This is my column this week in the New Zealand Herald, which is published in the digital edition every Thursday...
“Why do mental health staff ignore family information, why are we seen as a problem rather than an important part of treatment and recovery.”
There is no doubt that our childhood shapes and renders the people we will be for the rest of our lives. It is also beyond question that traumatic events in childhood, physical violence, sexual abuse, and neglect leads to all sorts of emotional problems.
But human beings are too complicated to assume that the relationship between these things is simple.
Psychotherapy has often been criticised for being blaming of parents – and mothers specifically – and it’s fair criticism.
Early theories of schizophrenia for instance focused on how certain family environments “cause” psychosis.
We now know complex problems such as psychotic disorders are caused by many factors combining in certain ways and at certain times in development, including genetics, trauma, and environmental factors.
Despite this, it can be too easy to jump to the simple and often wrong conclusion that if someone is suffering from a diagnosable mental illness it must be their parents fault.
What is true with every family is: it’s complicated. Working with families is time consuming, complicated and fraught.
We all naturally have the strongest emotions in response to those we love, and it isn’t always pretty.
For many people, just spending time with your in-laws at Christmas is a challenge, and as a clinician it can be difficult to wade into family dynamics, especially if you haven’t been trained in working with families.
Yet despite all that tension, despite all that emotion, despite all that history (or even because of it) our families often know us best.
Which is why it’s important that the system always listens to a family’s concerns about their child’s mental health.
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Tragically, no one was listening to Ross Taylor’s parents, and a report by the Health and Disability Commission highlighting those failings was released this week.
Sadly for the family, this report, and the validation they were seeking, is four years after the fact. And tragically for many others, this story is now familiar.
A number of internal reviews by District Health Boards into preventable deaths in the mental health system have shown that an overworked, under-resourced system struggling to manage the huge volume of at risk clients, fails to listen to families concerns, fails to be proactive enough, fails in standards of basic care.
But I don’t believe the answer lies in prosecuting individuals, doctors or staff, although I have no doubt that if it was my child I would feel the same way.
In the same way we need to listen to families, we need to listen to the concerns of all involved in the system.
A recent survey by the “Yes We Care” Health Funding Coalition found that 90% of people working in health in 2017 feel they don’t have the resources or staffing to give New Zealanders the health care they need, when they need it.
We also need to recognise the public has lost faith in a system that no longer listens to them.
And we need to make sure there is enough time and resources to always answer the phone and listen to the concerns of parents.
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