Waikato Herald

Mental health facitility overcrowde­d

Patient forced to sleep in conference room on mattress

AWaikato mental health facility was so overcrowde­d at least one patient slept on a mattress on the floor of a conference room for two nights as staff grappled with high occupancy.

The overcrowdi­ng at the Henry Rongomau Bennett Centre (HRBC) at Waikato Hospital meant the facility was operating at up to 115 per cent occupancy in late April and early May.

The centre was lambasted by the Chief Ombudsman in early 2020 for subjecting patients to degrading treatment including overcrowdi­ng and the high use of seclusion and physical restraints.

A $131 million rebuild of the facility set to open in mid-2026 will cater for only 64 beds, one fewer than was needed this month.

Health New Zealand Te Whatu Ora Waikato mental health and addictions operations director Vicki Aitken said 65 patients were in adult acute beds on May 2 at the centre, which has a capacity of 60 beds.

Aitken said for the two weeks to May 3, the centre operated between 100 and 115 per cent occupancy, with the four adult wards generally operating above 100 per cent.

“When this occurs we have additional spaces that we convert into bedrooms. These are a combinatio­n of interview rooms and quiet lounge areas.”

She said high occupancy reflected two key factors: the hospital was responding to high demand for the service and did not turn away anyone who needed admission; and it did not discharge people without them having somewhere to go.

“There is also the impact of not having sufficient longer-term rehabilita­tion or rehabilita­tion readiness capacity for some individual­s who are in hospital for long periods due to their complex needs.”

Aitken said the centre now had approval to proceed with developmen­t of a rehabilita­tion readiness

unit to address that demand.

“This unit will complement a new community-based intensive rehabilita­tion service specifical­ly designed for those with the most significan­t and complex needs. We hope to have this service running in October.”

Of the patients within the adult acute wards, 11 had been at the centre for three months or longer and the rehab-ready unit was targeted to them.

“We have a number of people who have been in hospital for long periods given their complex rehabilita­tion needs,” Aitken said.

“They have not been seen as suitable by other residentia­l settings or are not ready to live independen­tly.

“This is the group that is expected to be most suitable to receive the new service approach described above,” Aitken said.

In March 2020, the ombudsman was critical of staff burn-out, and notfit-for-purpose wards at the centre

such as Puna Poipoi Forensic Rehabilita­tion ward where bedrooms were small and there were not enough showers and toilets.

Aitken said though upgrades had been made to showers and toilets and two more beds were added in the forensic area, the bedroom size had not changed.

Staffing numbers had also increased significan­tly over the past year with 56 extra staff, made up mostly of nursing and healthcare assistants.

There was now a dedicated person focused on recruitmen­t, resulting in the centre being 98 per cent staffed.

Aitken said there had been specific work to address the ombudsman’s report, which said the facility was in crisis after unannounce­d inspection­s in September 2019.

These included working on a business case for additional rehab-ready beds, upgrades to the ward and lowstimulu­s area, and enhancing

bedrooms, bathrooms, seclusion rooms, and the outdoor environmen­t.

She said staff had also been praised in an independen­t surveillan­ce audit on their efforts to reduce seclusion and there were now designated and approved seclusion rooms.

There was also a change to a Mā ori-led practice model across mental health areas, focusing on the cultural aspects of care for patients, with Māori clinical nurse specialist­s working closely alongside a cultural support worker to provide intensive cultural support.

“This is assisting in reducing seclusion practices within the intensive care area.”

A month after the ombudsman’s inspection­s, the Government announced a $100m rebuild of the Henry Rongomau Bennett Centre, which then-prime Minister Jacinda Ardern said was not fit for purpose.

A business case with capital funding of $155m was approved by joint ministers in June 2022, funded through the Health Capital Envelope, which included funding for the replacemen­t HRBC as well as the Waikato Regional Renal Centre (WRRC), which was on the preferred site of the new mental health facility.

More funding was approved in September last year, bringing the total budget to $175.6m.

Aitken said the increase was needed to address extra costs when a contractor was hired to build both facilities, with $131.2m for the mental health facility and $44.4m for the renal centre.

The replacemen­t mental health facility would have space for 64 beds and eight internal courtyards, and would be in the northern part of the Waiora Waikato Hospital campus.

The contractor, Naylor Love, was expected to begin constructi­on of the new Adult Acute Mental Health Inpatient facility next month with completion set for mid-2026.