A University of Otago health academic has criticised the Mental Health Minister’s shift towards “peer-led” support to address the looming crisis.
It comes after the Otago Daily Times revealed Health New Zealand Te Whatu Ora was seeking tender applications to run a “peer-led” service that would host at least six acute beds in either Queenstown, Cromwell or Invercargill by the end of the year.
Peer-governed means that at least 50% of the governance members of an organisation (trustees, board members) have personal “lived” experience of mental distress and/or addiction.
Mental health scholar Prof Paul Glue was somewhat cynical about the initiative.
“Peer-led mental health services face significant challenges including funding instability, role ambiguity and stigma within clinical environments.
“Peer support workers often experience emotional burnout, professional isolation and poor compensation.
“Additionally, these programmes struggle with maintaining programme fidelity and lack standardised, high-quality research evidence to support routine implementation across all mainstream systems.”
There have been already two peer-led mental health services established in Christchurch and Auckland.
Mental Health Minister Matt Doocey has trumpeted it as a “new way of care” , but Prof Glue said there was often a lack of clarity regarding the specific duties of a peer worker versus clinical staff, leading to frustration and integration issues.
“While peer support shows promise for social functioning and empowerment, there is still a need for more high-quality, large-scale trials to confirm clinical effectiveness …
“Finding the right match between a peer and a recipient — someone with similar conditions or experiences — can be challenging.”
Mr Doocey said Prof Glue needed to engage more with his community and learn about the broad steps created to ensure more funding for peer-led services.
“We are delivering new peer-led acute alternative services to reduce inpatient ward admissions.
“The reality is people in crisis shouldn’t be waiting too long for an inpatient bed.
“Peer-led acute alternative services provide more choice for people experiencing mental health issues and get people seen quicker.”
But Prof Glue expressed doubt about the robustness of the model, as “maintaining appropriate professional boundaries while building an intimate, relatable connection is a constant tension”.
Other concerns included the possible “triggering” of peers when dealing with acute mental health issues.
Mr Doocey said Prof Glue was out-of-date in his views.
“I expect HNZ to work closely with the chosen provider to ensure all risks are mitigated.
“However, I reject any suggestion that these services are not worth the investment.”
The procurement phase is under way and expectations are the initial service delivery will begin towards the end of this year.