Psychiatric unit almost forced to close

By MARTIN JOHNSTON health reporter

A shortage of doctors meant one of Auckland's four acute adult psychiatric units nearly had to be closed, according to a psychiatrist.

Mental health workers in West Auckland yesterday continued to speak out about overloading and understaffing in the city's psychiatric care.

The psychiatrist at the area's Community Assessment and Treatment Team (CATT West), Dr Felicity Plunkett, said the chronic staff shortage at the Waitakere Hospital acute unit worsened in December.

"We were saying to the management that the unit [Te Atarau] was going to have to close because there weren't going to be any doctors," she said. Closure was narrowly averted, she said, when a retired psychiatrist and the Waitemata District Health Board's clinical director of mental health services, Dr Wayne Miles, both agreed to fill in.

"Because of the stress in the west, it's been hard to retain psychiatrists because people are getting burned out so fast."

However, the board's communications manager, Caroline Mackersey, said there was never any question of the unit closing.

"The registrar supposed to arrive before Christmas did not arrive and there was a re-allocation of doctors, including Wayne Miles and a registrar transferred from another service."

Dr Plunkett's comments follow the Herald revealing yesterday the fears of CATT West staff that it is only a matter of time until the next mental health tragedy, like the 1999 Lachlan Jones murder-suicide, because their team is under such pressure.

Because of difficulties finding beds for patients, high staff turnover and stress in the team of 17 fulltime equivalents, they walk a daily tightrope with patients and often take shortcuts of the type criticised in the official reports after the Jones case.

Dr Plunkett, who is leaving, warned board managers in a November email of a "clinical state of emergency" because of the routine detention of psychiatric patients in police cells, an "inhumane" practice that was medically risky for many. Yesterday, she said nothing had changed.

Another CATT West worker, who requested anonymity, said women and child patients were sometimes detained in the cells awaiting a bed.

Mrs Mackersey said the management was not aware of children being held in cells.

The worker recalled keeping a 15-year-old girl in an interview room at the Henderson Police Station overnight waiting for a bed at Starship's psychiatric unit.

She said a psychiatrist - not Dr Plunkett - urged her to get the police to charge the girl to hold her in a cell.

"She hadn't committed an offence. I wasn't going to let this poor young girl be locked up in a police cell with all the common criminals."

The worker said the police did a good job, but their cells were the wrong place for patients.

Mrs Mackersey said five Waitemata patients were in police cells at the weekend. Two went to court yesterday on criminal charges, one was diverted to the emergency care centre at North Shore Hospital and two were awaiting intensive-care beds at acute units.