By Jared Savage

A damning internal report into mental health and addiction services in the Bay of Plenty has led the DHB to commit to changing the “low-trust, punitive workplace culture”.

Around 150 staff in Tauranga and Whakatane were interviewed for 300 hours over 12 weeks by a consultant commissioned by the District Health Board in October last year.

The DHB refused to release the full report but a summary reveals the majority of staff gave “very negative” or “negative” ratings for their workplace.

Of the 70 nurses interviewed, none gave a “positive” rating and just 10 were neutral. The rest were “negative” or “very negative”.

The Bay of Plenty DHB is promising to change the workplace culture of mental health services in Tauranga and Whakatane.

Of the 31 social workers, occupational therapists, counsellors and advisers spoken with, none gave a positive rating and just two were neutral. The rest were “negative” or “very negative”.

“Most of what we found added clarity, context and greater understanding of themes of concern that some of you have been expressing over time,” according to report summary shown to staff in May.

An “immense workload” led staff to say “sometimes it feels like we’re drowning”, the accommodation was “awful”, staff felt unsafe and “nobody seems interested”, while the workplace culture was described as “low-trust, punitive”.

Consistent themes were the “significant amount of stress and distress”, the need to rebuild trust and confidence in the leadership team, and a strong desire to change the culture.

The report also listed “psychiatrist resources” and “complex HR issues” on a slide in the presentation titled “What we’ve been doing”.

“We’re making an immovable commitment to improve safety, culture and wellbeing,” was one of the key messages to staff, who were thanked for their commitment, expertise and desire to improve.

The leadership team was also rearranged and the report said one of the next steps was to seek Expressions of Interest for those interested in being the “Interim Clinical Director”.

The current Clinical Director, Dr Sue Mackersey, did not respond to email or voice messages from the Bay of Plenty Times.

The BOP DHB declined to release the full report, written by Rap Consulting, which was sought under the Official Information Act.

This refusal has been appealed to the Office of the Ombudsmen and the DHB, after being asked to reconsider by the Bay of Plenty Times, did release a slideshow summary of the report shared with staff.

“We would be happy to clarify any areas in the presentation as required as we are providing this in good faith and with the expectation that it is not misrepresented,” wrote Debbie Brown, quality and safety manager for the DHB.

When the Bay of Plenty Times asked questions to clarify certain aspects of the summary report, Brown said these would be treated as another request under the Official Information Act.

Government agencies, like the DHB, have up to 20 working days to respond to requests under the OIA.

“Mental Health & Addictions Services teams have been under significant pressure due to the growing volume and complexity of the work demands on them, along with having to work in suboptimal accommodation and enduring difficulties in recruiting expert staff,” Brown said in a statement with the summary report.

“In addition, there is a high level of risk of harm to staff who work in our inpatient and community teams from assault by unwell clients and a high degree of public criticism of the Mental Health system.

“All of these factors have contributed to high levels of stress within the services and the Executive Team wanted to give staff a safe place to share their concerns, perspectives and opportunities for the future.

“With this information, we expected to progress a series of improvements to improve the wellbeing of our workforce, so that in turn they are best equipped to serve the needs of our clients.”

While there is also a national review into mental health services, led by former Health and Disability Commissioner Ron Paterson, Brown said the DHB was taking a “fresh focus on our current services” in the Bay of Plenty.

“It matters to us that staff feel valued, listened to and taken care of – these were some of the issues of expressed concern from staff that prompted the [report]

“A few months on we have a new sense of energy, positivity and opportunity within the teams and are excited about what the future holds for the services.”

The report was commissioned in October just two months after the Bay of Plenty Times published leaked emails and a letter raising concerns about staff being attacked by patients high on P or synthetic cannabis.

Comments from mental health and addictions staff

• The workload is immense and sometimes it feels like we’re drowning.

• Some of our accommodation is awful.

• We feel unsafe at times and nobody seems interested.

• We have a low trust, punitive workplace culture.

• We need a safe place to have a voice and be heard.

• We want to help make things better.


  1. Tragic, isn’t it, how things have changed in our mental health units over this last generation. And I can tell you exactly why : It is simply due to our 1992 Mental Health Act which now allows you to behave insanely, to verbally threaten or scare people, to be obviously out of your senses – without any consequences. And unless placed under treatment order a patient can refuse medication. Before 1992 such citizens would be immediately uplifted by police and placed in the nearest mental hospital where trained psychiatric staff knew what to do : You would be placed in a secure room and seen by a psychiatric specialist. You would almost always be given medication whether you agreed or not – because in those days, by behaving insanely, by merely being non compos mentis, you had forfeited your ordinary civil rights. As soon as you came to your senses (within a day or perhaps a week) you would get an ordinary bedroom and join the other peaceful patients in the ward – new admission cases would be out of the acute unit within an average of three weeks. The result was that acute mental health units were the most peaceful, non-threatening places you can imagine – unlike today. In those days it was very common that people with ordinary depressions would admit themselves for a few days respite, soul-searching and treatment in the tranquil environment of an acute admission ward. Compare that with the circus you observe in such wards today – where staff are obliged to kowtow to patients no matter how abominably or how madly they behave. Yes, of course I know that they can be forcibly given medication if they cross a certain threshold of symptom-clusters (as the Act puts it) – but that is a complicated and time-consuming process. And quite often psychiatrists are unable (because of the Act) to sanction any treatment – this has caused many atrocious murders since 1992. That is the provision I want removed from the Act. If we did that (and acquired quite a lot more more psychiatric in-patient beds all over the country, I believe most of today’s problems would be solved.

    But just throwing more money to Mental Health Services will not work.


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