< Return to Contents | Previous I Next >

We heard that mental health services often make it difficult for individuals to stay connected to their families and communities. They acknowledged that mental distress can put immense pressure on an individual’s relationships with family and other networks, sometimes to the point of breakdown, and that family can generate and exacerbate distress. But relationships with family, whānau and community give lives meaning and provide a potential path back to wholeness. Many people described how mental health services have severed or jeopardised these relationships.

The moment that mental health became involved in his treatment, we were isolated from him. … As parents we were treated worse than criminals. (Family member of service user)

A significant number of submissions from families told of their being excluded, offered culturally inappropriate services or even treated with contempt or indifference.

Our experience is one of marginalisation, frustration, worry and never having a voice. (Family member of service user)

People praised Whānau Ora providers for valuing the role of family and whānau in keeping people well and supporting their recovery. They wanted service providers to share information in an environment of trust and to work with families to enable their support role.

When families and whānau are included in meetings with clinicians it makes a difference – families know what is happening for their family member and are given opportunities to ‘fill in the gaps’; so the clinician has the full picture of what is happening at home for the consumer and can make better informed decisions about subsequent treatment. (NGO-collated responses from family and whānau)

2.7.1 Privacy concerns

Families described being kept in the dark and excluded from treatment and discharge planning, even though they are the ones there for the long haul. Families and whānau reported struggling to support their loved one with complex needs or at risk of suicide while receiving little help from services, little education about what to do and limited respite. Families often felt excluded from care plans, treatment and follow-up, despite many times being primary supporters of their family member.

What families want is guidance on how to deal with situations, how best to reinforce the goals being worked on at that point, the opportunity to work as part of the [mental health] team. (Family support person)

Submissions from family members said that privacy was used inappropriately as a reason for withholding information from them (for example, in discharge planning). Families spoke of loved ones discharged without the family being notified and without appropriate support, and some described subsequent self-harm or suicides they believe could have been prevented with family intervention.

[My family member] went to hospital at 5pm that night after an attempt to kill [themselves]. Less than 5 hours later [they were] assessed and released with no way of getting home. (Family member of service user)

Some submissions noted that family members may be part of the problem or have agendas that conflict with the individual’s best interests. Others expressed concern about clinicians sharing information without the consent of tāngata whaiora.

2.7.2 Support for families

Families spoke of the difficulty of accessing advice, respite care or other forms of assistance to help them support their family member through mental distress and during recovery. They spoke of overloaded crisis services, a lack of integration and continuity of care, and having loved ones returned to their care with little information or support.

We are winging it. We are winging it. (Whānau Māori)

We heard from grandparents caring for their mokopuna while the parents were in residential programmes or in prison and from older people caring for adult children, concerned about what would happen once they were no longer able to provide or oversee care.

Some families said they were dealing with multiple intergenerational disadvantages, layers of trauma, limited skills and ongoing addiction. They asked for help to address their own wellbeing challenges.

2.7.3 Support for suicide bereaved families

Hundreds of submissions from families and whānau affected by suicide highlighted serious deficiencies in how they were supported through an extremely traumatic process. They spoke of lengthy police, coronial, DHB and Health and Disability Commissioner processes, feeling excluded from full involvement in DHB reviews, inadequate communication from services and professionals, a sense of being disregarded and excluded, a lack of affordable professional services, services that were not culturally appropriate for their grieving, and processes that were traumatising rather than healing.

No one should be made to feel tortured on top of feeling their immeasurable loss and grief … (Bereaved family member)

Those of us bereaved by suicide are the forgotten group, we’re expected to get over it, get on with it and fall back into life as it used to be. Well we don’t get over it, we try to manage it and where we are is our new ‘normal’ but we can’t do this alone … Postvention needs to sit alongside prevention and be resourced and supported … (Peer-support group for suicide bereaved)

2.7.4 Cultural support

Māori and Pacific peoples pointed to evidence that treating the mental health of an individual in isolation from family and community is ineffective and inappropriate for cultures that value collectivism. They argued that cultural approaches are vital to recovery and get much better outcomes – so should be funded and supported. Many Pākehā and other ethnic communities voiced similar concerns about treatment models that do not sufficiently acknowledge family, whānau and social context.

People were dismayed that many clinicians working from a biomedical model were reluctant to recognise cultural evidence and failed to appreciate the value of staff and support people from the individual’s own culture. Culturally appropriate services were described as rare and poorly resourced.

Communities need the opportunity to shape models of care so that they fit the needs (cultural and social) of the communities they serve. (Community advocate)

< Return to Contents | Previous I Next >

Last modified: