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An unannounced visit to Auckland City Hospital’s Te Whetu Tāwera mental health unit found that some users felt unsafe because they could not lock their room doors, while others could not access fresh air or hot water.
Mental health patients being held in an Auckland hospital could be seen while using a cardboard container as a toilet, according to an investigation.
On Monday, Chief Ombudsman Peter Boshier released a report following an unannounced inspection of the Te Whetu Tāwera Adult Acute Mental Health Unit at Auckland City Hospital.
While there was no evidence that any user of mental health services had been subjected to “torture or other cruel, inhuman or degrading treatment or punishment,” the report did highlight areas of “grave concern.”
These included that the inmates and the High Dependency Unit did not have access to fresh air, and that the inmates could be seen using the bathroom from the door window and the observation room, posing a “serious risk to [people’s] privacy and dignity ”.
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The inspectors also found that some users felt unsafe in the unit because they could not close their bedroom doors, for example.
“These issues are not acceptable in a mental health facility,” Boshier said.
It also found that the lack of adequate accommodation meant that 13 people stayed longer in the mental health unit than they needed, including one for 17 months.
The visit was carried out to ensure that the conditions and treatment of patients comply with New Zealand’s human rights obligations.
TDHB / Stuff
An example of a seclusion room in a New Zealand hospital. (Generic photo)
Seclusion is when a person is confined to a room and cannot leave. It should only be used in the short term if a patient is considered a risk to himself or someone else.
The Ombudsman found that the Auckland DHB was making a “concerted effort” to reduce isolation, and that the isolation and restraint paperwork was “detailed and robust”.
Consent forms for treatment for service users were in all files reviewed and progress and handover notes were up-to-date, according to the report.
However, he also found that Te Tūmanako (closed intensive care room) users did not have access to hot water independently of staff and had limited access to telephones.
An investigation in August at the Waiatarau Mental Health Unit of Waitākere Hospital found that people were also staying longer than necessary due to lack of accommodation, including five who had been there for six months.
Dom Thomas / RNZ
The Chief Ombudsman, Peter Boshier, made 15 recommendations to the Auckland District Board of Health, 11 of which had been partially or fully accepted.
Boshier said the purpose of an acute mental health unit is to provide assessment, treatment and care, “it is not adequate accommodation” for those who do not require care in that setting.
He “admired” Te Whetu Tāwera’s position on not “leaving service users homeless,” and appreciated that staff found it “frustrating” and “distressing” to see the impact that the lack of community housing in the region has on the patients.
Boshier made 15 recommendations, including reviewing the unit’s drug addiction and strip search policy to ensure privacy and dignity are not compromised.
Of these, three were accepted, including the drug policy review and strip search, eight were partially accepted, and four were rejected.
In 2018, the Health Safety and Quality Commission set the “aspirational goal” of eliminating insulation by 2020.
The watchdog states that confinement causes physical and psychological harm to those who experience it and, anecdotally, to the personnel who participate in it and observe it.
“Detention violates basic human rights and is not aligned with modern, evidence-based, high-quality care. In mental health and addiction services, its elimination is inevitable ”.
