Rotorua Intermediate learning support co-ordinator Dean Henderson. Photo / Andrew Warner
The number of young people in the Lakes district waiting for mental health assessments has more than doubled in five years despite referrals dropping.
This comes as one agency says there is a “woeful lack of services” in Rotorua for children needing support, while a school has seen a “huge increase” in children dealing with trauma and anxiety.
Data released from Te Whatu Ora Health New Zealand under the Official Information Act shows at the end of last year 74 young people were waiting for assessments through the Lakes Infant, Child and Adolescent Mental Health Service (iCAMHS).
Last year, 450 young people were referred to the service and waited an average 52 days for an assessment.
In 2016, 694 patients were referred and waited an average 33 days. At the end of the year, 24 were waiting for assessments.
The official information response said clinical teams were facing an increase in referrals for anxiety and mood-related disorders.
It said the outpatient caseload suggested the service would benefit from more staffing allocation for psychiatrists and potentially psychologists.
The Rotorua Daily Post asked Te Whatu Ora Lakes why the average wait time had risen despite the number of referrals dropping.
Hospital and specialist services interim lead Alan Wilson said this related to a “number of factors”.
“Around the world, we are seeing an increase in complexity and acuity of presentations, with many young people requiring more specialist interventions”.
The increased complexity of presentations was possibly caused by delays in referrals due to Covid-19, Wilson said.
Another reason could be recruitment difficulties during the pandemic. Wilson said “longstanding vacancies” had resulted in a reduced capacity.
Wilson said demand for the service remained “high” with many children and young people accessing support. Staff were “very busy” and did their “best to support our community with the resources they have,” he said.
Recruitment of skilled staff in the field remained “challenging” because demand outweighed supply, he said.
He said there was a lack of trained psychiatrists and psychologists internationally.
Discussing vacancies, Wilson said psychiatry had been fully recruited for more than five years but one clinician left in mid-February. A locum was covering the vacancy in the interim and interviews were under way.
The service had introduced two new psychology roles - each 0.8 fulltime equivalent - in the last 12 months.
They were advertising for two further roles that could be filled by a psychologist, he said.
Stand Tū Māia is a national charity providing intensive wraparound social service response for children and their families. The Rotorua site offers support to those in the central North Island.
In a written statement, Stand Tū Māia said it worked “very closely” alongside the service referring clients “both ways”. Cases were complex and often issues were not only related to mental health.
“We will work with iCAMHS to provide observations and then often become part of the intervention plan.”
Children with mental health needs may have developmental trauma, care and protection concerns, learning support needs, and physical, sensory and intellectual diagnoses, they said.
Some whānau were also dealing with issues related to homelessness or poor housing and poverty.
Commenting on the data, Stand Tū Māia said the situation was “a little more complex” than just long wait times for clinical assessment.
The charity described it as a “systemic issue” and said children with complex needs required a cross-ministry approach.
Overall there was a “woeful lack of services” available to support the increasing need.
In some situations it could take a “long time” for whānau to get the help they needed which could exacerbate challenges, they said.
Most mental health issues they saw could be “directly related to the impacts of whānau living with multiple sources of stress over long periods of time”.
“This affects the ability of both adults and children to self-regulate, be motivated, plan and problem-solve.
“So whānau relationships break down and tamariki reflect their emotional distress in ways that see them not attending or excluded from school, in trouble in their communities, and struggling with low mood and increased risk of self-harming and suicidality.”
Solving compounding issues - like poverty, inequality, violence, addiction, and poor mental wellbeing - required “a widespread and dedicated response” from multiple services, they said.
“They need one point of entry and a wraparound whānau ora approach if they are to find the trust and motivation to engage and change.”
Some progress had been made in the Lakes district but a “bigger sense of urgency and a willingness to take risks” was needed, they said.
“We need to continue to develop workforce capability, find ways to overcome workforce shortages, and learn to listen to the voices of our tamariki mokopuna and whānau.”
Rotorua Intermediate learning support co-ordinator Dean Henderson said it was “not surprising” wait times were increasing, despite the number of referrals reducing over the past seven years.
“We know they are at capacity - they are seeing as many as they can. The need is way greater than the actual capacity to service that need.”
He told the Rotorua Daily Post some parents had voiced frustration to him about the “worrying” speed at which their child was being seen. Often there was also a “huge waiting period” between initial assessments and follow-up appointments, he said.
“If we are getting kids with a real dire need to see iCAHMS we are having to do some work behind the scenes.”
He said in one instance last year they included the Children’s Commissioner in an email to make sure the case was “seen urgently”.
Meanwhile, he said the school’s pastoral care team was seeing a “huge increase” in the number of students dealing with trauma and anxiety.
Domestic violence and issues associated with emergency housing contributed to trauma, while some students’ anxiety stemmed from social media, he said.
Henderson, who has been in the role for four years, said he tried various avenues before referring a student to the hospital’s service. This included the school’s social worker, a Ministry of Education psychologist or the Gumboot Friday initiative.
“It’s trying to work out who’s going to get to these kids first.”
Malfroy School principal Nicky Brell said all services over the past three years had been “under pressure” and there had been an increasing focus on supporting children’s mental health during the pandemic.
Typically the school engaged with the Ministry of Education’s Resource Teacher: Learning and Behaviour Service before referring a child to the hospital service.
Brell said wait times had always been an “issue of contention” for families and schools.
“It is frustrating when you may have a young person who requires urgent intervention support having to wait for a diagnosis.”
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