Rotorua Hospital's new mental health inpatient unit might not be ready until at least April 2024 - nearly three years after it was originally expected to be built.
But local mental health advocates say a "flash building" and two extra beds won't be enough to cope with demand and believe more must be done to meet the community's needs.
It comes after the Government approved an additional $1.925 million for the project in December.
This was on top of the initial budget of $31m allocated to replace Te Whare Oranga Tangata o Whakaue, Rotorua Hospital's prison-like, 14-bed mental health inpatient unit.
The Crown's initial contribution to the project was $25m.
Rotorua Lakes District Health Board chief executive Nick Saville-Wood said the expected cost of the new building rose due to delays from lockdowns and the need for "geotechnical solutions" for the site's very high ground temperatures.
"It is expected costs will also be impacted by the effects of Covid-19 on the construction industry including international and national supply chains.
"The current budget is close to $33m."
Of this budget, Saville-Wood said $1,583,604 had been spent so far.
Work since November has included gaining resource consent approval, clearing the site, an archaeological workshop, cultural hui and design workshops.
Construction is set to start in December and the Lakes DHB expects the project to be completed in April 2024.
Initial groundworks are set to begin within the next few weeks.
Saville-Wood said the new facility would have 16 beds in pods of four.
'[This] will allow for patients to be cared for in similar cohorts [such as] age and gender.
"An additional area will be a shell to enable the building to increase easily to 20 beds in the future, if necessary."
Te Whare Oranga Tangata o Whakaue currently has a 14-bed capacity.
Concerns over the "archaic" state of Whare Whakaue led the Lakes DHB to seek approval for a $31m business case to replace the building in 2019.
Health Minister Andrew Little said he expected the build to go ahead as planned despite Government health reforms taking effect from July 1.
"We have committed to this project because it is needed," Little said.
"These are buildings that need to be able to provide clinical services in a therapeutic space to ensure people get the treatment and care they need.
"Building the appropriate facilities is of the utmost importance."
When asked whether he believed 16 to 20 beds would be enough to cater to the community's needs, Little said: "We know there are still gaps in specialist and mental health services, and we're already taking the next steps to improve services for those who have the highest needs.
"We know that for some families it's still too difficult to get help. One reason for that is there wasn't enough support to stop small issues becoming big problems."
Rotorua-based mental health advocate Michael Naera was anxious about how to meet mental health needs before the new facility was built.
"While we can celebrate that they're starting groundwork, it really isn't good enough that we have to wait for another few years before we see the facilities."
Naera said people would carry on using "archaic facilities in poor conditions" until 2024.
"Our whānau are entering into these facilities, being isolated in rooms that are not up to scratch, that are not kaupapa Māori-centric.
"So while waiting for the new building we could cause more harm than good."
Naera said contingency plans would be needed to protect people from being discriminated against by the system.
"Two extra beds won't make much of a difference for the demand on services that's out there at the moment.
"We're going to have this flash building but the funnel effect [of having more referrals than the service can cater for] will still be there."
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Lakes Psychology clinical psychologist Debbie Heron said she would like to know more about how patients could be cared for while the new facility was being built.
"I think it just comes down to what resourcing is available now.
"I know that the need out in the community is not being met by the services that are there. People are waiting months to be seen and to get the care that they need."
Heron said between now and 2024 she would like to see more frontline clinical resources made available.
A Lakes DHB spokesperson said Whare Whakaue was a high priority for Lakes DHB.
"We are building as fast as we can to ensure it will be a high-quality building fit for purpose."
The Mauri Ora Project was focused on producing a building with community-facing facilities that acknowledged tangata whenua and provided a therapeutic environment,
Philosophically, the new building was one of many enablers part of embedding Te Ara Tauwhirotanga - a sector-wide care model for the DHB's mental health and addiction services, the spokesperson said.
It was developed through extensive community consultation, including service providers, service users, whānau, and local iwi, the spokesperson said.
The Mauri Ora Build project, in partnership with Te Arawa and Tūwharetoa Iwi governance, included projects to move the service towards more contemporary practice.
Staff modelling took into consideration the staff ratios needed for 16 beds initially and 20 beds overtime should the building be expanded, the spokesperson said.
If it is an emergency and you feel like you or someone else is at risk, call 111.
For counselling and support
Lifeline: Call 0800 543 354 or text 4357 (HELP)
Suicide Crisis Helpline: Call 0508 828 865 (0508 TAUTOKO)
Need to talk? Call or text 1737
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Youthline: Call 0800 376 633 or text 234
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Safe to talk (sexual harm): Call 0800 044 334 or text 4334
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