Andrew Little: Christchurch stabbing: Health Minister was briefed about staffing issues at mental health service

Concerns about understaffing at a mental health service that treated a 37-year-old man accused of killing a mother-of-four in Christchurch were escalated to the Minister of Health Andrew Little, the Herald has learned.
In a briefing on January 20, officials at the Ministry of Health told the minister that the workforce at the Canterbury regional forensic mental health service was so stretched that its secure psychiatric facility at Hillmorton Hospital was operating only 12 of its 15 beds and "running a waitlist for acutely unwell patients".
The Herald understands that the man accused of killing Laisa Waka Tunidau, 52, in what police have described as a "random attack" in the suburb of Sockburn on Saturday was treated in the Hillmorton forensic facility.
The chief executive of Canterbury DHB, Dr Peter Bramley, confirmed in a statement on Wednesday that the man "was a patient of the DHB's specialist mental health service based at Hillmorton, who had been on community leave", but did not provide further details about his care.
The DHB is carrying out a full review, Bramley said.
The January briefing to Little followed a series of media reports about unsafe conditions and staff departures at the Hillmorton forensic facility. According to the document, officials from the ministry visited the hospital on January 19, where they discussed the problems with the DHB's leadership and were assured it was working with staff and unions to "put a strong contingency plan in place".
The Ministry later wrote to the DHB's chief executive asking for a turnaround plan with "short, medium, and long-term actions which will be closely monitored".
"The underlying issue appears to be staff have left and are not being replaced," officials told Little. This was a problem across the entire Canterbury mental health service, they noted, with 100 full-time positions vacant in a mental health workforce of around 1,100 at the time.
The problems at Hillmorton are indicative of wider pressures on forensic mental health services nationally, the officials said.
New Zealand's five regional forensic inpatient services were "under considerable occupancy pressures", running at an average occupancy of 104 per cent, officials told the minister in a related memo.
Since that briefing in January, the pressures on forensic services have continued.
The strain on forensic services starkly illustrates how publicly funded mental health providers across the country are struggling to cope with increasing numbers of people seeking their help at a time when there is a drastic shortage of skilled and experienced health professionals.
It also raises serious questions about the safety of some of the most unwell people in the mental health system, the staff who care for them, and the public.
The Herald obtained the briefings as part of a six-month investigation into the state of mental health services, which has included interviews with dozens of service users, carers, clinicians, researchers, and officials; a review of data from more than 25 public bodies; and an examination of thousands of pages of government and health authority documents, many of which have not been made public before.
In a series of articles in recent weeks, the Herald has exposed how the specialist services were weakened by years of underfunding, understaffing, and poor planning and are now failing to respond to an increase in demand that has been amplified by the coronavirus pandemic.
The five regional forensic services, operated by the Canterbury, Capital & Coast, Southern, Waikato, and Waitematā DHBs, exist at the hard end of this system, responsible for some of the most acutely unwell, risky, disadvantaged, and hard-to-treat patients.

The Mason Clinic, run by Waitemata DHB, is the regional forensic psychiatric facility in Auckland. Photo / Dean Purcell
The nature of their work requires intensive staffing and a high...

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