Job lot: The psychiatrist

By CARROLL DU CHATEAU

Verity Humberstone, 32, is a somewhat unusual psychiatrist. Every day of her professional life she gets in a white South Auckland Health Intensive Community Team Hyundai and visits the most disadvantaged people in the city. Her clients are from the Mason Clinic, Mount Eden and Paremoremo prisons and acute psychiatric units. Off duty she lives in central Auckland, supported by her family, boyfriend and cat. This year she won the Madison Medallion for the highest marks of any psychiatric graduate in New Zealand and Australia.

Why did you specialise in psychiatry?

I'd been aware of psychiatry from a very young age when a relative of my father died in Carrington Hosp-
ital. Later, when I was at Auckland Medical School, I realised early on that psychiatry was the most interesting and challenging specialisation available.


What is the single biggest problem for South Auckland mental health services?

There are two — housing and poverty. It's not uncommon for me to turn up at homes with food parcels. For me as a doctor to arrive with medication when people haven't had enough to eat, are living in caravans, and don't have warm clothes, I find so frustrating. These are the most vulnerable members of our community and some are listed as "whereabouts unknown," which is code for homeless.


In what way is your working style different?

When the Intensive Community Team was first developed, the ethos was that doctors would see people in clinics. We found it such a waste of time — going out to pick people up, then taking them home again. Why didn't I just go and visit them?


Why is the mental health system so stretched when funds were supposed to have been "ring fenced" for psychiatric services?

All I know is that funding hasn't filtered through to South Auckland community services. Historically, South Auckland has been more
disadvantaged than other areas in mental health. There is not enough funding. And other social services that lift people out of poverty are not working. The difficulties faced by people with severe mental illness, such as schizophrenia, are exacerbated by poverty. Benefits are simply not enough for people to get established. People are sometimes discharged from our acute mental health units with little more than the clothes they stand up in. I can't emphasise enough the importance of housing for these people. The
pressure on our acute unit, Tiaho Mai at Middlemore, is an absolute disgrace. Sometimes, because all the beds in Auckland are full, people are transported to Whangarei. And the impact on a person going through an acute psychiatric experience being dislocated like that is devastating.


What sort of psychiatric services would you like to see?

Our model at South Auckland, based around the mobile Intensive Community Team, is a good start. Many people we're looking after have serious mental illness, no car and often no phone — asking them to come into a clinic is a big ask. Most of our work is tracking people down and getting them on more effective medication. With this model our team is often able to see some people every day. It's not just a matter of dropping off pills and walking away. The important thing to do is to establish a caring and genuine relationship — to sit down over a cup of tea and spend some quality time with them.


Who was your mentor?

My most fundamental influence was Professor John Werry, who retired from the Auckland Medical School recently. Although his main field of interest was child psychiatry he pushed hard for better services for mentally ill people


What makes you keep doing it?

What I'm really interested in — and what my thesis was about — is "how do you work most effectively with somebody with mental illness and severe social needs?" I find the subject challenging and rewarding. I think this is a really exciting job. When we see people recovering and getting on with their lives — and we do see some marvellous recoveries and some courageous people — it's enormously satisfying.