Industrial Action by DHB Psychologists: A Letter to Right Hon Jacinda Ardern from Jeffrey Olrick, PhD, Registered Clinical Psychologist
The Right Honourable Jacinda Ardern
Private Bag 18 888
21 November 2019
Dear Prime Minister,
I am writing to you on behalf of DHB psychologists and tamariki and rangatahi with severe mental health needs across the country. I am a clinical psychologist working for the Waikato DHB Rural South Infant, Child and Adolescent Mental Health Service (ICAMHS). I came to New Zealand 2 1/2 years ago from the United States where I had practiced for over 10 years. I feel truly blessed to serve youth and their families in Aotearoa and hope I am able to settle here permanently and continue in my role providing treatment to those with severe mental health issues. I am also grateful to see a government that has taken concrete steps to begin addressing Aotearoa’s youth mental health crisis. The majority of the youth I work with have complex histories of trauma, loss, abuse, and bullying. Many of them are attempting to manage their pain by injuring themselves on a regular basis. It is an intense environment which requires specialised and highly coordinated care with evidence-based treatments.
Here is my concern: With recent funding being directed primarily to primary mental health while pay scales for DHB psychologists lag behind their colleagues in the Department of Corrections and private practice, the draining of our workforce is likely to further accelerate with serious consequences. Psychologists in primary mental health, working in isolation from other treatment providers, rarely hold clients with severe mental illness and suicide risk. These most difficult to treat, and most vulnerable to suicide and self-harm, clients will continue to collect in tertiary mental health but with fewer and fewer psychologists to treat them. Across New Zealand, 34% of psychologist positions remain unfilled. Counties Manukau has lost 67% of its psychology workforce in the last 2 years. Two psychologists cover all of Hawke’s Bay CAMHS. I am the only psychologist covering a region from Otorohanga to National Park, travelling over two hours each way from my home in Hamilton to do so.
As the government’s Mental Health report notes, medication management alone is neither supported by the science, nor acceptable to New Zealanders who want talk therapies to address their mental health concerns. While access to treatment at earlier stages of distress is vital for reducing the number of youth who deteriorate in their mental health functioning to the point of severe depression and debilitating anxiety, there will remain a significant number of youth who still require tertiary care, and these youth are the ones most likely to attempt suicide. Further, beyond my immediate concern that the youth most at-risk have access to the evidence-based care they need to recover, I also fear how the issue could be used to make bad faith arguments in an election year about the current government’s competence to address the issue (if the suicide rate remains stable or continues going up despite an influx of PMH funding).
With this in mind, I would ask for your support and advocacy in responding to Psychologist concerns as raised by APEX in their negotiations with DHBs across the country, negotiations which are now in their 11th month. Most of my colleagues, like myself, truly value working in the public sector in under-resourced communities. It is a calling for many of us, but one with a high emotional toll. I go home each day knowing half a dozen of the kids in my care, or more, will be battling thoughts of death and the urge to hurt themselves. The same is true for all of my colleagues in ICAMH services across the country. The accumulating pressures of working with youth with severe mental health issues without pay parity will surely result in further attrition and lack of recruitment, increasing gaps in treatment, and ultimately undermine the government’s message that it is addressing one of the most pressing issues of our time: the epidemic of suicide and self-injury among our tamariki and rangatahi.
Thank you for your time and consideration of this pressing matter,
Jeffrey Olrick, PhD
Registered Clinical Psychologist
APEX Waikato DHB Psychology delegate