Canterbury health board candidates share views on mental health and addictions

In the lead up the local elections this month, a Canterbury health service-user advocacy group has surveyed candidates running for health board about their views on a number of topical issues.

Awareness: Canterbury Action on Mental Health and Addictions has conducted candidate surveys for the last three years, for both local and national elections.

“The aim is to enable our membership and other people with experience of mental health or addiction issues to find out where candidates stand on issues that affect us, and make an informed vote” says Kelly Pope, coordinator for the group.

Questions this year focused on the availability of support for youth, candidates understandings of and views towards peer support and consumer advisory roles, physical health care for people with mental health or addiction issues, reducing Canterbury’s suicide rate, addressing long-term health and wellbeing issues related to ongoing impacts of the earthquakes, discrimination faced by people with addiction issues and smoke-free mental health services.

Thirteen of the twenty-six candidates standing for Canterbury District Health Board have responded to the survey and a summary of their responses, focusing on policy and action they plan to take in the role, is provided below. We have tried to best represent the candidates’ views, but some of the points have been reworded to be more concise.

Paul McMahon – Youth-specific services should be available for young people
– More resources should be directed to youth development and early intervention
– Services should be delivered in a less-restrictive, client-led, engaging and youth friendly way
– Peer support whether organised or informal is really helpful and important
– People with chronic mental health problems should be able to access a service where treatment teams can support them with physical, mental, and other health needs
– Less restrictive, client-led models of counseling should be funded which can be tailored to meet individual needs of people needing support in post-earthquake Christchurch
– Health promotion campaigns should be extended to help people cope with earthquake stress
– A proactive public health approach needs to be taken to housing to stop cold, damp, unsafe and unhealthy housing compounding peoples chronic health issues
– The Living Wage campaign is relevant to health – good, well-paying jobs help people to determine their own futures and have hope for the future.
– The funding model for DHBs should take into account the increased need in Canterbury
– The more consumer-led services the better, there needs to be more funding of consumer advisory services
– Addiction is a health issue and should be treated as such. There needs to be more resources and integration of care to support people with addiction issues
– It’s unfair on those with smoking addictions to be forced to deal with withdrawal symptoms without their consent while hospitalised

Margaret McGowan– As a mother I am very aware of the conflict and struggle our youth have in their journey to adulthood
– Public education is needed around healthy eating, fitness and the harms of drugs and alcohol
– Isolation, feelings of hopelessness and barriers to accessing support are important issues to address to reduce our suicide statistics
– While smoking is damaging to physical health, many people suffering mental illness use this as a crutch to assist them through rough times on their journey to good health
– Consumer advisory roles are valuable, if those in the role have personal experience on what they’re advising on
– Regarding the addiction struggle: I believe this is a double edged sword. While I would be happy to advocate for them on some areas, it is impossible for me to give any blanket assurance on this

Keith Nelson– Youth support is a priority. It varies across regions due to non-central control of service provision and is dependent on the motivations of individuals in a region
– Peer support is vital, mentoring is also important
– Some health services can support people with mental, physical and other health needs, but this depends on staff ability. Holistic care is a skill that can’t be taught
– If our suicide rate is to decrease people need to talk to each other and reach out. No one approach will help everyone.
– It would be nice if consumer advisor roles existed*
– People need to take responsibility for their own decisions and addiction issues
– Smoking should be banned in all public places, and in the vicinity of people who can’t make an informed choice about the hazards of smoking e.g. children in the home

*NB. Consumer advisor roles do exist is DHB and some NGO services

John Noordanus– Youth wellbeing is an important issue across the country, youth need to feel valued and hopeful
– Person-centred services with a strengths based approach are important for supporting people with addiction issues
– Our community should have the capacity to provide more creative and holistic interventions that complement traditional mental health interventions
– People should not be over-supported, duplication and silo service structure can be confusing
– Good assessment and early intervention programmes are needed to address suicide rates
– Schools should play a part in education that promotes being able to talk about depression
– Workplaces need to have resources and interventions to support people who are potentially unwell
– I would devote time to understanding how well current resources are addressing suicide reduction and would consider hosting a community forum to discuss this
– It will be important to advocate for assessing current approaches to long-term earthquake effects, identifying areas for improvement and incorporating these into a strategic plan
– It is imperative that consumers have the opportunity to be able to inform services
– Health services (for people with addiction issues) should be person-centred, culturally appropriate, family inclusive and care driven by the person receiving it
– Mental health services should have well-managed processes for allowing service-users to smoke

Jo Kane– We cannot continue to pay lip-service to youth health issues youth health needs to be a priority
– CDHB Needs Assessments should be able to identify areas to direct funding to support young people
– Peer support is tremendously helpful but under resourced. It can complement clinical support and should be available to everyone
– Service provision should consider the environmental and social factors needed to support a person
– A total package of support should canvas what the person need both physically and mentally
– We need to understand and stop accepting the extreme distress some many in our community are experiencing
– Support needs to be extended to the rural sector, particularly farming men isolated in hard times
– Community targeted campaigns with key messages, information and contacts are needed
– The NGO, education, social services and business sectors need to work together
– Consumer advisors should have a much bigger role along with community priorities
– Services should be well-resourced to support people with addiction issues and work with them individually and supportively to make small steps towards recovery
– There should be some exceptions for people disadvantaged by smokefree policy

Allison Franklin– Youth health should be a priority for any government entity
– The Canterbury earthquakes will have resulted in increased youth mental health issues which the board will need to address
– Peer support is an incredibly value resource in mental health and addiction issues, it should be well-resourced and widely available
– Mental health services need skills to identify physical health issues and mainstream physical services need to be able to work empathetically with mental health patients
– There isn’t an easy fix to reducing the suicide rate. Awareness and openness around suicide in secondary schools is needed with the message that life may seem bleak but will improve
– Cohesive communities are the answer to post-earthquake stress. Health mental and physical health problems and addictions stemming from the earthquakes can be managed in mainstream services
– It is incredibly important that the consumer perspective is a fundamental part of any service. I have worked as a consumer advisor for Lifelinks in the past
– It’s vital that staff providing health services have awareness raising training delivered by people who have successfully come through addictions to address stigma and discrimination
– Smoking cessation results in better physical health and improved personal finances for smokers. People using services who smoke should be offered alternatives such as vapour cigarettes

David Morrell– Youth suicide remains stubbornly high despite DHB mental health service efforts
– Difficulty accessing jobs contributes to youth mental health issues
– Schools and health services need to work closely, as school counselors and DHB mental health services have been since the earthquakes
– Addictions have long been a concern of mine and, during my time as Christchurch City Missioner, the Mission started a number of addictions support programmes
– Mental health services have structured themselves to deal with the ‘long tail’ of the earthquakes which will improve but not solve things
– We have a long way to go towards holistic health services and need to work towards this
– Enhancing wellbeing is relevant to everyone, but especially young people and people whose self-image or morale is down
– The ‘Circles of Support’ model used in intellectual disability services should be used more widely in health services

Sally Buck– Better youth support is not just a case of throwing more money at the main centers but also ensuring better knowledge and services in rural areas
– Peer support is absolutely essential – it has a huge benefit
– Doctors and nurses need to think about patients as a whole and work in with other health professionals to provide support. It is important to find out what else is happening in a person’s life and for paperwork to support a more holistic approach
– Signs and symptoms related to suicide need to be widely known in our communities, not just by health professionals
– Suicide statistics have been skewed by high rates in a couple of schools which might show targeted support is needed
– Post-earthquake there is more stress and use of medication. A holistic approach is needed, including green prescriptions, addressing housing issues and alternatives to medication
– Consumer advisory roles are good if advisors have real and relevant consumer experience
– Smokefree is good for health but it would be concerning if smokers choose not to access mental health services because of smoking ban
– I would like to have input from the consumer network and people working in mental health and addictions

Heather Symes – Poverty is a major factor in poor youth health and family violence also leads to health issues
– If we look after the working poor, health will improve for young people
– All people employed directly and indirectly by the CDHB should be paid a living wage
– Organised peer support such as that provided by NGOs works really well, as does peer support encouraged by staff within DHB services though it has to fit for the individual
– Specialist Mental Health Services make a huge effort to address people’s physical as well as mental health needs
– A media campaign should be developed to help people struggling with after-effects of earthquakes, particularly the elderly
– Rest homes should provide more mental health assessments for residents and the referral criteria to mental health support services should be lowered
– More funding should be directed to youth helplines and one stop shops
– We can learn from overseas research on post-disaster support and the ‘alright’ campaign should be extended
– Consumer advisory roles are money well spent
– Health service staff should work with people with addictions in the same way they would work with anyone else, that said, stigma and discrimination have reduced a lot and is rare
– We have to follow the law around smoke-free government buildings. Nicotine replacement therapy should be offered and is helpful

Andrew Dickerson– Youth wellbeing is a priority. Community based support services like Korowai Youth Wellbeing Trust and 298 Youth Health Centre should be supported
– I am very supportive of peer support groups for people with mental health/addictions issues
– Health professionals need to be aware of the barriers people with mental illness face in accessing health services for their physical health needs
– I support suicide prevention strategies and increasing mental health services to rural communities
– We need to avoid “medicalising” post-earthquake stress. Specialist psychiatric services, the CCC earthquake advocacy services and neighbourhood initiatives all help people who are vulnerable
– I am very supportive of consumer advisory roles
– Health service staff should treat people with addictions with respect and ensure their addiction does not impede access to essential health services
– CDHB buildings and cars should certainly be smokefree but outdoor areas less so, it would be concerning if people are not seeking support because of the CDHB smokefree policy. Smoking cessation support should be available

Andrew McCombie – Youth mental health is a priority and traditional support and treatment could be complemented by computerized interventions
– [with regard to peer support] Christchurch has Youth Specialty Service and many schools have guidance counselors*
– Computerised Cognitive Behavior Therapy could help address Canterbury’s high suicide rate and is something I will be advocating for. It is also extremely cost-effective
– Computerised interventions can also provide wide-reaching and cost effective response to post-earthquake health issues
– Consumer advisory roles are essential
– Addictions need to be treated with empathy and understanding. CCBT has also been shown to be effective in treating addiction and would be great to have in Canterbury
– Mental health patients should be encouraged to quit smoking but not forced to do so

*NB. Youth Specialty Service doesn’t currently offer peer support and clinical or counseling support is most often not peer support

Steve Wakefield– Youth wellbeing is a priority and an effective area to invest in for longer, lifetime benefits to individuals and communities
– I plan to become better informed about youth health needs, what works and the funding needed
– Peer support is one option out of many that could benefit people and whether it is an appropriate choice is a clinical decision. The board will have to fund to meet this need though
– Modern IT systems, information sharing and patient centric systems allow for more holistic treatment of the “whole person”
– I would ensure that the board is aware of research and frontline knowledge relevant to reducing our suicide rates
– We need to invest in approaches that deal with issues before they get to the extreme level of mental illness that results in suicide
– Ongoing analysis and research is needed to ensure we are directing funding where needed to address post-earthquake issues
– Consumer advisory roles are very important and require more investment, focus and visibility
– If greater education of health professionals [around addiction stigma and discrimination] is needed then the DHB would deliver this
– I would need to be briefed on the clinical view of the pros and cons of smoke-free for mental health before advocating one way or the other

Robin Kilworth – Youth support is a priority and early intervention is key. Free support offered through GPs needs to be extended and awareness expanded
– Peer support is valuable especially if peer supported have training and are well down the track in their own recovery
– Mental health staff and GPs should be working closer to ensure people’s mental and physical health needs are met
– Greater funding is needed for awareness resources, print, online, etc of mental health issues and what family and friends can do to support their loved ones who are experiencing issues
– Advisory roles are important
– Addiction issues need to be treated like any other issue. The presence of a support person when accessing services can make discrimination less likely to happen
– Mental health facilities should be smoke-free but have outside space for smokers to smoke