind of the every day kind of description
that I tend to use. If you feel that events
in your past, painful ones are still impacting you now
in the present, then it's probably something that you need
to address.
Speaker 2 (28:14):
Okay, we'll take your cause. By the way, I waite
hundred eighty ten eighty. Anything you'd like to talk to
Carl McDonald about, and we'll be back in just a moment.
News Talk said B. Welcome, News Talk, said B. This
(28:39):
song is not Carl MacDonald's choice, so he hasn't been
a very good boy.
Speaker 4 (28:43):
No, I I don't even know who it is, neither
do I.
Speaker 2 (28:46):
I forgot to ask you what you were a song
request was and I don't think my producer could find
mine because it's a slightly weird Alice Cooper song. Anyway,
we're asking how you stop your mental malays getting to
a point where you need help, how do we stop
people getting to crisis point when things aren't going great
for them, and any other questions you've got for Carl MacDonald.
Speaker 5 (29:05):
Gloria, Hello, Yes, good afternoon.
Speaker 6 (29:10):
Now this I'm not talking about serious clinical depression. I've
just I've been listening to the conversation and very good.
You know, how we can help ourselves eating well, you know,
decent sleep at night and all those things, and you
know some company also I find often people who are
(29:31):
in depression, often they don't get out into the community.
They're not doing anything. And you know, we get a
lot of joy from mixing with people and helping others,
and yeah, and it's sad when people get to such
a stage that they can't do that anymore, they're not
interested or yeah, but that is a you know, we
(29:54):
need to make where we were designed to mix with
other people. And you know, you're quite right once we
start this staying at home and not going to work
or you know, that's not good. The other thing I
was going to mentioned, and I'll set the cat amongst
the pigeons here.
Speaker 1 (30:09):
Oh.
Speaker 6 (30:09):
Yes, we also have a spiritual side to us, and
sadly we fill that spiritual side up with all sorts
of other stuff that ultimately doesn't help us. You know, drugs, alcohol, I.
Speaker 2 (30:21):
Mean religious or spiritual?
Speaker 6 (30:24):
I mean spiritual spiritual. We were designed, we were designed
originally to be in a relationship with God and he's
our helper and that's yeah, but we've, especially in the
Western world, we've walked right away from that. Now, you know,
we think we can do it all ourselves. But ultimately, I'm.
Speaker 4 (30:46):
Not a religious person, but I do actually agree with
you in the sense that, you know, what you're talking
about is that sense of community and connection, but you're
also talking about that sense of contributing to others. And
you know, what we know works for depression is anything
that gets us active again, whether that's active physically, active socially,
or active mentally. I think one of the things that
(31:06):
we have lost is those communities that we used to
regularly go to, you know, whether it was church, whether
it was a sports club, whether it was the Lions,
whether it was the night classes. I think, you know,
in modern life, it becomes far too easy to sort
of just be at home, you know, with a with
a with a sugarhead of connection, you know, whether that
(31:26):
be social media or whether that be you know, those
touch points, but not actually being in the same room
with another set of warm bodies.
Speaker 6 (31:35):
Yep, No, and you know there they've already worked it
out already. Now that kids spend child spending a childhood
on a device, when they grow up, they've they've got
no idea of social skills.
Speaker 2 (31:50):
So yeah, yeah, although it's interesting, Gloria that I think
that this generation or my kids devices and they're not
allowed on social media, that to me is an I know,
but but I do think that there's a generation of
kids who probably handle socialia better than their parents do
because they've grown up. You know that it depending, you know,
And I think that the banding of phones and schools
(32:11):
has been great because they it's all about practice and
developing those habits of human connection. But yeah, hey, thanks
for your call. I appreciate glory.
Speaker 4 (32:18):
I completely agree with you, Tim. You know, whenever anyone
complains something about their kids, if I use the first
thing I do to set my kead and marks the
bicheons as I say, what about yours?
Speaker 2 (32:29):
Look, I'm aware of stuff.
Speaker 4 (32:31):
How do the kids learn these things? They see other people?
Speaker 2 (32:33):
I sort of practice what I'm preaching. So, for instance,
I say, you can be on your device if you're
doing if you're doing some duo lingo or something, because
they they're doing the language Jap and learning some things,
and that's that's simply a tool for learning, as opposed
to how many people have liked the lipstick that I
just bought or something. Not that we're quite at that
age yet, thank goodness, that's probably only about a week away.
(32:59):
But the thing, because they did challenge me once because
I'm on my phone when I read the news. Yeah,
And I said, well, I'm reading the news and you
can look at my phone and see what I'm doing.
If you find me on Facebook on Instagram, then tell me.
Speaker 4 (33:11):
If you find me when X take my phone off me, take.
Speaker 2 (33:16):
My phone off me and punish me. Yeah. Actually, the
thing about engagement as well, because one of the things
you said earlier on when we were talking about the
Segar House was that not everyone engages. How do you
get It's like that you can lead a horse to
water and you can't, but you can't make it drink.
But how how hard is it to get someone to,
(33:37):
you know, to engage with I mean know, is it
just one of those things that you have no control over.
They don't want it, they don't want it.
Speaker 4 (33:43):
I don't think it's true you have no control over it,
but you're right. I mean I often call it the
horse to water problem.
Speaker 2 (33:48):
And it's one of.
Speaker 4 (33:48):
Those things that you know, you often get inquiries from
family members at our clinic saying, you know, we need
you to see this person. But actually what we know
from experience is if the person themselves not contacting, you
don't tend to get anywhere. But what is true is
that we can be aware that some things tend to work.
So it's a pretty good idea to make sure that
that you know you're finding someone that you get along with.
I mean that's sort of obvious in a way, but
(34:09):
often it is. One of the downsides sometimes of publicly
access treatment is you sort of get allocated someone and
actually it's important to find, just like any other human
relationship with therapist to counselor or a doctor for that matter,
that you actually get along with. The Other thing is
to make sure that they actually can help with the
problem that you're seeking help for. And you know that
(34:30):
there is such a thing as specialists. I mean, most
experienced therapists or psychologists and private practice can deal.
Speaker 2 (34:36):
With most things.
Speaker 4 (34:36):
But it's also true that most will have their specialty.
So making those initial inquiries, even if it is on
behalf of a family member, making sure that they can
work with the difficulties that you're wanting to solve and
they have some knowledge in the area, and then actually
often just going along for an initial session and making
sure it feels right.
Speaker 2 (34:54):
By the way, I've got a new acronym for you. Yeah,
it's your you call it the horse to water thing. Yeah,
it's H two H two. Oh, there you go. There's
a new way for you to write that one down.
And it's two five. Actually, I was going to go
to look, but we do need to squeeze another break.
We'll be back, Luke standby, will be back with you
in just a moment. Twelve minutes to five. This news
talk said, be right, let's go tous some calls Luke, Hello, Okay, Hi.
Speaker 3 (35:19):
I just wondered my thoughts on what was mentioned earlier
about what you can do for yourself to help out
with mood and energy and all that sort of and
I think for myself, i'd put exercise at the top
of that list. There's a lot of research that's come
(35:40):
out in recent years to suggest that it's one of
the best things you can do for yourself. Moments from
you exactly get moving for people who you know, I'm
fifty one now, so when I'm truly in that sort
of middle age bracket, and I talked to so many
(36:03):
guys in particular who who struggle with mood, energy, are
just general sort of well being in that sort of
mentally sort of area, and exercise for force these guys,
is in myself included is just essential.
Speaker 4 (36:23):
Yeah, look, I could agree, and I think one of
the challenges is your age in particular. I mean, I'm
fifty this year, so we're kind of in the same zone.
Is to keep sort of you know, shaping up what
we do and recognizing that as our body changes, we
might need to change what we do. But the main
thing is to keep doing something and to make sure
that what we do is sustainable over time.
Speaker 2 (36:43):
Yeah, that's a good point. Look, I mean, because I
don't know, there's not many people who if you get
them to go for a bit of exercise, a good
brisk walk or anything, get out in the sunshine, get
the how the physiological I mean, that's the whole thing
where we're product of our environment, aren't we, And so
makes sense. Lucky last Phil, Hello.
Speaker 5 (37:03):
Good eye are good?
Speaker 2 (37:04):
Thanks?
Speaker 5 (37:05):
Okay. Firstly, I must apologize to Coyle because I think
I think I abused him once and he told me
to grow up on Facebook wild with the Nutts Club
when I tried to call in and all start to
do as well, because I've set you some pretty bad
abuse of Texas, So I apologize to you as well.
I don't know if these suggestions will help. But I've
(37:28):
been struggling with my mental health and depression for the
last seven years, and I've been lucky enough to be
able to see a professional clinical psychologist, and he's got
me doing things to try and help me. I'm like
going for a walk each day just to get out
of the house because, like get said, I, yeah, I
(37:50):
tend to sit at home all day because I lost
my job and I don't work, and that was to
do with alcohol, which is said was another problem which
is involved in the depression. So that gets you out
of the house because it's hard when you have a
sense of guilt and shame now yourself and your thoughts.
It's hard to actually get out in the community and
even ring your family and your friends because you know
(38:11):
you're dwelling on your own sort of like that feel.
Speaker 2 (38:16):
Is it like the first step is the hardest. Just
get out the door, try say hello to someone, get
some get moving. Is that that what you found the
most hard part?
Speaker 5 (38:25):
Yeah, it is. It's like getting out of bed in
the morning instead of line there and thinking, gee, I
should get out now. And that is the hardest step,
is just moving. But then once you do move and
once I've gone from a walk and I've come back,
I feel good, you know, I feel better for having
done that. You know, sometimes that will lift my mood.
(38:48):
But he also says other things like writing helps as well,
writing your thoughts and feelings down in your mood.
Speaker 4 (38:55):
Yeah, anything that can get the what's going on inside
your head outside your head in words, whether it's talking
or writing, or some people even find drawing an art
is really helpful for that. So I'm really glad that
you're getting some help from the psychologists.
Speaker 2 (39:09):
So that's hey, thanks, thanks for your call. I appreciate it.
And you don't need to apologize again. By the I
do remember you apologize previously, so that's very kind of
your feel But apology except the apologics good or good anyways.
But let's just with about a minute to go, would
just get back to your your your project, your campaign
(39:30):
to try and save Seega House.
Speaker 4 (39:32):
And so if people want to learn more about it,
jump on my website psychotherapy dot in sid click on
the blog tab and they'll see there's been some other
coverage and some documents there that they can never look at,
and some action that they can take. And of course,
you know, you'll leave your radio on News Talks. He'd
be for the rest of the day, I'm sure, but
if you if you're still awake, it eleven. Should I
be back with another's club?
Speaker 2 (39:52):
Excellent, So stick around for that. You can have dinner
in the interim at some stakes, go for a walk.
There you go, Hey, great to see your car, Thanks
so much man, pleasure excellent. We're going to be back
smart money and horses with us talking about the Kiwi
Saber and the retirement age as well and whether raising
the age of super is inevitable, but also just the
(40:13):
budget for Kiwi Saber was cutting the governments and contributions
in half. Should they have just cut it all together?
And is at the right move that we need to
start upping our contribution to be talking about that shortly,
it's three minutes to three minutes to five News TALKSB.
Speaker 1 (40:29):
For more from the weekend collective, listen live to News
Talk ZB weekends from three pm or follow the podcast
on iHeartRadio.
You're listening to the Weekend Collective podcast from News TALKSB.
Speaker 2 (00:16):
You know I need someone anywhere these days. Well, we
thought we'd let that roll a little bit while I
(00:37):
found out why the choice of that song Wasn't it sad?
Of course that we as we do every every hour,
we invite our guests not only to come on our show,
but also they get the first pick of songs, and
maybe even the second pick if they're very very well behaved. Anyway,
by the way, if you've missed up Politics Centrally and
can go check it out of wherever that we get podcast,
go to iHeartRadio or News Talks website. Just look for
(00:58):
the Weekend Collective. We get each hour loaded up pretty
pretty quickly. Thank you, by the way for all the
feedback you got on the israelphin, which was not a
topic where where I was going to explore it anyway,
but I had a bit of time to make a
comment and the feedback has been significant. Thank you. Thank
you to most people, apart from you know, the ab
Hominem attacks, which always get a little bit tired tiresome. Anyway, right,
(01:20):
guess what it's time for a new hour. It is
the Health hub and we're gonna have a chat about
mental health. And there's been a range of governments have
flip flopped on mental health. And you've seen the headlines
about money, you know, so much money being allocated and
I think the reminding me of that story. I think
there was something about the labor government having allocated two
billion dollars and I just don't know do we know
(01:42):
where the money went? And so where should we be
spending our money in mental health? And it's a topic
that my my guest, who's well known to you all,
psychotherapist car McDonald, is kind of hot on right now.
Speaker 3 (01:56):
Coyle.
Speaker 2 (01:56):
How are you sure? Are you? Thank you? Yes? It's
are you keeping well? You're enjoying the slightly cooler temperatures
or are.
Speaker 4 (02:01):
You someone I like the change? I mean I love
some but it's nice that it's cooled down a bit.
Speaker 2 (02:07):
You can't be sporting a beard like that and not
like winter. I mean, that's the sort of beard.
Speaker 4 (02:11):
It's most Scottish ancestory.
Speaker 2 (02:12):
You need to go down to the South Island to
just hang out. You know, you probably get feature on
some sort of poster advertising Queenstown. This is that'd be
fun meet the locals visiting from Auckland. Now you've been
talking a little bit about this because there's been an
issue around the funding of one particular mental health institution
I think for one of a better word, tell us
about that.
Speaker 4 (02:33):
Yeah, So, Seeker House here in Auckland is a District
Health Board funded specialist mental health service. It's very dear
to my heart. I mean I actually trained there as
an intern back in two thousand and then was lucky
enough to work there for just under ten years from
about two thousand and five ish. And it's a service
it's been around actually as long as I have met.
(02:53):
It was born the same year as me, in years
nineteen seventy wow, and established by a very well known
psychiatrist actually for doctor Fraser McDonald who the psycho geriatric
unit here in Auckland is named after the Fraser McDonald's
you know. So it has a rich history and it's
always been I think it's fair to say, a bit
of a center of excellence. It's a specialist service that
(03:16):
over the years has had slightly different versions, but for
the last sort of twenty years has been an intensive
treatment service for people with borderline personality disorder, which for
people who haven't heard of that diagnosis. Essentially, it's people
who are extremely prone to getting very distressed, chronically suicidal
(03:36):
and can tend to self harm themselves as a way
to try to manage their distress. Often quite disabled obviously
by that difficulty, and often you know, the kind of
person who requires a lot of support, So you know,
from a resourcing point of view, they often use a
lot of mental health services, often calling and accessing crisis services.
(03:59):
You know, frequently require hospitalization in the in patient units
and s House is a program who specializes in providing
an intensive treatment, so people come in for sort of
four or five days.
Speaker 2 (04:12):
They come in in house four to seven for fou.
Speaker 4 (04:17):
Well, it used to be residential. We lost that funding
in about two thousand and six. There was a house
that people could live in and come into treatment. Now
it's a day program, so they come in for the
day and when people are in treatment, they're there four
or five days a week, attending multiple different groups and
all of the treatment sort of approaches are what we
call sort of empirically best treatment with other patients or
(04:40):
couple of therapists sort of six seven eight people in
a group, skills teaching around things like managing high levels
of distress a particular treatment approach called DBT or dialectical
behavior therapy. My field is full of acronyms, so it's
easy to get lost. Yeah, very nice.
Speaker 2 (05:01):
Wiw for what Sorry, let's see if we can throw
in a few acronyms during how many we can get
in there. We'll keep a score d.
Speaker 4 (05:09):
Yes, and so you know, trauma treatment in groups and
then also individual therapy, and then there's also a service
where they can access support out of ours as well,
so it's very much a wrap around treatment.
Speaker 2 (05:21):
Can you tell me, I mean, just as we dig
into this, because there's a punchline to this, which is
not a happy punchline. Yeah. What are the results you've
seen of the work that's done at Segerhouse.
Speaker 4 (05:32):
Yeah, so, as you can imagine, one of the things
about being a clinician and a service like this is
not a huge amount of time left over to do
lots and lots of research. But there has been research
done over the years, and I can certainly talk from
my own experience as well. When people engage and you know,
not everybody engages in treatment, but when people do engage
in treatment and make the most of it that they're
(05:52):
often leaving after sort of six, twelve or eighteen months
of treatment and often leaving mental health services all together.
So often people will leave a seger House program actually
be discharged and not require publicly funded mental health input.
They may go on to have private therapy with someone
like me in the community, which they are then able
(06:14):
to fund themselves because often they're moving back into work.
So when we think from a purely financial point of view,
the return on investment is quite huge when you take someone,
I mean, just to give you a number in patients
stay at the psychiatric unit here in Auckland is around
about two thousand dollars a day, and sometimes people would
come in to see your house and they may have
(06:34):
had stays of up to three months in the psychiatric hospital.
So you can you can very quickly see how if
you can get these people back on track and out
of the system altogether. The system is doing really well
in terms of finances. But also there's a bigger question here,
which is actually we're taking people who were barely holding
on to being alive and turning their lives around. So
(06:56):
the financial argument to me of closing the service has
never really stood up. But one of the problems, of course, Tim,
with health funding is if you're just counting bodies coming
through the door, yeah, and you're not actually counting outcomes,
then you're going to reach them pretty strange.
Speaker 2 (07:10):
So what's it? So when it's closing seeger house itself,
is it closing as a what's it? What does that
look like? Is it a is it a piece of
real estate where the building's doors are going to be closed?
But where are those services being subsumed or shifted elsewhere?
What does actually what does that actually look like?
Speaker 3 (07:29):
Yeah?
Speaker 4 (07:29):
Great question? So what is actually closing? So what the
proposal on the table is is the proposal proposal?
Speaker 2 (07:37):
So it hasn't happened.
Speaker 4 (07:38):
Yet, not that the service themselves has put a counterproposal
forward and there's going to be a decision made later
this week. And you know, it's one of those things, Tom,
I mean you would know what I mean here, when
when you sort of see a proposal process turn around
it so quickly with very little announcement, you sort of
wonder where there's been a predetermined outcome that they're just
sort of hammering the right process too. But nonetheless, the
(08:00):
proposal is that the three and a half full time
equivalent staff that are currently there funded for up to
six but they haven't been fully staffed for a variety
of reasons. Will be redeployed as the term and the
argument that the TEFA to Order is making that they
will redeploy the staff who are expert in this area,
and then people will just be able to access a
service at community level.
Speaker 2 (08:22):
So I'm going to, as I say often in the show,
I like to ask dumb questions that I'd normally be
nervous to ask. But is this Seeger House is a
particular location. It's a particular building, is it? This sounds
so trivial, but it's like we all have our favorite
we have favorite places to go as human beings. We
(08:43):
go to cafes. That's my regular this and that. Is
there something when you lose a physical piece of infrastructure,
so a place that is identified that patients recognize, people
in the mental health system recognize as providing a particular service.
I mean, because there be the argument, I imagine, well,
we're going to take these people, We're still going to
have those services. But the buildings closing's more than that.
Speaker 4 (09:06):
So I mean the building is relevant because one of
the factors that's in play here is that the least
for the service occupy that the service occupies the building
occupies it expires next month, and there is some question
as to whether that's actually what's really going on here.
So but nonetheless, what we've got as a service that
operates as a team of people operating together to provide
(09:28):
what's called a sort of a milieu or a therapeutic treatment,
therapeutic community.
Speaker 2 (09:31):
So the program itself is looking like that's going to
be correct.
Speaker 4 (09:35):
So if you scatter the clinicians, you no longer have
the program. They will see clients in the community, but
they will not be offered the same service. It's a
bit like you know, if you know, we looked at
GP's clinics and said, well, GP's clinics are understaff, So
how about we shut down the cardiac unit at the
Aukford Hospital and put those surgeons out into the community
and they'll just be able to see people with heart
(09:56):
problems out in the GP's clinic. And by the way,
GPS see a lot more patient So can we get
these cardiac surgeoncying more people?
Speaker 2 (10:04):
So where are we at with it?
Speaker 3 (10:06):
Then?
Speaker 2 (10:08):
Is it a lost course? From your point of view,
because I know you've been advocating strongly for keeping this
program as you won't be the only one, of course,
But where are we at with them?
Speaker 4 (10:16):
Well, it's not over until the opera singer things. So
I remain optimistic that whether it's too far to order
accepting the counterproposal from my colleagues, or whether it's actually
even the Associate Minister for Mental Health, Matt duc decides
to wade in and actually spend some of that money
that he's been spending on news services. You know, why
(10:39):
don't we spend some of that money on a service
that's been around for fifty years and has actually done
a tremendous job. And here's the thing, Tim, you would
know too. Once we lose these services, we don't get
them back, we will lose something that we will not
be able to access again, and it will cost people's lives.
Speaker 2 (10:55):
And be honesty, is there something fundamentally wrong with the
way where with the way we fund mental health services?
Because as I mentioned, you know, every time it comes
that money we spent I remember that headline. It was
a couple of years ago that about the two billion
dollars allocated for mental health and it didn't result in
a single mental health bed. Is there is there something
(11:15):
fundamentally wrong with the way where we're shuffling the money
around and what would you change about it? By the way,
if you're listening to this and you've got a view
on it, we'd love to hear from you as well,
whether you've I mean, I know if you've been a
patient of Seagar House and you may not want to
talk about it, but you are welcome to talk about
the outcomes you've had and why we should keep services
(11:37):
like this, But also on the way we spend money.
How would you be spending it if you were the
Associate Minister of Health? But carry on, sorry, kayle I
just jump in there and invite the calls.
Speaker 4 (11:46):
Yeah, no, absolutely. You know it's tricky because I think
the fundamental problem that we see across health is always
tricky to solve, which is we just don't have the
workforce in New Zealand.
Speaker 2 (12:00):
You know.
Speaker 4 (12:00):
One of the things that is true is that, yes,
there have been hiring freezers, and you know Seaga House
has not been immune to that. They've had vacancies of
their staffing that they haven't been allowed to fill. But
what's also true is they also have at times not
been able to find appropriate staff to actually come into
the roles. So that's the first problem that we have.
(12:22):
The second problem that we have is when a system's
under pressure, what we tend to do is we tend
to revert in mental health terms to what we call
a revolving door approach, which is people pop up when
they're a crisis, which of course we respond to. We
attend to that crisis, and then we patch them up
and we get them back out the door. An ongoing
treatment that actually gets people back on and even keel
(12:44):
and gets them back functioning at a higher level. It
tends to now be found much more in the private system.
Speaker 2 (12:53):
So where to from here for the Sea House Center,
you basically what you're about is lobbying advocating to try
and get because at the moment, this is a call,
it's been made by Tafar to Ora.
Speaker 4 (13:06):
I guess yeah, look it is. And if people want
to see if there's some actions that they can take,
they can jump on my website which is Psychotherapy dot Nz.
And if they have a look at my blog, there's
some details theory about how to write to the minister
for Mental Health Matt Doocy, but also some other coverage
of the story and a bit of background including the proposal.
But look, I remain hopeful. I think we've got a
(13:28):
week that deadline may even be extended. But I just
hope that the Futto Wader is engaging in good faith
at actually looking at how can we turn this around.
Acknowledging money needs to be saved. We all understand that
there's not enough money in house right now. But you know,
whether that's moving back to a hospital premise where the
costs are cheaper, whether it's seeing more patients. I think
the team really want to come to the party and
(13:49):
actually save the service.
Speaker 2 (13:51):
If it's a case of the leases out and they
can't actually renew the lease, I mean they can still
save the program, though, can't they? Because what we're talking about,
the program itself is under threat.
Speaker 4 (13:59):
You know, one of the things about therapy is all
we need is a chair in a room. We don't
need any expensive machines that go bing. You know, we
don't need bython fan, we don't need stayless steel tools,
we don't need anything costly. It's literally a couple of
warm bodies and a couple of cheers to sit in
and actually, when you think about it, from that point
of view, three and a half fts in a building
is an incredibly small amount of money in the context
(14:20):
of a health budget.
Speaker 2 (14:21):
FTA being full time employers. By the way, boofer, we'll
try and get on top of that asap. Now, sorry,
I couldn't not myself. What's the role of the minister
in this? And I realized that this health but we're
in a little bit of political realm here. What's his
ability to instruct a futt aora what to do on
(14:41):
specific things? Because there is that ministerial this is we
want you to focus on. Broadly speaking, this money is
for this, this money is for that, and you know,
you can't really tell the what can he do within
the cabinet manual in terms of it's like the crude example,
not the crewed example. An example would be the Minister
(15:01):
of Police cannot instruct the police commissioner on what to
do in it enforcing the law in the way police
is what can the minister do when it comes to
tafartu wura to saying I want you to preserve this project.
Speaker 4 (15:12):
Well, the police is a little bit different though wasn't
it because it's a constitutional matter. Yeah, okay, But I
mean I'm a bit cynical. It might surprise you to
hear t sim that I think that the ministers can
can trot out the old it's an operational matter when
they don't want to get involved. Equally, they can wade
in and save the day when they decide that they
want to. So I think it's all about what the
political decision is. One of the things that I think
(15:34):
is fantastic that the Minister has done in his time
is he has had a pot of money which he
has allocated to some tremendous new services. Just to give
you one example, peer support workers in the emergency department
in christ Church as a pilot, so people who've had
their own experiences of mental health. They're in the ed
to help support people who are in crisis. Great initiative.
(15:56):
But one of the things, of course is that also
governments like new things. They like to be able to
cut ribbons and roll out new programs. And if there's
a pot of money, then you know, why not throw
a bit of money to something that we know works
and actually is struggling to stay afloat right now? Money
is money, right, and yes it's tight, but it's not
a lot of money to.
Speaker 2 (16:14):
Keep a service like this going.
Speaker 4 (16:15):
How much money are we talking, Well, I don't have
the exact numbers, but we're talking you know, three and
a half to if it was fully staffed just under
seven FTEs you know, I mean a psychotherapist serve as
anywhere half a million for staffing, maybe a bit more
plus a building. It's you know, maybe two million dollars maximum.
(16:36):
It's not a lot of money in the health budget, right.
Speaker 2 (16:39):
We'd love to set your calls on this, and we're
also going to explore with cob just to tie it
into your own health health questions as well. As you've
heard the services that Seeker House provides it for people
who really, you know, the consequences for not getting the
right sort of help can be tragic, catastrophic, and we
(17:01):
know as we as you know Kyle is the psycho
three prist as well. But I'm quite keen to dig
on into the question. Of course, the last thing any
of us wants to have to do is to rely
on our mental health services, and so is there are
there ways that also you can look after your mental
health in such a way as to as to give
yourself the best chance of not needing the sort of
(17:22):
help of places that well, it's difficult. I've summed that
up very crudely because Sega House, a lot of these
problems can't be helped, I'm sure, but we do have
a chat about that as well. You give us a
call weight one hundred eighty twenty four past four new stalks.
He'd be.
Speaker 3 (17:38):
Going to help.
Speaker 2 (18:11):
And welcome back to the Weekend Collective. This is the
health happen. My guest is Carlin McDonald. He's a psychotherapist
as you know. Oh look it I should just say
we've got Carl McDonald in the studio. But we always
have new listeners Kyle, so it's always good to and
a host of the Nutters Club.
Speaker 4 (18:25):
Yeah, thank you. I must be it must have been
well behaved because I've got the second song choice as well.
Speaker 2 (18:28):
You did you have been? Now if you've been a
very very good boy, you might get how patronizing can
we be? Now? Hey, by the way, if people were
just on the Seeger House question around the funding, and
that's what we've been talking about just because it's a subject,
it's not a subject that's something else is a word
(18:50):
for it. It's a something that is close to Kyle's
heart as somebody who's worked there, and it is in
danger of being closed down. Now again, if people do
want to find out about this and support it, or
right to.
Speaker 4 (19:00):
The mast psychotherapy dot nz it is my website. Just
click on the tab at the top of this, says,
and you'll see a whole bunch of posts, including some
action you can take and easily right to the minister
to let them know.
Speaker 2 (19:09):
What psychotherapy dot ends. And you must have got on
early with that one.
Speaker 4 (19:13):
I did.
Speaker 2 (19:16):
Hey, look moving on onto people's personal callers as well,
but just on the on the whole mental health question.
Are there things we can do? It's we have Alex Flint,
for instance, who had who's a personal trainer, and and
we chat about, you know, ways to avoid you know,
your body aging and to look after yourself so you
(19:38):
don't have that heart attack. Are there ways that we
can look after ourselves with our mental health where we
can make certain choices or whatever to stop that mental
malaise or that problem, or that it might be it
might be just a little bit of creeping negativity which
leads to a bit more depression and are there ways
to stop to avoid And this is without judgment that
(20:02):
people who end up with problems have owned themselves to blame,
which I'm not saying at all, because there's a multitude
of physiological reasons and everything that people are the way
they are. But are therefore people who do encounter problems
with their moods and depression are things we can do
to look after our mental health to stop us heading
in that direction where you might need some more serious help.
Speaker 4 (20:25):
Yeah, it's a great question, and we do know a
little bit about what the sort of those pre existing
factors are. There does seem to be a strong role
for genetics, but genetics are not They're not a lie sentence.
So you know, if you have a family history of depression,
it doesn't mean you're going to experience depression, but it
doesn't crease your chances. We also know that trauma during
(20:45):
childhood is a strong predictor of mental health outcomes in adulthood,
and we also know an adulthood that trauma obviously is
a strong predictor of mental health outcomes. But when it
comes to the things across the board that we know works,
I'll give you the boring things. First are things that
everybody kind of knows, right, which is make sure you're
getting sort of six to eight hours sleep every night,
(21:05):
trying to stick to a routine when it comes to sleep,
and try to make sure that you get good quality sleep,
which means, god, I'm screwed. Not drinking, you know, making
sure you know you're not lying there all night, you know,
sort of in a light stay to sleep, exercise of course,
moving your body and whatever way works for you. And
diet's really important to and avoiding alcohol and drugs, which
(21:27):
doesn't mean mean you have to teetotal. If you haven't
had a problem with those things, you know, drinking every
now and then, it's fine, but it becoming a way
of coping with life stresses.
Speaker 2 (21:36):
Is when you run into trustee, I'm curious. I mean,
I don't want to get get into marijuana or anything,
but you know, there's people say often when people are
using marijuana, there's a form of self medication that's going on.
But are there's some drugs that you should definitely avoid
because you might think they're helping you, but they're just
going to make the problem worse. Well, excess alcohol being obvious, Yeah.
Speaker 4 (21:56):
Alcohol is by far and away the biggest in terms
of what's in New Zella.
Speaker 5 (22:01):
Now.
Speaker 4 (22:02):
Nicotine use is decreasing significantly, but we often forget about nicotine.
Speaker 2 (22:06):
But alcohol, in.
Speaker 4 (22:06):
Terms of drugs is by far and away the biggest
use and biggest problem. Look, it's about always about balance,
isn't it too? I mean, you know, some things have
a much higher addicted potential, like methamphetamine, for instance, is
generally not something you can dabble with and use lightly
or socially. But yeah, alcohol is by far and away
the biggest problem for most people. And then there comes
(22:28):
the slightly more subtle things that we know, which is
I often like to think in terms of connection and community.
So isolation, you know, and not necessarily that doesn't mean
not being around people, but it does mean not having
a connection with the people that you're around. So it
is possible these days to live your quite a lot
of your life disconnected, whether that be being able to
(22:48):
shop from home or work from home. We know that
actually that social connection with others is really protective. And
the other thing that we know that tends to predict
poor mental health outcomes or is a red flag for
people who are heading in this direction is what we
generally think of as avoidance. So you know, when we
have a tendency to retreat from the world and avoid
(23:08):
our problems, or we want to avoid painful emotions and
painful situations that might be going on in our life.
So for instance, you know, difficult conversations with the flatmate,
you know, conflict with our partner. If our first response
is to kind of keep retreating from that and not
talk about the issues, we know obviously that can cause
practical problems, but it can actually also cause emotional problems
because we start to ignore our feelings, avoid our emotional responses,
(23:32):
and become cut off from what's actually going on for
us feelings wise.
Speaker 2 (23:35):
Is that why sometimes you get people who are quite
out there and they vent very quickly, and they get
in arguments very quickly. But most of those people I've found,
they're actually quite happy. They can we invent to their
feelings all the time, and even if they're leaving a
bit of carnage in their.
Speaker 4 (23:49):
Way, everybody around them might not be always happy. But
I know what you mean, right, like, so sort of
better out than in. I mean, I think you know,
obviously everything has its downside, but generally I think people
who are able to more readily express their feelings. That's
a good example of the op of that kind of
emotional avoidance.
Speaker 2 (24:07):
Actually, how do you express I mean, this is where
people express themselves in a way that comes out violently,
which is I mean, how do you if you are
feeling those senses of rejection and anger and resentment and
all that sort of stuff, and there's it? I mean,
is there a way of physically exercising those demons?
Speaker 3 (24:24):
Off?
Speaker 2 (24:24):
I could use it, you know, sort of slightly heavy
metal analogy, But is there a way of dealing with
those violent impulses?
Speaker 4 (24:35):
Yeah, well it's a good question. I mean, you know,
in general and therapy, what we think about is being
curious and being able to observe without action. So you know,
it's kind of obvious in a way, but what gets
us into trouble is what we do, not what we
think and feel. So if we're able to observe what
we're thinking, observe what we're feeling, and make some sense
of it, even though the feelings often might be quite
(24:55):
big and may feel out of proportion, generally we can
understand what's actually led us to feel that way, and
then to address the real problem, which is, you know
what's triggered the feeling in the first place, Because there's
a question.
Speaker 2 (25:06):
I've got as a lay person. Again, I've just worked
out for myself as a guess the thing that I
worry about. It's one of the pet topics in politics
at the moment, is smoking vaping. But vaping the thing
that I'm worried about. You know this the popcorn lang
and all this sort of thing. But what I've said
to my daughters about it as well, I mean they're
not interested, hopefully that's what they say. And I don't
(25:29):
think there's any way they're going to be famous last words.
But the chief villain for me in vaping is introducing
young people to a substance which is addictive. And as
soon as is there something in avoiding substances which are addictive,
because it starts to train your body to like finding
(25:49):
something that gives you a high or that is addictive.
In other words, if you you know, if you if
you go through your three your life just eating you know,
meat and three vegi and fruit and all that sort
of thing. And there are some people as soon as
they hit an addictive substance, boomfer. That's the that's the moment,
and I'm very suspicious of anything that's main causes to
deliver an addiction.
Speaker 4 (26:10):
Yeah, it's a really good question. The answer is a
little bit complicated, but if we just zoom out a
little bit for a moment, the core problem with addiction
is often people who end up addicted to things are
trying to solve a sense of discomfort.
Speaker 2 (26:25):
So there's something else they're dealing with, yep.
Speaker 4 (26:27):
And wanting to avoid that discomfort. So it's why trauma
tends to set people up for addiction more readily than others,
because they're trying to solve the pain that they're in.
And then once you're locked into the cycle of addiction,
not being able to tolerate the pain of not doing
the thing that you're addicted to becomes the problem.
Speaker 2 (26:45):
Okay, before we go to the break, what is trauma?
Speaker 4 (26:50):
Any experience that overwhelms our capacity to cope and in
doing so, causes a sense of memory dysfunction where we
can't escape the memory of what's occurred, whether that be
through flashbacks, nightmares, or re experiencing it, and it keeps
us on some level locked in that state of distress
in ways that feel out of control, because I.
Speaker 2 (27:11):
Wonder where there are people who downplay what might be
the cause of their problems because they look at others
and think, well, no, no, I haven't been through trauma.
I can imagine that child there who was abused, you know,
or beaten as a young person, that's trauma. What I've
gone through is not trauma. So you know, I mean
imagine for some people the break up of a long
(27:31):
term relationship where your hopes and dreams have gone out
the door. That could be a trauma, but they might think, oh, look,
it's just a relationship, even though they are some part
of them as hemorrhaging.
Speaker 4 (27:42):
Well, check another acronym at you. There's a difference between
PTSD trauma with a big T and trauma with a
small tea, which, now in everyday language we kind of
used to describe distressing events rather than traumatic events.
Speaker 2 (27:55):
So where are we at with trauma then?
Speaker 4 (27:57):
Well, I think we have to acknowledge that sometimes things
in our past get in the way and the present,
and that's kind of the every day kind of description
that I tend to use. If you feel that events
in your past, painful ones are still impacting you now
in the present, then it's probably something that you need
to address.
Speaker 2 (28:14):
Okay, we'll take your cause. By the way, I waite
hundred eighty ten eighty. Anything you'd like to talk to
Carl McDonald about, and we'll be back in just a moment.
News Talk said B. Welcome, News Talk, said B. This
(28:39):
song is not Carl MacDonald's choice, so he hasn't been
a very good boy.
Speaker 4 (28:43):
No, I I don't even know who it is, neither
do I.
Speaker 2 (28:46):
I forgot to ask you what you were a song
request was and I don't think my producer could find
mine because it's a slightly weird Alice Cooper song. Anyway,
we're asking how you stop your mental malays getting to
a point where you need help, how do we stop
people getting to crisis point when things aren't going great
for them, and any other questions you've got for Carl MacDonald.
Speaker 5 (29:05):
Gloria, Hello, Yes, good afternoon.
Speaker 6 (29:10):
Now this I'm not talking about serious clinical depression. I've
just I've been listening to the conversation and very good.
You know, how we can help ourselves eating well, you know,
decent sleep at night and all those things, and you
know some company also I find often people who are
(29:31):
in depression, often they don't get out into the community.
They're not doing anything. And you know, we get a
lot of joy from mixing with people and helping others,
and yeah, and it's sad when people get to such
a stage that they can't do that anymore, they're not
interested or yeah, but that is a you know, we
(29:54):
need to make where we were designed to mix with
other people. And you know, you're quite right once we
start this staying at home and not going to work
or you know, that's not good. The other thing I
was going to mentioned, and I'll set the cat amongst
the pigeons here.
Speaker 1 (30:09):
Oh.
Speaker 6 (30:09):
Yes, we also have a spiritual side to us, and
sadly we fill that spiritual side up with all sorts
of other stuff that ultimately doesn't help us. You know, drugs, alcohol, I.
Speaker 2 (30:21):
Mean religious or spiritual?
Speaker 6 (30:24):
I mean spiritual spiritual. We were designed, we were designed
originally to be in a relationship with God and he's
our helper and that's yeah, but we've, especially in the
Western world, we've walked right away from that. Now, you know,
we think we can do it all ourselves. But ultimately, I'm.
Speaker 4 (30:46):
Not a religious person, but I do actually agree with
you in the sense that, you know, what you're talking
about is that sense of community and connection, but you're
also talking about that sense of contributing to others. And
you know, what we know works for depression is anything
that gets us active again, whether that's active physically, active socially,
or active mentally. I think one of the things that
(31:06):
we have lost is those communities that we used to
regularly go to, you know, whether it was church, whether
it was a sports club, whether it was the Lions,
whether it was the night classes. I think, you know,
in modern life, it becomes far too easy to sort
of just be at home, you know, with a with
a with a sugarhead of connection, you know, whether that
(31:26):
be social media or whether that be you know, those
touch points, but not actually being in the same room
with another set of warm bodies.
Speaker 6 (31:35):
Yep, No, and you know there they've already worked it
out already. Now that kids spend child spending a childhood
on a device, when they grow up, they've they've got
no idea of social skills.
Speaker 2 (31:50):
So yeah, yeah, although it's interesting, Gloria that I think
that this generation or my kids devices and they're not
allowed on social media, that to me is an I know,
but but I do think that there's a generation of
kids who probably handle socialia better than their parents do
because they've grown up. You know that it depending, you know,
And I think that the banding of phones and schools
(32:11):
has been great because they it's all about practice and
developing those habits of human connection. But yeah, hey, thanks
for your call. I appreciate glory.
Speaker 4 (32:18):
I completely agree with you, Tim. You know, whenever anyone
complains something about their kids, if I use the first
thing I do to set my kead and marks the
bicheons as I say, what about yours?
Speaker 2 (32:29):
Look, I'm aware of stuff.
Speaker 4 (32:31):
How do the kids learn these things? They see other people?
Speaker 2 (32:33):
I sort of practice what I'm preaching. So, for instance,
I say, you can be on your device if you're
doing if you're doing some duo lingo or something, because
they they're doing the language Jap and learning some things,
and that's that's simply a tool for learning, as opposed
to how many people have liked the lipstick that I
just bought or something. Not that we're quite at that
age yet, thank goodness, that's probably only about a week away.
(32:59):
But the thing, because they did challenge me once because
I'm on my phone when I read the news. Yeah,
And I said, well, I'm reading the news and you
can look at my phone and see what I'm doing.
If you find me on Facebook on Instagram, then tell me.
Speaker 4 (33:11):
If you find me when X take my phone off me, take.
Speaker 2 (33:16):
My phone off me and punish me. Yeah. Actually, the
thing about engagement as well, because one of the things
you said earlier on when we were talking about the
Segar House was that not everyone engages. How do you
get It's like that you can lead a horse to
water and you can't, but you can't make it drink.
But how how hard is it to get someone to,
(33:37):
you know, to engage with I mean know, is it
just one of those things that you have no control over.
They don't want it, they don't want it.
Speaker 4 (33:43):
I don't think it's true you have no control over it,
but you're right. I mean I often call it the
horse to water problem.
Speaker 2 (33:48):
And it's one of.
Speaker 4 (33:48):
Those things that you know, you often get inquiries from
family members at our clinic saying, you know, we need
you to see this person. But actually what we know
from experience is if the person themselves not contacting, you
don't tend to get anywhere. But what is true is
that we can be aware that some things tend to work.
So it's a pretty good idea to make sure that
that you know you're finding someone that you get along with.
I mean that's sort of obvious in a way, but
(34:09):
often it is. One of the downsides sometimes of publicly
access treatment is you sort of get allocated someone and
actually it's important to find, just like any other human
relationship with therapist to counselor or a doctor for that matter,
that you actually get along with. The Other thing is
to make sure that they actually can help with the
problem that you're seeking help for. And you know that
(34:30):
there is such a thing as specialists. I mean, most
experienced therapists or psychologists and private practice can deal.
Speaker 2 (34:36):
With most things.
Speaker 4 (34:36):
But it's also true that most will have their specialty.
So making those initial inquiries, even if it is on
behalf of a family member, making sure that they can
work with the difficulties that you're wanting to solve and
they have some knowledge in the area, and then actually
often just going along for an initial session and making
sure it feels right.
Speaker 2 (34:54):
By the way, I've got a new acronym for you. Yeah,
it's your you call it the horse to water thing. Yeah,
it's H two H two. Oh, there you go. There's
a new way for you to write that one down.
And it's two five. Actually, I was going to go
to look, but we do need to squeeze another break.
We'll be back, Luke standby, will be back with you
in just a moment. Twelve minutes to five. This news
talk said, be right, let's go tous some calls Luke, Hello, Okay, Hi.
Speaker 3 (35:19):
I just wondered my thoughts on what was mentioned earlier
about what you can do for yourself to help out
with mood and energy and all that sort of and
I think for myself, i'd put exercise at the top
of that list. There's a lot of research that's come
(35:40):
out in recent years to suggest that it's one of
the best things you can do for yourself. Moments from
you exactly get moving for people who you know, I'm
fifty one now, so when I'm truly in that sort
of middle age bracket, and I talked to so many
(36:03):
guys in particular who who struggle with mood, energy, are
just general sort of well being in that sort of
mentally sort of area, and exercise for force these guys,
is in myself included is just essential.
Speaker 4 (36:23):
Yeah, look, I could agree, and I think one of
the challenges is your age in particular. I mean, I'm
fifty this year, so we're kind of in the same zone.
Is to keep sort of you know, shaping up what
we do and recognizing that as our body changes, we
might need to change what we do. But the main
thing is to keep doing something and to make sure
that what we do is sustainable over time.
Speaker 2 (36:43):
Yeah, that's a good point. Look, I mean, because I
don't know, there's not many people who if you get
them to go for a bit of exercise, a good
brisk walk or anything, get out in the sunshine, get
the how the physiological I mean, that's the whole thing
where we're product of our environment, aren't we, And so
makes sense. Lucky last Phil, Hello.
Speaker 5 (37:03):
Good eye are good?
Speaker 2 (37:04):
Thanks?
Speaker 5 (37:05):
Okay. Firstly, I must apologize to Coyle because I think
I think I abused him once and he told me
to grow up on Facebook wild with the Nutts Club
when I tried to call in and all start to
do as well, because I've set you some pretty bad
abuse of Texas, So I apologize to you as well.
I don't know if these suggestions will help. But I've
(37:28):
been struggling with my mental health and depression for the
last seven years, and I've been lucky enough to be
able to see a professional clinical psychologist, and he's got
me doing things to try and help me. I'm like
going for a walk each day just to get out
of the house because, like get said, I, yeah, I
(37:50):
tend to sit at home all day because I lost
my job and I don't work, and that was to
do with alcohol, which is said was another problem which
is involved in the depression. So that gets you out
of the house because it's hard when you have a
sense of guilt and shame now yourself and your thoughts.
It's hard to actually get out in the community and
even ring your family and your friends because you know
(38:11):
you're dwelling on your own sort of like that feel.
Speaker 2 (38:16):
Is it like the first step is the hardest. Just
get out the door, try say hello to someone, get
some get moving. Is that that what you found the
most hard part?
Speaker 5 (38:25):
Yeah, it is. It's like getting out of bed in
the morning instead of line there and thinking, gee, I
should get out now. And that is the hardest step,
is just moving. But then once you do move and
once I've gone from a walk and I've come back,
I feel good, you know, I feel better for having
done that. You know, sometimes that will lift my mood.
(38:48):
But he also says other things like writing helps as well,
writing your thoughts and feelings down in your mood.
Speaker 4 (38:55):
Yeah, anything that can get the what's going on inside
your head outside your head in words, whether it's talking
or writing, or some people even find drawing an art
is really helpful for that. So I'm really glad that
you're getting some help from the psychologists.
Speaker 2 (39:09):
So that's hey, thanks, thanks for your call. I appreciate it.
And you don't need to apologize again. By the I
do remember you apologize previously, so that's very kind of
your feel But apology except the apologics good or good anyways.
But let's just with about a minute to go, would
just get back to your your your project, your campaign
(39:30):
to try and save Seega House.
Speaker 4 (39:32):
And so if people want to learn more about it,
jump on my website psychotherapy dot in sid click on
the blog tab and they'll see there's been some other
coverage and some documents there that they can never look at,
and some action that they can take. And of course,
you know, you'll leave your radio on News Talks. He'd
be for the rest of the day, I'm sure, but
if you if you're still awake, it eleven. Should I
be back with another's club?
Speaker 2 (39:52):
Excellent, So stick around for that. You can have dinner
in the interim at some stakes, go for a walk.
There you go, Hey, great to see your car, Thanks
so much man, pleasure excellent. We're going to be back
smart money and horses with us talking about the Kiwi
Saber and the retirement age as well and whether raising
the age of super is inevitable, but also just the
(40:13):
budget for Kiwi Saber was cutting the governments and contributions
in half. Should they have just cut it all together?
And is at the right move that we need to
start upping our contribution to be talking about that shortly,
it's three minutes to three minutes to five News TALKSB.
Speaker 1 (40:29):
For more from the weekend collective, listen live to News
Talk ZB weekends from three pm or follow the podcast
on iHeartRadio.
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