Clinical psychologists in Hawke's Bay fear for those in need if their own calls for help aren't heard soon.
Their union says the sector is in crisis - underpaid, undervalued, and overworked - a combination which it says is causing a mass exodus.
In two years, Hawke's Bay District Health Board's Child and Adolescent Mental Health Service has lost six psychologists, leaving just 2.4 full-time equivalents.
Union Apex says based on the international benchmark, health services should employ one psychologist for every 5000 people, meaning Hawke's Bay ideally would have nine psychologists in their child and adolescent services.
HBDHB clinical psychologist, and union delegate, Dr Raewyn Barry says her caseloads border on being unsustainable.
She is unable to take on any new clients until January next year.
Despite losing staff, the number of referrals for their service has been on a sharp incline over the past four years.
Six-hundred psychologists employed by District Health Boards around the country, all of whom are members of the union, are in their third month of partial strike action.
The strike includes psychologists working across a range of mental health services, including forensic services, community mental health, addiction and inpatient services.
It has meant psychologists have stopped accepting allocations of new patients onto their caseload.
Technical Advisory Services (TAS) said the parties were in mediation in Auckland on Thursday and a formal offer was tabled.
The union will be taking the offer to its members for a vote, a spokesman said.
Next week, members will begin voting on the new offer from their employers to settle their collective agreement negotiations.
A Hawke's Bay DHB spokesperson said it was unable to comment while national bargaining was under way.
Apex says it wants to close the salary gap with other state sector employers of psychologists and wants DHBs to commit to employing one psychologist for every 5000 people living in a DHB area.
Dr Barry, who has worked in the sector for seven years, says she is "really angry".
She fears DHB psychologists will just quit if things don't change. "Those who are hanging on by their fingernails for an offer to stem the haemorrhaging will let go and leave."
Fellow HBDHB Clinical Psychologist, Dr Arna Witkowski says they are in a "really difficult situation" because their job is "helping people not harming people".
"We know it is going to cost our clients and our colleagues and we don't want to do any harm.
"We're actually not allowed to do any harm - that's part of our mandate as psychologists so that's obviously why the strike has been structured in the way it has to impact people as little as possible," she added.
Dr Barry said when teachers and nurses went on strike, they were "really visible".
"For us, it just feels like nobody really knows psychologists exist until they need one and if you have to wait then that's when you realise there aren't enough."
Psychologists work with moderate to severe mental illness that is "seriously impacting on the lives of young people".
Not only that, but universities rely on interns for their final year of training - something which Dr Barry says they are struggling to do.
The New Zealand College of Clinical Psychologists (NZCCP) said recent research showed the average waiting time for an appointment with a psychologist in a Child and Adolescent Mental Health Service was nationwide was 11 weeks, with some services taking much longer.
The average time to see a psychologist in an Adult Mental Health Service was 15 weeks.
Information about Hawke's Bay DHB wait times was not immediately available this week.
While each case is different, Dr Barry says wait times in Hawke's Bay are "longer than advisable".
"We're really short and it's really hard for us to leave people waiting but its also hard for us to keep going under the workload that we're facing at the moment.
"I just don't think anybody should have to wait when they're in distress."
People are seen urgently in crisis, usually by non-psychologists, she said.
"It is more that their ongoing care can be compromised if psychological interventions or assessments aren't indicated."
"That means that the therapy or assessment they need for them to get well is delayed or not available, or psychologists are burning themselves out trying to see too many people which also raises safety issues."
New Zealand College of Clinical Psychologists president Malcolm Stewart says psychologists are in high demand by a range of other social service sectors, such as Oranga Tamariki, Corrections, and ACC, with pay and conditions in these other sectors often seen as preferable.
Additionally, around 40 per cent of psychologists work part or full-time in private practice. This means there is substantial competition for the psychology workforce.
Dr Witkowski knows lots of people who have thought about leaving, and others who have left. For her, however, it is not something she wants to do.
"Personally my heart is in the public sector but I also know that I have lots of really good options in other places as well so if it is something that changes for me then I can."