Board plans $36m boost for mental health services

By MARTIN JOHNSTON

Plans to spend $36.5 million on improving and expanding mental health facilities are aimed at reducing repeats of tragedies like the Lachlan Jones murder-suicide case.

Waitemata District Health Board members yesterday voted their preliminary approval for demolition, rebuilding and expansion work in West and North Auckland.

Under the plan - which needs fine-tuning, board final approval and Government consent - the board would:

* Build integrated community mental health facilities near the acute in-patient units at North Shore and Waitakere Hospitals.

* Refurbish and extend the Waitakere Hospital acute unit, Te Atarau.

* Build, at the Mason Clinic in Pt Chevalier, a 10-bed forensic kaupapa Maori medium-security in-patient unit and a 12-bed unit for people with intellectual disabilities.

The scheme, which would be entirely Government-financed, is expected to go to ministers by April.

In August 1999 Malcolm Beggs, aged 25, was killed in his Henderson home with an axe and knife by 19-year-old Jones, his paranoid schizophrenic flatmate. Jones was found dead in the garage from self-inflicted carbon monoxide poisoning.

Coroner Mate Frankovich ruled last year that Mr Beggs should have been told that Jones, who answered an ad for a flatmate, was dangerous.

Mr Beggs did not know that Jones had just discharged himself from Te Atarau against medical advice.

The Jones case's legacy figures prominently in plans for the facilities at North Shore and Waitakere Hospitals, in which the aim is to consolidate scattered services.

"Nothing will ever take away the risk, but we believe this approach will significantly reduce the risks [of similar cases]," said Waitemata board chief executive Dwayne Crombie.

In a paper to the board, officials were blunt about how service failings could lead to mental health tragedies.

They say the review of Jones' care "illustrated how the separateness of services can lead to fragmentation of care delivery and contribute to such tragedies".

Housing community teams, especially crisis teams, placed near acute in-patient units produce the safest and most-effective patient care, the officials say.

Government mental-health funding to the board has increased by 325 per cent since 1993-94, to $88 million this year. But extra money had often come at only a year's notice, leading to ad hoc development.

A board business manager, Rosalie Percival, said one patient could have five files spread across different facilities.

"Unless you have those five pieces of information you can't make the right decision."

The Public Service Association - whose mental health worker members at Waitemata and in South Auckland have been taking industrial action because of overcrowding they consider unsafe - welcomed the planned spending.

But association organiser Warwick Jones said more immediate action, such as providing extra "sub-acute" facilities to relieve pressure on the acute units, was needed.

A spokesman for Health Minister Annette King said she would not comment on the Waitemata proposal because she had not seen it and some issues it raised might be covered by the review of Auckland mental health services, due to be issued soon.