Short-staffing and staff burn-out at Waikato's state-run psychiatric services have been highlighted in an inspection led by the Health Ministry's director of mental health, Dr John Crawshaw.

In his report, made public today, Dr Crawshaw says the Waikato District Health Board "needs to devote attention to some immediate staffing relief in critical areas - especially in some of the community teams - to reduce staff burn-out and churn, fill vacancies and improve staff retention".

The ministry says the investigation was prompted by public concern following several serious events affecting the Waikato services last year: the suicide of one patient, the unplanned departures of three patients and the employment of an overseas doctor as a psychiatrist who now faces court charges related to identity fraud.

"Apart from the employment of the overseas doctor ... the inspection does not look specifically at those events, which are being investigated or followed up separately, but instead examines how the services are functioning and whether there are any systemic issues."


The ministry says many of the report's recommendations "support changes already planned by the DHB".

The report says, in regard to the recommendation on staffing, the DHB "has moved to bring immediate staffing relief to critical areas". The number of acute inpatient registered nursing staff has risen by six full-time equivalents.

Dr Crawshaw calls for a clear strategy to balance risks with good clinical management and patients' rights, build support for mental health services within the DHB and in the community, build governance within mental health services, and provide regular progress reports.

Longer term, the mental health services need to become more patient-focussed and evidence-based, and strengthen their cultural practices.

The report identifies weaknesses in the mental health services' relationships with patients' families. It calls for "a more consistent commitment across the services to engage with whanau members as equals to the individuals accessing services. This is likely to assist ensuring wider community support for the services."

Dr Crawshaw says that overall, the services were found to be well-managed and led but facing considerable pressure.

The ministry says there has been a 21 per cent increase in demand for mental health services nationally in five years, "which has impacted on service delivery".

Health Minister Jonathan Coleman, who welcomed the report, says the Government has increased mental health and addiction services funding from $1.1 billion in 2008/9 to more than $1.4 billion for 2015/16.

Mental health report

• Waikato District Health Board mental health services have had a formal inspection

• Prompted by a patient suicide, other incidents involving patients, and the alleged identity fraud by a doctor

• Inspection led by Health Ministry's director of mental health, Dr John Crawshaw

• Twelve recommendations, including need to address staffing levels

• DHB says it has employed more staff