Some criminals are bailed to Tauranga from Waikeria Prison near Te Awamutu. Photo / File
A Tauranga homeless advocate says criminals suffering mental health issues are getting stuck in a "cyclic" system where they are reoffending before getting the medication they need.
However, Bay of Plenty District Health Board mental health and addiction portfolio manager Caleb Putt says the board provides "continuity of care" for those who have left prison.
And Department of Corrections' Juanita Ryan says prisoners were supplied with medication when released but this depended highly on risk.
Tauranga homeless advocate Heidi Tidmarsh described the current system as "cyclic" and said she believed the system was failing some of the city's most vulnerable.
She said men suffering from mental health issues were getting bailed to Tauranga from Waikeria Prison and were not being given appropriate opportunities to get medication.
They were then reoffending in a short space of time, in her opinion, as a result of not getting this treatment from the district health boards.
"It's a systematic failure."
She said she met a man a few weeks ago who was on the streets after being bailed to Tauranga. He suffered from severe schizophrenia and had done several stints in prison.
She took him to Tauranga Hospital to get help with his illness. He was taken into a small room where began to have a panic attack from being in an enclosed space, she said.
The nurse was unable to help him as a result of this and he was "turfed back out on the street", Tidmarsh said.
She said she was told he would be able to come back in and get treatment but a security guard would need to be present.
Within weeks, the man had committed another petty crime while not medicated and was back in the justice system, she said.
"Where is the duty of care here? These are vulnerable people and the system is letting them down."
The health board was unable to comment regarding specific situations, however, Putt said that a lot of work had been done to offer a variety of settings in which people could engage with services.
These included home visits, clinics in community health settings or appointments at another service's office, he said.
"When an individual is being released following a custodial period and returning to a local health board, local mental health and addiction services will only be made aware of this if referrals are received from these forensic services as part of a transfer of care process."
Bay of Plenty people could receive support from a forensic mental health and addiction service that was based in Waikato while in prison or on remand, he said.
Care for the individual during their time in custody was the responsibility of this service, with both Lakes and Bay of Plenty district health boards providing funding for it, he said.
Once released, any individual could engage with mental health and addiction services available but some services would have criteria that needed to be met, he said.
The person was able to refuse to engage with services but medication could be prescribed through secondary specialist services, he said.
But Tidmarsh said this was easier said than done for many.
Putt said they worked with several community providers to support clients with more "complex" needs.
Te Tuinga Whanau Support Service director Tommy Kapai said Tauranga did not have robust "reconnective services" for people who came out of prison.
He said about 90 per cent of people in prison faced mental health and addiction issues and once they were released, they were "flying solo".
"These people need their medication from day one but many are not from here and do not have the support to be able to get it. So they act out and then the cycle repeats itself.
"We need a circuit breaker in there."
He said his service went into prisons such as Waikeria to try to build relationships before the offenders got out so they knew who to reach out to when released.
Many of the crimes these people stuck in the cycle were committing were "petty", he said, and a lot of money would be saved if they funded "social services on the ground" for these people.
Department of Corrections deputy chief executive of health Juanita Ryan said they worked with district health boards to ensure that people who were under the care of forensic mental health services in prison were referred for ongoing care from community providers when they were released.
"Our Medication Management Policy requires the prison Health Centre Manager, or a delegated registered nurse, to ensure that any patient being released from prison has an adequate supply of any prescription or over the counter medication they need."
She said they did undertake a risk assessment and may limit the amount of medicine supplied to the patient on release.
A discharge summary was also prepared to support continuity of the person's care when they are in the community.
"Every effort is made to provide people under the management of Corrections with support/referral to appropriate services to enable their successful transition back to the community.
"However, there may be times when someone is released from custody unexpectedly, for example following a court appearance, where this is not possible.
"We know that people who enter the corrections system have often had limited contact with healthcare services in the community. It is not uncommon for them to have undiagnosed or poorly treated health conditions."
People in prison were three times more likely than the general population to have been diagnosed with a mental health disorder in the past 12 months and 91 per cent will experience either a substance use disorder or a mental health disorder over their lifetime, she said.
A total of $128.3 million over four years has been invested through Budget 2019 for mental health and alcohol and drug services for prisoners and people on community-based sentences.
Ngāi Te Rangi's chief executive, Paora Stanley, said the justice system kept "close eyes on people after they were released" and handled their needs "the best way they can".
He said people who were released faced a "straight forward process" when it came to getting their medication and community GPs were "proactive" in this field.
Mental health illnesses in the region were "profound" and "complex" and the "bar to being admitted for help was high" and "near impossible" in some instances, he said.
Emergency road repairs are being carried out tomorrow, November 28.