To:

• Mike Shepherd, Group Director of Operations, Te Whatu Ora Te Toka Tumai District.
• Matt Doocey, Minister for Mental Health.

We the undersigned call on you to:

• Abandon the proposal to disestablish Segar House and work with the clinical team to co-design a new model of care.
• Properly fund this essential service so that the clinicians here can continue to offer their unique, life-saving work to some of New Zealand’s most vulnerable people.
• Change referral rules so that the team can take on as many clients as possible.

After half a century of serving some of Aotearoa’s most vulnerable mental health clients, Rauaroha-Segar House is the latest health service to be in the coalition Government’s firing line.

Why is this important?

Segar House is a totally unique, nationally recognised service. They take on clients who have highly complex histories, a few different diagnoses, and experiences of trauma early on in life.

To meet their clients’ needs, the care at Segar House is multi-disciplinary. They work with people to discover what kind of therapy – or therapies – work for them. Amongst their staff are psychologists, psychotherapists, an art therapist, and a psychiatrist. They use the whole environment – physical space, relationships, and group social interactions to support whānau care.

Segar House is a supportive place where people can learn healthy coping tools, develop critical social skills, and restore wellbeing. Their ultimate aim is to give the clients the right tools and the confidence to make positive change in their lives.

People who come to Segar House for care have usually tried everything else in the public health system. This is the service that stops whānau getting left to the streets or imprisoned.

Clinicians at Segar House say that, without their care, many clients from their service may well be lost to suicide.

Why should we save Segar House?

Te Toka Tumai first proposed disestablishing Segar House in April this year, 50 years after it first opened.

Their argument was that Segar House was being underutilised and that its funding and staff would be more useful when distributed to other mental health facilities.

But that is demonstrably untrue. Segar House is the only facility of its kind in the country. The whole point of Segar House is to offer a wrap-around service with many different kinds of therapies available; diluting that service by sending its clinicians elsewhere makes no sense. There is no other configuration of these health workers that provides more clinical and financial value than they do right now.

Te Toka Tumai also argued that not enough clients were being taken into Segar House. And funnily enough, the Segar House team agree.

Currently, clients must exhaust all other options for care before being referred to the service – even if the severity of their condition would otherwise qualify them for care. That’s right – it means that the reason not enough clients are being admitted is due to overly stringent conditions imposed on the service by the employer. Self-fulfilling prophecy much?

After pressure from the clinical team last year, Segar House trialed working with Primary Care Liaison teams to drop the barrier for admission and had good results with an increase in clients getting access to their intensive treatment.

Without Segar House, the options for people with complex mental health conditions (and their whānau) are bleak.

That’s why we’re calling on Te Whatu Ora to abandon the plans to disestablish Segar House, and for the Government to support this leading facility at a national level.

Signed,

The Public Service Association Te Pūkenga Here Tikanga Mahi

Association of Salaried Medical Specialists | Toi Mata Hauora