Mental health apps are part of the solution, but the contexts that create mental distress matter too Image: Tina Tiller
Worrying accounts of interactions with mental health services are reaching tens of thousands on TikTok, as young New Zealanders shine a light on a broken system.
Warning: This piece includes reference to suicide.
A small colony of ants crawls over a toothbrush into a grime-covered sink. Dark splotches resembling black mould grow in the corners of the ceiling. Mysterious stains splatter across the linoleum floor.
“This is a video of an ant-infested bathroom in a public mental health unit in New Zealand,” writes a frustrated patient.
“Would you want yourself or your loved one to be admitted to somewhere like this?”
An anonymous user has gone viral on the social media platform TikTok through documenting their experience at a New Zealand mental health facility over the past month. The user, who goes by the pseudonym @fullmoon.nightshift, has garnered over 177,900 views across eight videos on the account.
The videos, showing everything from an unclean bathroom to an occupational therapy room covered in “disturbing artwork”, serve as a bleak reminder of the current state of New Zealand’s mental health system. The posts have been met with similar sentiments shared amongst commenters: “The biggest thing I learned in my mental health journey is that I cannot rely on the system to help me,” responded one viewer.
The anonymous creator confirmed in a comment that the facility was Hillmorton Hospital in Christchurch, which in July was called “one of New Zealand’s worst mental health hospitals”, with Stuff reporting that almost a third of staff resigned in 2021 amid what the nurses union said were serious staffing and safety issues.
Screengrabs from videos shared by @fullmoon.nightshift on TikTok
Other videos on the account document the patient’s daily life in the ward, with one showcasing the hospital’s outdoor exercise area, which has been compared by viewers to a “prison yard”: tall wire fences wrap around a small patch of grass as a camera pans to show graffiti-covered walls and worn-in wooden benches. “I’m posting this for awareness of the conditions us MH patients are faced with… I’m forever thankful for the ward and staff providing MH care but these conditions need to change!”
This account is just one of a growing number across social media platforms being used to share experiences of rejection, frustration and heartbreak from people who feel failed by the New Zealand mental health system, both within the private and public sector.
But why are people resorting to sharing their grievances on social media rather than directly to the providers of the services?
It’s a trend that isn’t surprising.
“[Social media] feels like a much safer place in regards to mental health than the real world…,” Bianca Tosh told me. “Just because there’s access to so many people around the world that are suffering or are facing the same things as you, so it’s comforting being less alone.”
Aucklander Tosh, 19, went viral on the same platform a few months ago when she posted a video asking for others to share their experiences with the national 1737 service – one of the multiple mental health helplines available in New Zealand, but the only government-funded service. The helpline was launched in 2017, funded by the Ministry of Health, designed to “fill the gaps” for people who felt like they couldn’t contact specialised helplines available, such as The Lowdownor The Suicide Crisis Line.
“I’ve reached out to it and not had a good experience, and I’ve talked to other people,” Tosh explained. “I hadn’t really talked to anyone who had had a really good experience with the number, so that just sparked my interest.”
The original video posted by Tosh has received over 127,000 views and 1,000-plus comments, many from people saying they had a similar experience with the service.
And the responses were heavy.
“I got told to man up because I’m an Islander,” wrote one user.
“They put me on hold for 2 hours then told me to call back when im not crying,” wrote another.
The sheer volume of responses was alarming enough to sift through, let alone the heartbreaking stories accompanying them.
“With my video I did say I had a negative interaction but I never asked for negative responses only – it was just so shocking to see so many people react, and to have the vast majority of them be negative,” Tosh told me.
Screengrabs from Bianca Tosh and Grace Pene’s TikTok videos
Like Tosh, Whitianga-based Grace Pene posted a video on TikTok expressing her frustration when her sister received a letter from the Bay of Plenty District Health Board. In the video, Pene explains how her sister, who struggles with depression and anxiety and has previously made attempts to take her own life, went to her GP to ask for help. The letter she received stated that her sister did not meet the criteria for enrolment in secondary mental health services.
“What the fuck does that even mean?” asks Pene in the minute-long clip. “You have someone right in front of you, asking for help, and she doesn’t meet the criteria.”
The video, originally posted to her account on June 12, has now more than 79.7k views and over 1,100 comments. While Pene put up the video initially out of frustration and to spread awareness, she didn’t expect it to garner such attention. “[My sister] feels like she’s just another cog in the machine that’s just going round and round and getting spat out at the end of it,” Pene said. The letter, she said, was the catalyst to starting her own local mental health support group in Whitianga after being dismayed by the lack of services available in her community.
Pene felt that sharing her story on social media was the only way she would be listened to. “In my experience, people are just sick and tired of getting turned away or turned down… If you put those videos out there, people can’t look away,” she explained.
“The more that people spread that awareness, I think, hopefully, the more the health system listens.”
It’s clear that social media has become more than a platform in terms of exposing the country’s mental health crisis – it’s being used as a tool to highlight the cracks of a mental health system that has failed its most vulnerable time and time again. But whether the government is listening remains unclear.
WHERE TO GET HELP
Lifeline – 0800 543 354 (0800 LIFELINE) or free text 4357 (HELP).
Free call or text 1737 any time for support from a trained counsellor.
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Clockwise from left: UAE, Portugal, Uruguay, Denmark, Singapore (photos: Sacha Fernandez CC BY-NC-ND 2.0, Sam Valadi CC BY 2.0, Getty Images, Creative Commons)
Clockwise from left: UAE, Portugal, Uruguay, Denmark, Singapore (photos: Sacha Fernandez CC BY-NC-ND 2.0, Sam Valadi CC BY 2.0, Getty Images, Creative Commons)
Scott Morrison has urged New Zealand to ‘come out of the cave’ and open up to the world once our vaccination rates ramp up. So what is happening in the world’s most vaccinated countries? George Driver takes a look.
New Zealanders in lockdown are enviously scrolling through images of European summer, where life in some countries appears to be returning to normal.
Croatia is experiencing a mid-summer tourism boom, with thousands lined towel-to-towel on its beaches. In the UK, hundreds of thousands of people are attending events around the country, with about 300,000 turning up to Wimbledon alone.
Meanwhile, New Zealand – currently in the midst of the democratic world’s strictest lockdown – is being urged to follow suit and give up on elimination.
Last week, Australian prime minister Scott Morrison said we can’t stay in the “cave” of Covid-19 elimination. We need to rejoin the world and reduce restrictions, he argued. A few commentators in New Zealand have said we should follow other countries’ lead. But what does life outside of the cave look like?
A handful of countries have surpassed a 70% vaccination rate, giving a glimpse into what opening up with high levels of vaccination might look like. I have looked at the five countries with the highest vaccination rates in the world (excluding territories and microstates): United Arab Emirates, Singapore, Portugal, Denmark and Uruguay.
Their experiences to date will likely make New Zealanders tentative about opening up until we reach higher vaccination rates. On average, these countries are getting 105 cases each day per million people and a death every two days per million people. At that rate, New Zealand would have 2.8 Covid deaths and 541 cases each day. But cases and deaths can be expected to fall as vaccination rates continue to climb.
Restrictions in these countries are at about level 2.5 in the New Zealand classification. Numbers at events and restaurants are limited and mask-wearing and physical distancing is mostly mandatory in public places. Vaccine passports are widespread, with the vaccinated getting perks like being able to attend larger events, and dining and drinking indoors again.
But most of these countries are also opening up further. Denmark plans to drop all Covid restrictions this month, except at the border, while Singapore and Portugal plan to roll back restrictions when the vaccination rate reaches 80% and 85% respectively.
Pedestrians wait to cross the road in Cais do Sodre, downtown Lisbon, on August 1 2021, the day that Portuguese commerce, restaurants and live shows returned to their usual schedules following the Covid pandemic (Photo: Horacio Villalobos/Corbis via Getty Images)
In the context of what some of these countries have been through recently, with thousands of deaths and tens of thousands cases, it’s a remarkable improvement. They are beginning to remove strict controls that have, in some cases, been in place for more than a year.
But it also looks remarkably worse than what New Zealand has been through over the past year. Last month an expert panel, chaired by Sir David Skegg, recommended we continue with elimination as a long-term strategy, even as the borders open, by stamping out cases with lockdowns and other controls as they arise.
But support for a long-term elimination strategy appears to be weakening in the face of delta. Last week, epidemiologist Michael Baker said we should stay the course in the medium term until vaccination rates are up, then we can “choose our future”. Covid-19 response minister Chris Hipkins has said it’s “too early to tell” if elimination is still viable and that delta raises some “pretty big questions about what the long term future of our plans are”.
But does the experience of other countries show that opening up will mean accepting more deaths and more restrictions than we’ve had during the past year?
University of Otago epidemiologist professor Peter McIntyre says New Zealand will eventually have to join the ranks of the countries opening their borders and reducing restrictions due to delta’s infectiousness. But that doesn’t mean we will see the same number of cases and deaths when we do.
“What we will be seeing when we open up, if we have high vaccination rates, will be quite different to what these other countries are experiencing,” McIntyre says.
That’s because the other countries have been reaching high vaccination rates while battling high case numbers during the height of the pandemic, which is different to introducing the virus to a Covid-free country with a high vaccination rate.
“When the virus does arrive, if we can have appropriate use of public health measures like masking, ventilation, distancing, testing and contact tracing then we can keep numbers down as low as possible,” says McIntyre.
“But we won’t keep cases down to nothing. There are going to be people in hospital with Covid, there are going to be people who die, but we want to keep that down so hospitals can cope and it will hopefully not be so different to what happens with influenza.”
New Zealand also has the chance to learn from other countries who are starting to dive into the unknown as they open up.
At the moment, here’s what’s happening in the world’s most vaccinated places.
Total Covid-19 cases: 717,374 / 71,509 per million
Total Covid-19 related deaths: 2,039 / 203 per million
Daily cases: 1,023 / 102 per million
Daily deaths: 3 / 0.299 per million
Lockdown stringency: 54.63
Beyond the microstates and territories of Gibraltar, Malta, Iceland and Pitcairn Island, the UAE is leading the world in vaccinations, with 74% of the country fully vaccinated.
Cases are declining but are still averaging over 1000 a day with three Covid deaths a day.
According to the stringency index, its level of restrictions is between New Zealand’s level three and level two.
There are different restrictions in each of the seven emirates. According to CNN, Dubai reopened to visitors who could present a negative Covid test in August last year and has now opened up quarantine-free travel to fully vaccinated travellers from select countries.
Mask wearing and physical distancing is still compulsory in most public places, but people can go to concerts, restaurants and cafes. Large events are limited to 70% capacity and only the fully vaccinated can attend them.
In Abu Dhabi, access to a range of public places is restricted to those who are vaccinated, including restaurants, malls and gyms.
An Emirati man gets vaccinated against the Covid-19 in Dubai on December 24, 2020. (Photo: GIUSEPPE CACACE / AFP) (Photo by GIUSEPPE CACACE/AFP via Getty Images)
Total Covid-19 related deaths: 55 / 9.3 per million
Daily cases: 118 / 20 per million
Daily deaths: 1 / 0.169 per million
Lockdown stringency: 44.44
Singapore has been transitioning from an elimination strategy to a “live with the virus” strategy, contingent on high rates of vaccination.
On average, someone dies from the virus each day and 118 people get infected.
Currently its restrictions are a bit higher than New Zealand’s level two, but it’s dependent on vaccination status. According to the government, unvaccinated people can’t drink or dine out, while the vaccinated can be served in groups of up to five. Social gatherings and house visits are also limited to groups of five. Cinemas and events can host up to 1000 vaccinated people, or 50 unvaccinated, while public facilities like museums and libraries are limited to 50% capacity.
But the country plans to open up further once it’s vaccinated 80% of the population, a milestone which the government claims to have reached last week. CNN reports it plans to abolish lockdowns and contact tracing, open the borders to travellers, allow large gatherings and stop counting Covid cases. But the timeline for easing restrictions is unclear.
A senior citizen getting the Pfizer-BioNTech Covid-19 vaccine in Singapore, March 8, 2021 (Photo: Wei Leng Tay/Bloomberg via Getty Images)
Total Covid-19 cases: 1,036,019 / 101,945 per million
Total Covid-19 related deaths: 17,730 / 1745 per million
Daily cases: 2,218 / 218 per million
Daily deaths: 12 / 1.18 per million
Lockdown stringency: 52.78
Portugal has just come out of its official “situation of calamity” and started lifting restrictions from August 31, but a range of restrictions are still in place.
On average, 12 people are dying from the virus each day and 2,218 become infected. But that’s down from a peak of 330 deaths and 16,332 cases a day in January.
Restaurants and cafes are limited to eight per group and “cultural shows”, weddings and baptisms are limited to 75% capacity. Nightclubs are open, but for drinking only – no dancing – and people have to be seated in restaurants and cafes.
According to UK government travel advice there are also a range of restrictions for the unvaccinated, who can’t eat inside a restaurant on weekends or public holidays, stay in hotels, use gyms, spas, enter casinos and bingo halls or attend major events.
People have to provide a negative test to enter the country, while those from the UK and other high risk countries have to quarantine for two weeks unless they’re vaccinated.
The country plans to remove restrictions further once 85% of the population is vaccinated, with no restrictions on numbers in restaurants and cafes and events, but people would still need a negative test or a vaccination certificate to enter bars and clubs.
People wait to be inoculated with the Covid-19 vaccine in Cascais, Portugal, on July 16, 2021. (Photo: Pedro Fiúza/NurPhoto via Getty Images)
Total Covid-19 cases: 384,778 / 110,321 per million
Total Covid-19 related deaths: 6,029 / 1728 per million
Daily cases: 86 / 25 per million
Daily deaths: 2 / 0.573 per million
Lockdown stringency: 55.56
Uruguay was one of the world leaders in controlling Covid-19 until a large outbreak took hold earlier this year. It recorded the world’s highest number of deaths per capita on some days, peaking at 7,289 cases and 88 deaths in April.
Now Uruguay is down to 85 cases a day and two deaths and the outbreak looks relatively under control, which is being attributed to the country’s swift vaccine rollout. Nature reports that deaths have plummeted by more than 95% among the vaccinated.
The country’s borders remain closed to visitors, but CNN reports it plans to open to vaccinated visitors in November. It said many bars and restaurants were still closed and masks and distancing are mandatory, with restrictions at about NZ’s level 2.5.
A taxi driver is vaccinated at Carrasco airport in Ciudad de la Costa in Uruguay on April 08, 2021 (Photo: PABLO PORCIUNCULA/AFP via Getty Images)
Total Covid-19 cases: 344,088 / 58,162 per million
Total Covid-19 related deaths: 2,580 / 444 per million
Daily cases: 946 / 163 per million
Daily deaths: 3 / 0.516 per million
Lockdown stringency: 38.89
Denmark has achieved the second highest vaccination rate in Europe and its restrictions on daily life are currently about the equivalent of a New Zealand level 2.5.
On average it’s getting 946 cases and three deaths a day, down from a peak of 4,508 cases and 43 deaths a day in January.
Restaurants and bars are open, but people need a “corona passport” proving a negative test or vaccine status to dine and drink inside, and discos and nightclubs are closed. People also need corona passports to go to the gym and for indoor events with more than 500 people and outdoor events with more than 2000 people.
But Denmark has announced a bold plan to remove all Covid-19 restrictions, except border controls, on September 10, Forbes reports.
The country has border restrictions including 10 days quarantine, a negative pre-departure test and testing at the airport for arrivals from high-risk countries.
A customer in a Copenhagen bar shows their Corona Pass, an app that displays the results of recent antigen tests and the user’s vaccination status. (Photo: Tom Little / AFP via Getty Images)
New Zealand is in the midst of the world’s hardest lockdown, according to Oxford’s Our World in Data, although daily case numbers and deaths are still lower than in the world’s most vaccinated places as we continue to pursue elimination.
Will we stay the course with elimination in six months time? As the world’s most vaccinated countries open up further, and vaccinate more, over the next few months options will become clearer. In the meantime, we still have time to vaccinate and then, in the words of Michael Baker, “choose our future”.
The data above has been sourced from Oxford University’s Our World in Data programme’s vaccination rates and stringency index, while case numbers and deaths are from Worldometer. Territories and microstates have been excluded. Daily deaths and case numbers are a seven day average. Vaccination figures are for the percent of the total population fully vaccinated. Figures are as of August 30.
