A $131 million rebuild of the Henry Rongomau Bennett Centre is set to open in mid-2026. Photo: Supplied
A Waikato mental health facility was so overcrowded at least one patient slept on a mattress on the floor for two nights as staff grappled with high occupancy.
The overcrowding at the Henry Rongomau Bennett Centre (HRBC) at Waikato Hospital meant the facility was operating at up to 115 percent occupancy in late April and early May.
The centre was lambasted by the Chief Ombudsman in early 2020 for subjecting patients to degrading treatment including overcrowding and the high use of seclusion and physical restraints.
And a $131 million rebuild of the facility set to open in mid-2026 will only cater for 64 beds, one less than was needed earlier this month.
Health New Zealand Te Whatu Ora Waikato mental health and addictions operations director Vicki Aitken said there were 65 patients in adult acute beds on 2 May at the centre which has a capacity of 60 beds.
Aitken said for the two weeks to 3 May, the centre operated at between 100 and 115 percent occupancy with the four adult wards generally operating above 100 percent.
"When this occurs we have additional spaces that we convert into bedrooms. These are a combination of interview rooms and quiet lounge areas."
She said high occupancy reflected two key factors including that the hospital was responding to high demand for the service and did not turn away anyone who needed admission.
It also did not discharge people without them having somewhere to go.
"There is also the impact of not having sufficient longer-term rehabilitation or rehabilitation readiness capacity for some individuals who are in hospital for long periods due to their complex needs."
Aitken said the centre now had approval to proceed with development of a rehabilitation readiness unit to address that demand.
"This unit will complement a new community-based intensive rehabilitation service, specifically designed for those with the most significant and complex needs. We hope to have this service running in October."
Of the patients within the adult acute wards, 11 had been at the centre for three months or longer and the rehab ready unit was targeted to them.
"We have a number of people who have been in hospital for long periods given their complex rehabilitation needs," Aitken said.
"They have not been seen as suitable by other residential settings or are not ready to live independently.
"This is the group that is expected to be most suitable to receive the new service approach described above."
In March 2020 the Ombudsman was critical of staff burnout, and not fit-for-purpose wards at the centre such as Puna Poipoi Forensic Rehabilitation ward where bedrooms were small and there was not enough showers and toilets.
Aitken said while upgrades had been made to showers and toilets and two more beds were added in the forensic area, the bedroom size had not changed.
Staffing numbers had also increased significantly over the past year with 56 extra staff, made up mostly of nursing and healthcare assistants.
There was now a dedicated person focused on recruitment resulting in the centre being 98 percent staffed.
Aitken said there had been specific work to address the ombudsman's report, which said the facility was in crisis after unannounced inspections in September 2019.
These included working on a business case for additional rehab ready beds, upgrades to the ward and low-stimulus area, and enhancing bedrooms, bathrooms, seclusion rooms, and the outdoor environment.
Aitken said staff had also been praised in an independent surveillance audit on their efforts to reduce seclusion and there were now designated and approved seclusion rooms.
There was also a change to a Māori-led practice model across mental health areas, focusing on the cultural aspects of care for patients, with Māori clinical nurse specialists working closely alongside a cultural support worker to provide intensive cultural support.
"This is assisting in reducing seclusion practices within the intensive care area."
A month after the Ombudsman's inspections, the government announced a $100m rebuild of the Henry Rongomau Bennett Centre which then prime minister Jacinda Ardern said was not fit-for-purpose.
A business case with capital funding of $155m was approved by joint ministers in June 2022, funded through the Health Capital Envelope, which included funding for the replacement HRBC as well as the Waikato Regional Renal Centre (WRRC), which was on the preferred site of the new mental health facility.
More funding was approved in September 2023, bringing the total budget to $175.6m.
Aitken said the increase was needed to address extra costs when a contractor was hired to build both facilities, with $131.2m for the mental health facility and $44.4m for the renal centre.
The replacement mental health facility would have space for 64 beds, as well as eight internal courtyards and be located in the northern part of the Waiora Waikato Hospital campus.
The contractor, Naylor Love, was expected to begin construction of the new Adult Acute Mental Health Inpatient facility next month with completion set for mid-2026.
The new renal centre building was on track to open early next year.