The mental health and addictions workforce is in crisis, with hundreds of unfilled vacancies leading to stressed and over-worked staff and patients unable to receive the help they need, medical professionals say.
Figures obtained by Checkpoint show there were about 650 mental health and addictions vacancies at Health New Zealand.
Mental Health Foundation chief executive Shaun Robinson said the high number was frustrating.
"It's not good enough and it really reflects decades of neglect and lack of planning around mental health, across multiple governments, and particularly around workforce.
"It makes me sad. It makes me angry."
Over 650 mental health and addictions vacancies at Health NZ
The figures show that at 31 March there were 656 vacancies in New Zealand, including 380 registered nurses and 130 psychiatrists.
Health NZ is working on getting updated figures, but mental health staff have told Checkpoint they had not noticed any change in the past few months.
The shortages should not come as a surprise, Robinson said.
"This level of vacancies hasn't emerged overnight. It's been mounting over the last decade and yet there has been very slow movement to address it, either from politicians or the health system itself."
The number of vacancies doubled between 2018 and 2022, and had since remained high.
Robinson said the government's mental health workforce plan and its concrete targets were a substantial change, but staffing levels could take five to 10 years to build.
"That's not something that the public likes to hear and it's not something that politicians like to say loudly because everybody wants to see a quick fix to mental health but, sadly, there isn't one."
New Zealand Nurses Organisation mental health section chairwoman Helen Garrick said the mental health and addictions service had been at crisis point for some time and there were difficulties attracting skilled, experienced, specialist nurses.
"The effect is the under resourcing of the key areas of acute inpatient forensic and community mental health settings, which means that our service to people within those areas is declining because we're unable to meet the needs of the people who come into those services."
This caused stress for staff and patients.
"Every nurse I talked to across the whole country says they're under staffed. I think there are probably some areas where it's difficult to attract staff but, overall, I think, most of the services are struggling with this."
Royal Australian and New Zealand College of Psychiatrists chairman Dr Hiran Thabrew said the shortage of psychiatrists meant people needing early intervention and help could not get it, and become more unwell.
"That's one in five positions that are vacant and we know that has quite an effect on the workforce.
"People come into the profession to look after people, so when these workforce shortages are that severe people often feel like they can't do their best for their patients, and it does affect them."
It was harder attracting staff to certain areas, such as Northland, and some specialist psychiatrists were particularly difficult to recruit, Thabrew said.
"We know that certain sub specialities have been more affected than others.
"Child and youth mental services have greater shortages of psychiatrists - probably about one in four rather than one in five, as other specialist areas do.
"I think young people are disproportionally affected by the workforce shortage."
Having a specialist minister for mental health, Matt Doocey, was a good start, as were improvements in collecting data, such as recent work that found the average age of psychiatrists was 55.
Making decisions based on 20- to 30-year-old data wasn't good, Thabrew said.
Health NZ said there was a programme of work this year to grow and upskill the mental health and addictions workforce, and since February there had been international campaigns to recruit experienced workers.
Earlier this year, Checkpoint revealed a senior addictions clinician, Dr Leon Nixon, was getting flown in from Australia to the Palmerston North Hospital for one week out of every four, working the remaining three remotely.
Health NZ said that short-term arrangement to address a gap in services ended in August and local staff were now doing that work.