Police move lifts pressure on hospitals

By MARTIN JOHNSTON health reporter

Hospital beds for the mentally ill will be even scarcer than usual for nearly a month because police have reduced their co-operation in parts of Auckland.

Waitakere police will no longer hold mentally ill patients in their cells unless they have committed a crime.

The end of the longstanding local policy increases pressure on an already-stretched mental health system.

There is no national police policy to keep patients in cells.

The Waitemata District Health Board has been forced to restrict admissions to its acute mental health units, Taharoto and Te Atarau, even more than usual, but expects some relief within a month.

Mental health nurses believe the police change will increase the risk of potentially dangerous patients being discharged into the community too soon.

But, like patient groups, they say using police cells for people who are unwell is repugnant.

Auckland mental health services are in a perpetual crisis because of lack of money, staff and beds for the numbers of patients.

There are too few community services, increasing pressure on acute units, which must discharge people before they are well.

The Waitakere police started the policy of not "accommodating" patients in cells while a hospital bed is found last Friday.

On the strength of a legal opinion, the North Shore-Waitakere police commander Superintendent Roger Carson said yesterday that the Mental Health (Compulsory Assessment and Treatment) Act did not permit police to hold patients for more than six hours.

That was the maximum time a patient could be held under the act for a doctor's initial assessment.

In recent months, about six patients a month have waited in the cells for Waitemata hospital beds. The longest wait was four days. In one period of just under a month last year, 13 patients were held for an average of nearly 20 hours each.

Three new acute beds came into use at Te Atarau in April, but board papers have since noted that "acute inpatient bed capacity" was still being exceeded.

Three more beds, at Taharoto, would be available in about four weeks, once the necessary extra staff had been appointed, said Waitemata's mental health services general manager, Dave Davies.

Until then, Waitemata would have to rely more heavily on the region's other boards for beds and on respite care, under which nurses cared for patients possibly at the patient's home or a motel.

"We are going to have to be prioritising access to our inpatient beds, not that we haven't been doing that in the past.

"But for four weeks we have to be really stringent in ensuring that those with the highest level of need have access to our services and we look to appropriate alternatives for others."

He said the board had contracted a non-government group to provide six "step-down" beds to help recovering patients, but this had been held up by delays in obtaining a house.