Photo: RNZ
Warning: This story discusses suicide
An Auckland mother struggling to get help for her daughter is not surprised another teen took her own life after a long wait for mental health support.
The mum - who RNZ has agreed to call Emily to protect her daughter's identity - has spent the past eight years dealing with the public mental health system for her daughter, who is now 13.
It was suspected Emily's daughter had ADHD, so she was first referred to Auckland's Kari Centre, for youth mental health, as a five-year-old.
"They ended up telling me I needed to go on a parenting course, which I found weird since she wasn't my first child, but I did it," Emily said.
"The next referral was when my daughter was nine and things got really bad with her mental health - she was depressed, self-harming, reusing to go to school, acting aggressively and sleeping poorly."
Emily said she had to call police on her own child eight times due to fears for her own safety and there were frequent hospital stays.
"I begged the centre to see her and help me. I ended up trying a private psychiatrist as I thought that might be less of a wait, but it was so expensive and the wait times weren't any better."
The Kari Centre started Emily's daughter on medication, and told her that she would "grow out of it".
"There was one night she attempted to end her life and I ran after her and called the centre and had to beg for them to help us".
Emily said her daughter was eventually diagnosed with severe ADHD and Oppositional Defiant Disorder (ODD).
"It's been a traumatic eight years for our family - I've been pushed back over and over again and it's been a full-time job trying to get help.
"At one point I thought about sending her to live with my sister in England so she could access mental services over there".
Service 'woefully inadequate' - coroner
Emily is not the only one concerned about the wait times and care at youth mental health services in New Zealand.
In 2020, a 14-year-old girl who had been waiting for an assessment at the Kari Centre took her own life the day before she was due to be seen.
Coroner Alison Mills said the girl had been on a six-month waitlist for help in the months leading to her death.
She ruled it was "unacceptable" for a young person with suicidal thoughts and previous attempts to have to wait so long for help.
The teen had first been referred to the centre in 2018 and again in March 2020, for four "mindfulness sessions", which she said "weren't useful".
She was referred again, two months before her death, and was on the waiting list for assessment, treatment and an urgent risk review.
Unfortunately she died before an urgent assessment could take place.
Coroner Mills said the service provided by the Kari Centre had been "woefully inadequate" and recommended the centre ensured it was fully staffed and had senior clinicians, along with auditing the waitlist and current practice to make sure there was compliance.
The findings were provided to Te Whatu Ora and the Mental Health and Addiction Directorate to "draw attention to the traumatic consequences of understaffing", Mills said.
'Not surprising'
When Emily was told about the 2020 death of the teenager she said it was upsetting, but she was not surprised to hear a child died while waiting for help.
"It's so hard to get help and it really does impact the entire family," Emily said.
"I'm a single mum and my daughter has other siblings who have been impacted by all this too, I ended up spending time in respite care a year and a half ago because I had a nervous breakdown over it all".
One message Emily wanted to get across was that while dealing with mental health issues in your children could be "hard and isolating", there were hundreds of parents experiencing a similar thing.
"You're not alone even though it can feel like you're the only person in the world going through it".
High demand for service
ADHD New Zealand spokesperson Darrin Bull, said he had heard from many families that their children had to be in a crisis situation before they could be seen.
"It's hard to get an appointment and people have to wait a long time. It means many parents choose to go private and the wait time there is now just as long as the public waitlist."
The issue had been building since the late 90s, Bull said, but had ramped up since the Covid-19 pandemic.
"It's a systematic issue - we need more workers to relieve pressure across the mental health sector".
Clinical psychologist Doctor Marthinus Bekker agreed there was high demand on the sector which did not have enough clinicians.
"There are a lot of caring people working in mental health, but we lack resources and the shortcomings are quite notable.
"Staffing shortages is a big contributor and it means we can't keep up with community demand".
While the system faced serious challenges, Bekker stressed it should not deter people from reaching out for help when it was needed.
"Finding help can be a challenge, but it's still best to go to your GP and advocate for yourself. The earlier we catch these things, the better the outcomes".
Te Whatu Ora responds
Te Whatu Ora hospital and specialist services director Dr Mike Shepherd said wait times could be long due to a range of issues, including increasing demand for services and workforce shortages.
"When a person is referred to a specialist service their needs are triaged, with people who have the greatest need being prioritised and seen urgently if necessary.
"In non-urgent cases, there may at times be delays in accessing specialist treatment. However, we want to emphasise that when a young person who needs acute care for mental health issues is referred to a specialist service, they are always prioritised and seen urgently".
There was presently a 10 percent vacancy at the Kari Centre, Shepherd said.
If an urgent or acute referral was made, Shepherd said the young person would be seen within a week, depending on their need, while non-urgent referrals were seen for an initial assessment within three weeks.
Further treatment had an average wait time of 3.5 months, Shepherd said, but many young people did not need this and could be treated by other providers.
Since the coroner's report on the death of the 14-year-old girl, Shepherd said the amount of time it took for a child or young person to be seen for an initial assessment had been "significantly reduced" as well as for ongoing treatment.
He said since January 2023, six complaints had been made about the Kari Centre.
Where to get help:
Need to Talk? Free call or text 1737 any time to speak to a trained counsellor, for any reason.
Lifeline: 0800 543 354 or text HELP to 4357
Suicide Crisis Helpline: 0508 828 865 / 0508 TAUTOKO (24/7). This is a service for people who may be thinking about suicide, or those who are concerned about family or friends.
Depression Helpline: 0800 111 757 (24/7) or text 4202
Samaritans: 0800 726 666 (24/7)
Youthline: 0800 376 633 (24/7) or free text 234 or email talk@youthline.co.nz
What's Up: free counselling for 5 to 19 years old, online chat 11am-10.30pm 7days/week or free phone 0800 WHATSUP / 0800 9428 787 11am-11pm Asian Family Services: 0800 862 342 Monday to Friday 9am to 8pm or text 832 Monday to Friday 9am - 5pm. Languages spoken: Mandarin, Cantonese, Korean, Vietnamese, Thai, Japanese, Hindi, Gujarati, Marathi and English.
Rural Support Trust Helpline: 0800 787 254
Healthline: 0800 611 116
Rainbow Youth: (09) 376 4155
OUTLine: 0800 688 5463 (6pm-9pm)
If it is an emergency and you feel like you or someone else is at risk, call 111.