Health Minister Matt Doocey says he supports changes to a Government bill replacing the Mental Health Act, which will make it clear mothers and babies should be kept together in the first instance.
“In mental health and acute mental health there is risk. That is why we have highly trained clinical staff who will make those decisions.
“Potentially at times, due to safety concerns for both mum and baby, there might need to be a separation, but if we start off with the explicit principle that they be kept together, and then we can work from there,” Doocey said.
Doocey was speaking to the Herald after three parents blew the whistle on problems in New Zealand’s perinatal mental healthcare.
One mother, Kristy Maguire, was sectioned and separated from her baby in a general mental health inpatient facility.
She spoke to the Herald about the importance of keeping mothers and their babies together and has become an advocate for more mother and baby units (MBUs), which allow mothers to be treated without being separated from their children.
New Zealand only has two such units, one at Starship Children’s Hospital in Auckland and the other in Christchurch. They are only for people who live locally, meaning those who do not live near an MBU may be treated in a general mental health inpatient facility, away from their child.
The Government’s mental health bill initially did not include a clause specifying the desire to keep mothers and babies together.
This was the recommendation of the Health Committee, pushed by Labour’s Ingrid Leary and Ayesha Verrall.
Leary told the Herald the change meant “the law will now require that wherever women and their babies can be safely kept together they should be.
“Labour actively sought opportunities for improved protection for the human rights of people subject to the Act.”
Doocey said the Government will pick that recommendation up in some form when the bill heads back to the House to complete its remaining stages.
“They’ve [the committee] read the submissions, they’ve heard the stories, and some quite sad and tragic stories where mothers and babies have been separated, and you really have to question whether that is the right thing,” Doocey said.
“They’ve made some recommendations about how mother and baby can stay together and I support that.”
Doocey said the proposed change “makes it more explicit” that mothers and babies should be kept together.
“That should be the first principle, can we keep mother and baby together?” he said.
The challenge will be funding and building the units. In a 2023 report, the United Kingdom’s Royal College of Psychiatrists estimated there is a need for about 0.4 MBU beds per 1000 deliveries.
New Zealand records more than 55,000 live births a year.
The Starship unit has just three beds. At a ratio of 0.4 beds per 1000 deliveries, it should have closer to eight beds just to serve Auckland, to say nothing of the rest of the country.
Asked about whether funding and investment would accompany the mental health reforms to provide a consistent standard of care, Doocey said “very much so”.
“We’re committed to ensuring people get timely access to care. What I know as Mental Health Minister, is feedback people tell me is the mental health system is quite fragmented, and when you look at geographically across the country, it’s quite variable.
“We’re going to join up that fragmented system and provide a consistent level of care across the country,” he said.
Doocey said the Government would “look to see” if MBUs could be “rolled out across the country”, and “potentially” building more of them.
He said new mental health facilities currently under construction had more “flexible spaces within them” meaning “you can segment a part of it for when you have a mother and baby coming in”.
Another mother, Serra Clark told the Herald that after her baby was stillborn, she was unable to access the same postnatal support as other parents because she did not have a live baby in her care.
A 2023 Health NZ stocktake of these services found them to be fragmented and patchy.
A promise to provide a better, standardised care for bereaved parents was meant to arrive in March of this year, but has not.
Doocey admitted problems.
“We haven’t got it right within the bereavement pathway,” he said.
Doocey reiterated a $4.9 million investment in some regions such as Hawke’s Bay and Wellington to lift their care for bereaved parents.
Doocey said standardising care - a vision of the 2023 stocktake - was a goal.
“That’s what I’m focused on. The first part of that was the $4.9m, and we’ll be looking to invest more into not only the bereaved pathway and maternal mental health as well,” Doocey said.
Doocey said fundamentally he agreed parents following a stillbirth should have access to the same quality care as parents who have living children.
“The simple answer to that is ‘yes’,” Doocey said.
“There will be a different level of care required, and I have heard the heartbreaking stories where a mother [after still birth] has been put on a ward with other mothers and babies, and I don’t think that should be happening.”
Alastair Taylor spoke to the Herald about losing his wife Kristin Taylor to suicide after she gave birth.
He noted that some of the mental health facilities in which Kristin Taylor was treated were more penal than therapeutic.
Doocey said this was an “accurate observation of some of our facilities in NZ”.
“I’ve visited them - some, quite candidly, look like prison cells or police cells,” he said.
“It is reflective of a generation ago when they were the dominant views of mental health when people were locked up and asylums and other detaining facilities. Thankfully we’ve come a long way in the field,” he said.
Doocey said the new facilities the Government was opening were “more therapeutically designed”.
“People go into these facilities to get well. You can’t go into a facility that doesn’t enable that,” he said.
Doocey would not give a date for when the last of the old penal-style facilities would close.
“It’s an active programme as we roll out the new facilities,” he said.