The future of who responds to mental health callouts is changing in Aotearoa.
The future of who responds to mental health callouts is changing in Aotearoa.

SocietyNovember 6, 2024

The police pullback on mental health callouts, explained

The future of who responds to mental health callouts is changing in Aotearoa.
The future of who responds to mental health callouts is changing in Aotearoa.

Police have begun gradually reducing their response to mental health callouts, with health staff expected to step up. Here’s what you need to know.

The changes to police’s mental health response, led by NZ Police, the Ministry of Health and Te Whatu Ora, were revealed at the beginning of 2024, and will be implemented in phases over five years. Police have already confirmed the first four stages, to be completed between now and September 2025, which will involve gradually lessening the resources and time spent at low-risk and crimeless mental health callouts, with the end goal of the first year being police only needing 15 minutes to handover patients to emergency department (ED) staff. A health-led response is expected to pick up where police left off.

The first phase began this month, with the introduction of higher thresholds for mental health transportation requests and attendance at mental health facilities before police agree to get involved, as well as police reducing the time spent on voluntary mental health handovers (where people ask to undertake a mental health assessment with health professionals). Police emphasise they will still attend incidents where there is an offence or an immediate risk to life or safety.

Why are police doing this?

To reprioritise where the police are spending time and resources to focus more on instances that pose immediate risk to life and safety, in order to “relieve demand pressures”, they say. According to police data, attending mental health-related incidents made up 11% of all callouts in the 12 months to May 2024, a figure that has risen by 64% over the last five years

Police say pulling back from mental health callouts will redirect resource to more pressing jobs (Photo by Kai Schwoerer/Getty Images)

In August, then police commissioner Andrew Costner said the force received a mental health-related call every seven minutes, which he said took up “about half a million hours of police frontline time per year”, and only 5% of these calls had a criminal aspect. “It has been clear to me for some time that this is simply not sustainable and prevents us from keeping other areas of  the community safe,” Costner said in a statement. “It impacts our ability to deliver core policing service.”

Reducing the “criminal justice response to many mental health-related calls” also aligned with Kia Manawanui, the whole-of-government plan for mental wellbeing, and would “minimise trauma and coercive treatments”, said a police briefing sent to the minister of police in July. “Most persons in distress do not want police to attend their event unless it is absolutely necessary,” said the briefing. “People experiencing mental distress deserve to have the right people helping them.”

While acknowledging that reduced attendance could “create a reputational risk that Police is perceived not to care”, it was rarely the best agency to respond to a mental health event, said the briefing. “Limiting Police-led responses can have a positive impact by reducing the stigma of mental health and avoid inadvertently criminalising a health event. Additionally, it will likely result in increased Police visibility in the community, contributing to a greater perception of safety.”

What are the next stages?

The second phase, originally planned to commence in January 2025 but now delayed until March, will see 60-minute ED handovers, with police leaving hospital emergency departments within an hour of transporting a person detained under the Mental Health Act. A tightening of mental health custodian rules will also be introduced to ensure those in distress are not needlessly assessed in police custody.

Police will now be spending less time in emergency departments. (Photo: Phil Walter/Getty Images)

The third phase, originally planned for April to June, is a higher threshold for responding to requests from health practitioners,, and a rejig of handling of reports of missing mental health patients. On the latter change, police said these reports generate more immediate attention than other missing persons reports, and police will work with agencies to establish a new approach that will include the police not being the first to begin a search.

The fourth phase, planned for July to September, will see ED handovers reduced to 15 minutes, and a reduced response from frontline officers to welfare check requests from the public and agencies. “Police have been over responding to welfare checks where there is no risk of criminality or to life or safety,” a statement read. “We are aiming to reduce demand on frontline staff but are conscious the issues are complex so we will continue to talk to partner agencies before making any final decisions.”

Police minister Mark Mitchell and minister of mental health Matt Doocey are expected to discuss the phases in years two to five with Cabinet in November.

Who will help now?

Health staff will now be considered the first responders to mental health callouts. These staffers, including those who may have already completed a full shift, will be expected to respond to after-hour callouts and to transport patients for admission with less – or zero – police assistance.

Te Whatu Ora documents obtained by Stuff last week showed standard operating procedures (SOPs) for health staff responding to mental health callouts were yet to be finalised. Interim SOPs outlined expectations before police would attend a mental health callout, including de-escalation techniques, medical or pharmaceutical intervention, using security teams or family for help, caring for a person in a low-stimulus area and removing staff and others from the area. Te Whatu Ora’s interim national clinical chief for mental health and addiction, Murray Patton, said SOPs would be finalised as the changes were rolled out and staff had given feedback.

Some health staffers take on extra responsibilities as duly authorised officers (DOAs), who are expected under the Mental Health Act to ensure required procedures are met when undertaking a compulsory assessment. A RNZ report on Monday found that at least half a dozen DOAs had forfeited their extra duties in the lead-up to the changes to the police’s response to mental health callouts because of concerns for their safety. Te Whatu Ora said this was “a very small proportion of the total number of DAOs in that area and this does not appear to be happening in other places”.

What do police and health workers think?

Police have continuously defended the decision to change their response to police callouts, with the argument that resources are being taken from criminal jobs, and that police are not always the appropriate force to respond to a mental health crisis. The Police Association has petitioned for changes in the past, and last year lobbied the government for a police response similar to the UK’s Right Care, Right Person approach to mental health, another model that has seen police reduce their response to these instances and instead treat health staff as first responders.

The New Zealand Nurses Organisation has criticised the changes, with the warning that mental health services are already over-stretched, and many nurses lack the legislative power to detain people and the tools to keep themselves safe in a crisis situation. A survey conducted by the NZNO found that 90% of respondents believed they and their patients would be more at risk without police. Another survey by the Public Service Association, mental health workers, said that nine in 10 employees also believed they and their patients would now be more at risk.

“It’s been a disaster – the police said months and months ago this was going to happen,” said NZNO chief executive Rob Goulter. “Clearly Te Whatu Ora has been so absorbed with its own internal problems that this one sailed straight past them.

“To be at the last minute still trying to sort it out at this critical juncture, when it’s a critical health and safety risk for patients as well as for staff… it’s not acceptable.”

Most mental health workers believe they and their patients will be more at risk without police assistance. (Photo: Getty Images).

Yesterday afternoon, Te Whatu Ora put out a statement saying it had a phased implementation plan in place, and acknowledged that “changes like these are not easy, and we recognise there will be a period of adjustment”. 

“We value the work of our people throughout this transition and emphasise that we do not want staff to put themselves in risky situations,” it said. “Teams should continue to follow usual processes, including shared decision-making, seeking support of senior staff for advice, and escalating matters as needed.”

Te Whatu Ora faces its own challenges as it looks to a forecasted $1.7bn deficit by June 2025, which has been chalked up to overspending on hiring nurses, despite health workers  across the motu having consistently complained about staffing and resource shortages for years. This also includes a shortage of mental health workers, an issue Te Whatu Ora plans to address with its Mental Health Workforce Plan released in September, which aims to increase the number of mental health and addiction nurses by 85% from 2025 to a total of 22 experts trained year on year.

Who else has concerns?

The Mental Health Foundation supports the concept of a health-led response, but in September wrote to police minister Mark Mitchell to express “serious concerns” about the “rapid police withdrawal”, given it had “not seen a tangible response from Health New Zealand about how the health system will be able to fill the void in acute mental health crisis presentations given unprecedented demand and the severe workforce shortages, other than a commitment “to put a robust operational plan in place”.

Sarah Gordon, an associate professor at the University of Waitako’s school of health, shared a similar sentiment in comments to the Science Media Centre, saying “an unintended result of this plan is that people experiencing mental distress may not have access to any help whatsoever. These lines in the sand for Police reducing services must correspond to others being prepared and having the ability to increase services.”

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Outdoors with Maggie (Photos: Alex Casey)
Outdoors with Maggie (Photos: Alex Casey)

SocietyNovember 5, 2024

I survived a night camping with my dog

Outdoors with Maggie (Photos: Alex Casey)
Outdoors with Maggie (Photos: Alex Casey)

Alex Casey takes her rescue dog Maggie on a dog-friendly camping adventure and lives to tell the tale.

Part of my bargaining in us adopting a dog this year was that I swore not to become one of those barmy people who takes their dog with them on holiday and keeps a daily journal written in the dog’s voice of everything that the dog experienced that day (I’ve seen it done, I’ve read the pages). But when Joe started packing for our camping trip and asked where his backpack was, my reply made me realise that perhaps I hadn’t entirely kept my word. 

“That’s Maggie’s bag,” I said, gesturing to his Macpac backpack, now overflowing with an assortment of chew toys, food bowls, treats, towels, poo bags and even a dog sun hat. 

Maggie is our giant-headed one-year-old terrier cross mutt, born in the Huntly pound and shuffled through a few homes before we adopted her in January this year. Like any rescue dog, she has her quirks, and it has been a long and expensive road to get to the point where I was packing her an overnight bag to come camping with us. But if there’s one thing Maggie still loves more than growling at tall men and anxiously chewing the legs of our bed, it’s spending time with us. 

Maggie shows off her large head at Victoria Park, Christchurch

Even a dog with a head as remarkably large as Maggie’s can’t go camping just anywhere. There are 77 dog-friendly DOC campsites around the country, and plenty of useful listicles as a starting point. It always pays to ring ahead and double-check, so I was delighted when the woman from Leithfield Holiday Park, a beachside campsite 45 minutes north of Christchurch, confirmed they are still dog-friendly – provided the dog stays on lead and you “pick up after him” (dogs are boys, cats are girls).

To be honest, my primary concern in ringing ahead was actually to ask about the weather, specifically whether anyone in their right mind was even camping in Canterbury at this time of year. A sting in the tail, Joe’s dad always says – beautiful warm sunny days but bitterly cold nights in spring. Local lore suggests that, just like planting out your tomatoes and your cucumbers, you probably don’t want to be spending too much time outside at night before Show Weekend

Joe was slightly more emphatic about what a stupid idea it was to go camping in November. “People don’t camp here until January at the earliest,” he muttered, quietly resigning himself over to yet another night of “hell” for a Spinoff story. But with our alpine-level sleeping bags, multiple vintage wool blankets probably used by Hillary himself, beanies, thermals and a 14kg dog that runs hotter than the solar core, I was convinced we’d be OK for one night. 

Along with the winter woolies, I had packed two different leads, a dog harness, a couple of stuffed Kongs, dog food in the chiller bag alongside the fancy cheeses and dips (sorry Joe) and roughly 30,000 poo bags (just as you assume you will soil yourself 40 times on holiday, the same must be assumed for your pet). We headed north, with a brief stop at Burger King where Maggie snaffled an undisclosed number of french fries from the back seat. 

It never fails to astound me just how quickly the surroundings in Christchurch can change. Not just from suburb to suburb, where you go from wide open state housing streets to Fort Knox McMansions in the space of five minutes, but how fast the developed areas peter out into rural farmland, and then suddenly into small towns with vege stands and signs promoting charming community events. What I would give to go to “Big Kev’s Big Dig” on December 27! 

We eventually tumbled out of the car into our fully fenced site complete with a cute picnic table, and lined with pine trees for privacy and shelter from the wind. I could hear the ocean, which was just a short bush walk away. Maggie ran around excitedly sniffing all corners of the site, while a big golden boy named Leonard eyed her through a nearby fence. Across the way, a tiny Sydney Silky named Ruby basked in the sun outside her vintage caravan. It was dog heaven. 

Maggie outside her new abode

Joe got to work pumping up the mattress (sorry Joe) and I took Maggie for an on-lead walk through the grounds. Nobody else was in a tent like us, but there were a pair of little Maltese-cross types in a glamping yurt, a Mastiff-cross puppy lolloping around a ute while his owner vaped next to their flash caravan. The great signs continued – a “beer and bullshit” area by the kitchen, the toilets emblazoned with “men to the left because women are always RIGHT”. 

When we got back, Maggie seemed bamboozled by the bright orange dome we were trying to coax her into. Much like a vampire, she requires a formal and persistent invitation to cross a new threshold, and we had to eventually resort to luring her in with dog treats. She was much more comfortable racing up and down the pebbles on the nearby off-leash beach, sniffing bums with a Kate Bosworth-eyed Blue Heeler and eating only the finest rotting seafood. 

Everything the light touches etc etc

About 10 minutes walk up the road was a little shack set up like a mini outdoor market, so that was our next stop with Maggie. We perused a colourful fridge painted up as “Nan’s Book Exchange”, which contained devastating items such as a copy of romance novel The Savakis Mistress inscribed with the reminder “2 x Ibuprofen at 6.20pm”, a self-help book about fathers reuniting with their estranged children, and Monsters University on DVD. 

Although there was a post to secure your dog while you shopped, we took turns going inside as I wasn’t confident enough Maggie wouldn’t tear out the post and devour a pair of glittery espadrilles as revenge for being left alone in Leithfield. I bought a big floppy denim hat, Maggie looked at herself for a long time in the mirror, and we headed back home past the swimming pool (no dogs allowed) and tennis court (no dogs allowed). Fair enough. 

It’s like you’re my mirror, woah-oh

It was nearing dinner time now, but I had done my research. The historic Old Leithfield Hotel up the road welcomed dogs, and we were delighted to enter through tinsel curtains to find the sequin-covered locals were gearing up for a “Great Gatsby Night”. In the corner, blokes in gumboots and high vis vests drained jugs of beer at the pool table. When one of them let out a loud guttural groan at a missed shot, Maggie tried to fit in by joining him in a low growl. 

The bloke in gumboots didn’t have much luck getting a pat from Maggie – “he doesn’t like the smell of me” – but she did let a few kids indulge. We ate our vegorama burger and chicken schnitzel outside in the dwindling sun, as a chocolate brown Australian Kelpie paced around the tables, potentially taking orders. A leather-clad biker sipped a Guinness and played classic rock on his phone, interspersed with ads for Grammarly. The night was cooling, and fast.

Melancholic barfly Maggie

Back at camp, Maggie enjoyed her al fresco Barry Soper dinner and we hastily put on extra layers. Temperatures were plummeting, and the clear blue skies had been replaced by juicy-looking grey clouds. I felt a raindrop on my head, then another, then another. “It’s been threatening us all day” said a lady wearing her pyjamas and an Oodie at the beer and bullshit area, while I paced around waiting for our phones to charge up. “Time to hunker down.” 

Soon enough, the rain was pelting our cheap tent as we huddled under sleeping bags and blankets. Instead of sleeping in her bed, Maggie had wedged herself firmly in the middle of us on the inflatable mattress, suddenly the size of an NBA player and firmly pushing us both off each side with every subtle stretch. Joe checked the weather – eight degrees but feels like five, heavy rain for the next few hours. “This is the worst thing you’ve ever done,” he said, pulling a beanie over his head. 

I tried to stay positive. I posited that we could be doing Te Araroa, despite being nearly 200km away from the trail. We could be like our idol Naomi Arnold! Toughing it out in the middle of the bush in the freezing cold! We could be doing Outward Bound right now! We could be German tourists who didn’t know any better! We could barely hear the episode of MAFS UK on my phone over the torrent of rain. I wondered whose marriage was in more trouble: mine and Joe’s or Polly and Nathan’s?

At least Maggie slept soundly between us all night long. 

The Author, Maggie, and Joe in hell yet again

The next morning we awoke to sun streaming in, rapidly shrinking the scary pools of water on the roof of the tent. We were dry, we were warm, but unfortunately Maggie’s big sleep had led to a factory reset in her brain and she was startled by every little noise as the campsite began to stir. I was grateful we had booked a fully fenced site as she charged around the place growling at trees and having a loud bark-off with Leonard next door. At least we were all dog people here.

We had one more walk down the beach before preparing to head back south. Like a fed-up kid, Maggie huffed into the back seat of the car while we packed down the tent and did one last poo patrol around the perimeter. Leonard and his dad had already headed home in their caravan, as had Ruby and her mum. We stopped at a dog-friendly cafe in Amberley for breakfast, followed by a quick visit to the dog-friendly SPCA opshop (open on Sundays!).

I don’t believe that dogs should be entitled to all spaces and activities, but I was surprised at many dog-friendly places we found, and how much Maggie enhanced the experience of camping, especially camping in the same temperatures you might find at Everest Base. At one point in the deluge, I was laughing so hysterically that I woke up Maggie, who lifted her head and sneezed directly into my open mouth, before going straight back to sleep. 

And, as much as I swore I wouldn’t become someone who writes about their dog’s holidays, 1500 words later I’ve become someone who writes about their dog’s holidays. I look forward to camping with Maggie again, but will probably wait until sometime after Big Kev’s Big Dig. In fact, as a wise man once said, probably not until January at the earliest. Sorry again, Joe.