Hospitals throughout New Zealand remain choked with the comparatively small number of people with severe or enduring mental illness. These illnesses make managing a normal life extremely difficult for many reasons, but often because they are combined with serious physical health conditions.
These co-morbid conditions are not unusual or coincidental, yet their cause is rarely discussed. As doctors it might be a sense of shame that prevents us from highlighting the fact that medication for serious psychiatric conditions can cause other life-threatening conditions such as diabetes or renal failure.
We wish we had better medication options for our patients, but for many people with schizophrenia or intractable depression, these medications are an immediate saviour, and it is imperative to win the battle at hand.
There is no doubt that psychiatrists throughout New Zealand would like to see improved access to better, more modern mental health medication. Pharmacological treatments for many conditions have been largely unchanged since the 1960s. And it seems a great irony that as a society we are working hard to prevent illnesses like diabetes in one group of people, whilst potentially creating it in another.
However, for many years we have accepted the shortened life expectancy of people with serious mental illness even as we deplore the mistreatment of other vulnerable groups. The 30 per cent reduction of life expectancy of people with schizophrenia globally is on par with the tragic life expectancy of many indigenous people.
The situation for Maori and Pacific people with serious mental illness is even worse.
People with severe and enduring mental illness are represented in all New Zealand's most disadvantaged groups - they are often homeless, imprisoned, or unemployed. They are male and female, young and old.
In fact the Royal Australian and New Zealand College of Psychiatrists is increasingly concerned about the impact of childhood deprivation or poverty as the body of evidence mounts regarding the long-term impact. In New Zealand serious deprivation is felt by 27 per cent of children, with Maori and Pacific children and those living in more deprived areas experiencing a disproportionate burden of morbidity and mortality.
Related events of violence or distress can have adverse effects on children's mental health, including post traumatic stress disorder, addiction, anxiety, and mood problems that continue to impact on them and their whanau and communities throughout their lives.
Psychiatry training aims to instill several different areas of expertise and responsibility in every specialist doctor. These include caring for patients, managing complex medical conditions, providing clinical leadership, teaching and training other psychiatrists and advocating for our patients. Traditionally we have focused on advocating on a patient-by-patient basis, but more and more our members are encouraging proactive advocacy addressing the systemic obstacles between our patients and their well deserved health and happiness.
There is no doubt that being a psychiatrist is a privilege - an opportunity to help people at their most vulnerable and in many cases help to bring about real improvements to people's lives. With modern medicine and an appropriate health care system people with severe and enduring mental illness can get and stay well.
They have many years to catch up on, and we look forward to helping them do so.
* Dr Murray Patton is president of the Royal Australian and New Zealand College of Psychiatrists
This week is Mental Health Awareness Week.
WHERE TO GET HELP
• Lifeline: 0800 543 354 (available 24/7)
• Suicide Crisis Helpline: 0508 828 865 (0508 TAUTOKO) (available 24/7)
• Youth services: (06) 3555 906
• Youthline: 0800 376 633
• Kidsline: 0800 543 754 (4pm to 6pm weekdays)
• Whatsup: 0800 942 8787 (1pm to 11pm)
• The Word
• Depression helpline: 0800 111 757 (available 24/7)
• Rainbow Youth: (09) 376 4155
• CASPER Suicide Prevention
If it is an emergency and you feel like you or someone else is at risk, call 111.
