A visiting judge was critical of the lack of allocated beds available for offenders at Tūmanako mental health inpatient unit.
A visiting judge was critical of the lack of allocated beds available for offenders at Tūmanako mental health inpatient unit.
After a visiting judge criticised the lack of mental health resources in the North, a leading psychiatric expert has questioned the legality of sending people to prison who are mentally unwell and require treatment.
Judge Noel Cocurullo usually sits in the Waikato District but recently sat in the Whangārei District Court and was shocked when two defendants who came before him were unable to receive the mental health support they required.
The two men were on compulsory mental health treatment orders for psychiatric issues at the time of their offending.
On a compulsory treatment order, a person can be recalled to the hospital to stabilise mood, but, as there was no bed available, the offender was sent to Northland Regional Corrections Facility where he was treated on remand.
The Tūmanako mental health inpatient unit at Whangārei has 29 beds and is not a secure facility for prisoners. The Mason Clinic in Auckland is the closest to Northland but currently has more than 15 prisoners on the waitlist.
The man was a first-time offender who had committed a low-level breach of a protection order, had reportedly halved his medication and was exhibiting signs of schizophrenia. Although he was unwell, he did not meet the threshold as “acutely unwell” to qualify for a bed.
Judge Noel Cocurullo was critical people in Northland are being sent to prison when they should be in a mental health ward. Photo / NZ Herald
“I was surprised that I learnt today in this region that your correction facility does not have beds reserved at the hospital for the acutely unwell. In the Waikato, we have the advantage that the two local large prisons have the facility with the good people who run the mental health unit at the hospital,” Judge Cocurullo said.
“The first instinctive response is why you were not ordered on recall of an inpatient status at the hospital. I now know the answer to that.
“Despite the best interests of clinicians, there is no bed available. This is not a criticism of those who work in the environment. It is a criticism of the lack of resources on two occasions I have seen.”
The offender had since been in prison for some time and his lawyer sought a prison sentence as he would have been time served, however, Judge Cocurullo declined the request and said a term of imprisonment was masking the real issue.
“I’m not prepared to mark a jail sentence on his record for this level of offending, he is a first-time offender, and now he’s done jail time and it is masking the problem that no bed is available for him.
“I’m told you are getting better but in my view, under a compulsory treatment order, it should have always been the case you enter a mental health ward and not a prison. I have no doubt the forensic people at prison manage you as best they can,” Judge Cocurullo noted.
Consultant in forensic psychiatry, Dr Erik Monasterio, who has 27 years of clinical experience, said the Government has been warned for the past 10 years of projected mental health rates and Canterbury had shut down 25 per cent of their acute inpatient beds due to a lack of staff - an issue right around the country.
“It is the same if someone turned up to a hospital with an acute appendix. Should we say, ‘Sorry you’re not going to get an operation.’ That is the comparative example of the urgency,” Monasterio told NZME.
“There’s so much pressure on our health services that there’s little empathy to address this issue when there is a shortage elsewhere. This hasn’t happened by accident. There’s a lot of negligence behind this issue,” Monasterio said.
Monasterio said due to a lack of beds, it has now been normalised to send people who are under the Mental Health Act to prison but a key relationship was between the courts and health services.
“I do wonder what the legality is to send someone to prison when they qualify under the Mental Health Act and meet the criteria for treatment. Clearly, the Mental Health Act binds the Crown and if a person requires treatment under a compulsory order, is it legally justifiable to send them to prison? That is the test that has not been had before the courts.”
“Health services need to reassure the courts they will provide adequate care or they put the public and themselves at risk ... It takes a commitment to addressing what is an urgent health need,” Monasterio said.
Dr Erik Monasterio said the country is in a crisis and it has become normal to send mental health patients to prison instead of hospital.
Ian McKenzie, General Manager of Mental Health and Addiction Services, Te Whatu Ora Te Tai Tokerau told NZME that prior notice is required if a patient comes through the courts who is acutely unwell.
“If they advise us that the likely outcome of a court hearing will be that a person will require admission to an acute inpatient service, we coordinate this with the forensic team.
“Due to the demand for our acute inpatient beds, we do not routinely hold beds open for people coming through the court system as this may have an adverse impact on other people needing admission.
“However, if a judge directed the admission be that day, we would need to find a bed. We can work with other mental health services to facilitate this if required,” McKenzie said.
Judge Cocurullo commended those who work in mental health and sentenced the man to supervision ensuring his mental health was monitored.
“I am really concerned when you are released from prison there is nowhere for you to go. In an ideal world, I would have wanted to see you on an open ward in a hospital.
“This is where the lack of resources really bites in my view, the best outcome is to sentence you with conditions, there’s little else I can achieve.”
Judge Cocurullo ordered his court minute be sent to the director of Te Whatu Ora Te Tai Tokerau.
Shannon Pitman is a Whangārei based reporter for Open Justice covering courts in the Te Tai Tokerau region. She is of Ngāpuhi/ Ngāti Pūkenga descent and has worked in digital media for the past five years. She joined NZME in 2023.
