KEY POINTS:
Medical and nursing staff have been strongly criticised for their handling of mental health patients, including cases which ended in suicide.
The criticism of mental health services at the Auckland District Health Board follows an external review commissioned by the board and the Ministry of Health.
In a report, made public by the board today, the reviewers said four key cases, and two others they were also asked to consider, "show evidence of unacceptably poor clinical judgement and practice by some medical and nursing staff within Te Whetu Tawera".
The board management said it acknowledged the findings of the review and that failings had occurred.
"As the report makes clear, there have been failings within the service," said the general manager of mental health services, Fionnagh Dougan.
"Clearly this is not good enough and is deeply regrettable. We are in the process of offering our sincere apologies to representatives of the families involved."
The main four cases investigated by the review team involved:
* A homicide alleged to have been committed by a man after he was discharged from the board's acute inpatient mental health unit, Te Whetu Tawera, located near Auckland City Hospital.
* The suicide of a man in an open ward at the unit.
* The death of a patient at night following admission to the unit's intensive care unit.
* The "apparent" suicide of a man at the unit, in a case now before the coroner.
Some of the cases featured in the Government's list of hospital errors released earlier this week.
The review is one in a long line of highly critical reviews and inquiries into the Auckland region's mental health services dating back decades to the now-closed psychiatric hospitals, Carrington and Oakley, in Mt Albert.
Today's report said: "We consider that families and whanau affected are entitled to an apology from ADHB.
"We believe that this has occurred because of a lack of appropriate leadership in medicine, nursing and management within Te Whetu Tawera.
"These difficulties have been brought to the attention of senior clinical management of mental health services for ADHB over some years, and no effective action has been taken."
The review panel - Stephanie du Fresne, Joan Chettleburgh and Brian Vickers - acknowledged the board's mental health services had to contend with many issues "such as resources", relations with other services, and the changing nature of the patient population.
"The need for additional resources will be able to be more accurately measured when service delivery within existing resources has improved," they said.
As a result of the external and internal reviews, the board intends to introduce changes and has already implemented some, including:
* Te Whetu Tawera's leadership now includes a nurse adviser, in addition to a service manager and a clinical director
* Observation of patients has been boosted
* An assertive outreach model has been established in the community service.
