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The Mental Health Foundation is worried appalling conditions at two secure mental health units have harmed some patients and will scare off people seeking help.
The Chief Ombudsman has named and shamed the two units - one at Wellington Hospital and the other at Waitakere Hospital. The report found some of their practices amounted to degrading, cruel or inhuman treatment.
At Waiatarau Mental Health Inpatient Unit in west Auckland patients had excessively long stays, with restricted movement because there was apparently no appropriate accommodation for them to move to.
They were kept for a long time in seclusion rooms intended for people in imminent danger. Patients were given a cardboard container to go to the toilet in.
At Wellington's Te Whare o Matairangi Mental Health Inpatient Unit, stark seclusion rooms with barely any furnishings were routinely being used to house patients because the unit was over capacity.
Mental Health Foundation chief executive Shaun Robinson says these accounts are disgusting and change is needed now.
"I totally endorse the Ombudsman's outrage and the fact that he is naming and shaming. I have seen his reports year after year, and every year we have said this is completely unacceptable.
"To see [District Health Boards] accepting the recommendations and then doing nothing about it, to see Judge Boshier spelling things out in pretty graphic detail - the appalling conditions… these are people who need healthcare," Robinson told Checkpoint.
"These are not criminals, they're not people who are in prison. And we wouldn't even accept this kind of treatment for people that were in prison for some heinous crime. It's just not good enough.
"In a context where as a country we're trying to lift our game about our response to the mental health and wellbeing of the population, that this kind of atrocious service is still carrying on is just appalling."
He said the captivity nature of the conditions at the two units were alarming.
Peter Boshier. Photo: RNZ /Dom Thomas
"Mental health services are supposed to be about care, treatment and recovery. So much around mental health is derived from trauma. This is a re-traumatising situation, as is being put in a seclusion room with no privacy and having to go to the toilet in a cardboard box.
"That would be enough to activate me into considerable mental distress. And I think most people would become very distressed if they were put in that situation. And yet we're putting people who are already mentally very vulnerable into that situation. It's just appalling.
"I do have sympathy for DHB services. I think they're massively under the pump. The demand for those services has sustained at ridiculously high levels regardless of the government's attempts to put more money into to alleviate that. I just don't think that has worked yet.
"So the services are usually understaffed and they don't have sufficient space, often for people. But I think another aspect can be the whole service approach, so I don't think DHBs can simply say, 'oh look it's all the government's fault and politicians' fault for not giving us enough resource'.
"I think that is part of the picture but you still have to orient your service to what it's trying to achieve, and for managers, leaders in those services, to be day to day accepting those conditions for patients is just… I find that very hard to fathom.
"Another avenue to explore is what has happened to the $300 million that has been put into DHB mental health services? Because again I do know from various mental health staff that sometimes the resources don't seem to make it to the places that they need to get to.
"Politicians, past and present, need to really look at the resourcing that's going into these services and into these units. Managers and leaders in those services need to look at the practices, and what's become acceptable and what isn't acceptable.
"They also need to look at how have those resources been used in those DHBs, because, to be fair, government has been trying to put more resources in. Whether it's enough... I would say it's not enough.
"All of those factors are combining to do harm to people that we're supposed to be trying to care for and lead them on a path to recovery.
"This should not be acceptable, [DHB leaders] should be drawing a line, well before it comes to this, and certainly to see this happening, even for a short time, should be enough to sound a very loud alarm and create change.
"And when the Ombudsman has pointed this out, year after year, and they have accepted that it's not good enough year after year, and get they make no change, I think this is just disgusting."
Yesterday, Capital and Coast District Health Board and Mental Health, Addictions and Intellectual Disability Service (MHAIDS) general manager Nigel Fairley said capacity issues at the Wellington unit would be addressed.
"We also recognise that work is needed to address TWOM (Te Whare o Matairangi Mental Health Inpatient Unit at Wellington Hospital) high occupancy, while also understanding that high occupancy is a national - rather than regional - issue indicative of increasing demand on acute mental health services across the country."
"MHAIDS works hard to strike a balance between supporting and treating clients with complex conditions, while ensuring the safety and protection of other vulnerable clients and staff," he added.
Boshier said Waitākere had been using its intensive care unit as long-term accommodation for a patient.
"The patient was missing out on approved unescorted leave, was unable to attend daily programmes, and had limited access to phone calls.
"While the patient had originally been moved to the ICU because of the risk of violence, there was no evidence this risk still existed."
Waitematā DHB said it could not comment on the specifics of the case in order to protect privacy, but "this patient posed a significant risk to themselves and others and was unable to be managed in an open environment".