Children at risk while DHB can't fill mental health positions

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Children needing specialist mental health services face long delays and fewer therapy groups because a DHB can't find staff for nearly half its positions.

Documents obtained by the Herald on Sunday reveal the vacancy rate at Te Puawaitanga, the child and adolescent mental health team for south Manukau and Franklin, reached 62 per cent late last year and is now 45 per cent.

Autism NZ and a health workers' union say the situation is concerning, reflects nationwide problems and is causing harm.

Vacant positions include in psychiatry, psychology and nursing. The service gets sent children and teenagers who can't be managed by community services. It has hundreds of kids younger than 12 on its books.

"The team have struggled with a decreasing workforce. This in turn has had an impact on service delivery," a Counties Manukau DHB briefing from last year stated. "The ability for the team to deliver a clinically safe and responsive service is at risk.

"Clinicians remain able to respond to acute presentations however as they are prioritising the clinical resource to meet this demand, the consequence is lengthy delays for young people waiting for treatment and the service has had to decrease the number of groups offered to young people and their families."

There is a national shortage of mental health specialists. Other reasons for the recruitment crisis given by the DHB included higher pay and better conditions in the private sector and Auckland's cost of living and grinding traffic.

Leaders suggested temporarily closing the neurodevelopmental treatment pathway, which covers autism, attention deficit disorder, developmental delay and difficulties with attachment.

Tess Ahern, general manager of mental health at Counties Manukau DHB, and Clive Bensemann, acting clinical director for mental health and addictions, told the Herald on Sunday no children had come to harm because of the delays for "non-urgent" cases.

"We are seeing some people, but some kids are probably waiting months. And that is unsatisfactory," Bensemann said.

Therapy groups now running less often include those addressing anger, distress and anxiety issues, and the DHB is considering outsourcing neurodevelopment work to a private provider. Help has also been provided from elsewhere, including from the team covering the DHB's northern suburbs.

Bensemann and Ahern said recruitment and caseloads were improving, thanks to "passionate and awesome" staff.

An ongoing nationwide strike of DHB psychologists has put a spotlight on hospital-level care.

Nationwide vacancies for psychologists in DHBs are 34 per cent, an open letter by psychologists at Auckland and Counties Manukau DHBs stated, and in Counties Manukau 67 per cent of the psychologist workforce left in the past two years.

Dr Deborah Powell, national secretary for Apex, the union representing DHB psychologists, said there was a potential agreement in sight that would pay staff more and make recruitment less difficult.

The current problems were extremely concerning, Powell said, particularly because many kids came from families struggling with poverty, and unable to get private help.

Dane Dougan, Autism NZ chief executive, said the problems extended across the country. The charity would soon release research that found it takes an average of about four years from signs of autism in a child to getting a diagnosis.

"The sooner we intervene, the better chance that child has to go on and live to their full potential."
The 2019 Budget allocated $1.9 billion of new spending over five years to mental health initiatives, including placing trained mental health workers in doctors' clinics.