Funding cuts result in pressure to medically sedate individuals
We are going backwards at a rapid rate when it comes to disability
In August last year policy changes directed by the Minister of Disability Issues, Louise Upston, meant disabled people currently living with carers only had a chance of getting into residential care if they had committed a crime, were leaving mental health care/hospital and had no place to go, or they had escalating needs that could only be met by hospital-level care:
Leaked document shows plans to restrict residential care for disabled people and cut allocated budgets
A leaked document indicates the government is seeking to severely restrict and reduce access to residential services for disabled people.
As predicted, despite the Minister of Disability Issues insisting that there “is no halt or freeze on new residential placements and disabled people were continuing to enter care” disabled people are indeed being prevented from accessing independent living, as reported on by the New Zealand Herald today (emphasis by me):
Intellectually disabled people in residential care were being moved between homes because providers could not afford to pay for them, which was especially stressful for autism spectrum disorder patients moving from small, quiet flats into larger ones.
A combination of factors related to the funding changes has led to a rise in violent and suicidal behaviour, resulting in more presentations to emergency departments.
All of these factors were leading to pressure to increase the prescribing of anti-psychotic and sedative medication to moderate difficult behaviour – reversing years of progress in reducing medicalisation and institutionalisation.
Professor Richard Porter, a psychiatrist and lead author of the editorial, said: “I’ve worked in the NHS in the UK for about 10 years and in New Zealand for about 25 years, and honestly, this is the most inhumane change I have seen in my career.”
The situation is so dire, 5 clinicians have taken the extraordinary step of writing an editorial for the New Zealand Medical Journal:
The editorial covers what has occurred in the sector over the past year, the impact on services and families, and the observations of the clinicians working in the sector. In summary:
Effectively, no new residential places are being funded
Some that were planned but not started have been withdrawn.
Some individuals with severe difficulties who were in hospital (often a general psychiatric ward which is entirely inappropriate) have not returned to community living due to the funding freeze.
Higher levels of care within residential services are now not available when individuals with ID experience worsening mental health difficulties.
Individuals with ID experience dementia at an earlier age but funding is now unavailable to meet these changing needs.
Individuals have had existing packages of care reduced and providers have had to amalgamate houses and close homes. Homes with fewer residents were often set up for individuals with ASD, who require a quieter, more structured and predictable environment.
Funding for activities outside the home has become constrained, leaving residents at home without meaningful activity or distraction from sources of distress.
Increased pressure to prescribe sedative and antipsychotic medication in an attempt to “medicate” behaviour disturbance.
Services under pressure to introduce or re-introduce antipsychotic medication to mitigate the effects of inappropriate placements and low staffing levels resulting from the funding cuts.
Subsequent increase in high-risk suicidal and violent behaviour, resulting in higher rates of presentation of individuals with ID to mental health services, emergency departments and police.
Horrifying. A breach of multiple articles of the UNCRPD, as well as a violation of the Royal Commission of Inquiry Abuse in Care Report findings.
The Minister and Ministry were told that these policy changes were a terrible idea. I was in one such meeting where this was very clearly explained to Ministry staff, yet the staff present pooh poohed our feedback and said we were catastrophising and going straight to a worst-case scenario. We are here now, at the worst-case scenario, and I am not sure this government is listening yet.
If you’re wondering about the Minister’s double-speak on funding, this post explains why, despite increased budget allocation at a ministry level, individuals and providers are experiencing a funding cut (TLDR; increased need, decades of underinvestment, out of date assessment tools, more disabled people entering the system):
Disabling lives
Earlier this week, Carers NZ took the extraordinary step of posting their concerns on social media. If you know Carers NZ, you know they mostly prefer to work hard behind-the-scenes with Minsters and staff alike to make practical, real-world changes that benefit carers and disabled people.
If you’re wanting to know more about the UNCRPD and New Zealand’s commitment to upholding disability rights, this post gives an overview:
NZ quietly downgrades its commitment to implementing disability rights.
This one can be tricky to get your head around if you’re not involved in the disability sector, so I’m going to do a short explainer first. If you already know this background material feel free to scroll on past!
Absolutely devastating. Thank you for this write up. We need everyone to understand this.
Absolutely devastating! Another act of cruelty from the Coalition of Cruelty. How can they possibly justify this? Unconscionable, despicable pettiness—yet we know the Ministry and Minister will roll out the usual spin, pretending there’s nothing to see here. Shame on them. Shame, shame, shame!