A public meeting in Levin was told by a clinical expert that health workers are being swamped by cases of mental illness and mental distress in the region.
MidCentral District Health Board held a public meeting on Tuesday, where Horowhenua District Councillor Victoria Kaye-Simmons asked what was planned to counter inadequate mental healthcare.
Kaye-Simmons cited the numbers of people with severe mental health issues wandering the streets at all hours and said she had visited Ward 21, Palmerston North Hospital's acute mental health unit, which had shaken her.
The challenge prompted an impassioned speech from MidCentral DHB clinical executive for mental health and addictions Marcel Westerlund, who said not all cases were mental illness, they were often mental distress too, resulting from circumstances outside the control of health professionals.
Exacerbating factors were poverty, unemployment, homelessness and drug use, as well as mental illness, which are the most important issues New Zealand has to deal with, he said.
Mr Westerlund said the recent governmental inquiry into mental health showed there was a paradigm shift and a major overhaul of the system was needed.
He said turning around the outcomes for people with mental health problems was like slowing and turning a supertanker around, with some time needed, and everyone required to be on board.
"It has to be addressed collaboratively ... with all other stakeholders around our beautiful country," he said.
Mr Westerlund said there were 70 admissions to Palmerston North's mental health ward every month, and up to 400 referrals for acute care, which meant hospital-based services were pushed to breaking point.
"We need more funding because we are inundated with clients with all sorts of needs," he said.
He said a pilot scheme would be started by the end of the month that would see a collaboration between his team and the hospital's emergency department, and that there would also need to be more focus on children's services and care of the elderly, especially in areas like Otaki and Levin, that had an ageing population.
Children could turn up later as clients in the mental health system if their issues weren't addressed early, he said.
Poverty was causing major issues for clients in the mental health system who couldn't afford their medication too.
"Many people with mental illness are reluctant to pay for medication because they simply haven't got the money," he said.
"Are you going to spend your last bucks on food, or spend it on [medication]?"
We need to have funding in place for these people, a special authority so the medication can be provided to those in need. That is not yet in place."
He said the DHB needed to work together with Primary Health Organisations so they have services that can help those people because "we cannot sort it out ourselves."
Suicide was at the top of the agenda needing change, Mr Westerlund said.
There were 606 officially recorded suicides last year in New Zealand and 34 of those were in the MidCentral region - figures that may not even be a true representation as it was not always possible to ascertain if a death was actually suicide, he said.
Mr Westerlund said an increasing number of people were attempting suicide because of mental distress.
His stance was backed by clinical executive for primary, public and community health Dave Ayling, who said there was an overload of clients in the system and the acute care services may never have the resources to cope with the sheer numbers of people needing help.
"The solution to mental health problems cannot be compartmentalised," he said.
"We need to turn that tap off."
MidCentral DHB appointed member and meeting chair Brendan Duffy said Mr Westerlund had provided valuable background and data to an "extraordinary challenge" facing the country.
"That overarching message of the pain, the stress and the challenge, is way beyond the physical structure," he said.