Broken households, broken hearts and broken streets. The Canterbury earthquakes of 2010 and 2011 had dramatic impacts on many aspects of our lives. Perhaps less obvious but no less significant than the damage to our buildings and streets is the breaking of minds.
This article explores issues around the state of mental health in Canterbury since the earthquakes and how we should respond in the context of Catholic social teaching (CST).
Earthquake related mental illnesses include posttraumatic stress disorder (PTSD), anxiety, depression and anger management difficulties. Clinicians note the onset of such illnesses in individuals with no previous histories, as well as recurrences in people with existing conditions.
According to Pegasus Health GP mental health manager Cerina Altenburg, pre-quake referrals were stable at 90 per week but had risen to over 150 per week by the first three months of 2013.1 And Pharmac data reveal that almost 210,000 prescriptions for anti- depressants were issued in the Canterbury District Health Board (CDHB) region in 2012, compared with 125,000 for the similarly sized Auckland District Health Board region.2 Indeed, mental health professionals worry about the state of Cantabrians, with the New Zealand Association of Psychotherapists holding “grave concerns” for their psychological and psychiatric welfare.3
Ministry of Health research released in 2015 found a sizeable increase in the percentage of adults with diagnosed mood or anxiety disorders in Canterbury since the earthquakes.4 Christchurch Health and Development study director Professor David Fergusson comments that this result is consistent with his findings, with the most affected people being those who suffered both ‘shock trauma’ and ongoing post-earthquake issues.5
Supporting the Ministry of Health, a survey of one thousand residents of Christchurch, Waimakariri and Selwyn commissioned by All Right? reported that 63 percent of the respondents found life much worse than before the earthquakes.6 Common complaints included deterioration in health, distress caused by living arrangements, financial concerns and behavioural issues such as irritation and anxiety.
Experts are perplexed by the Ministry of Health’s finding that hazardous drinking has dropped significantly in Canterbury.7 City Missioner Michael Gorman believes that alcoholism has been fuelled by the trauma and issues arising from the earthquakes: “we suspect that alcohol is masking depression and anxiety and general low mood”.8 Also, both alcohol related hospital admissions and referrals to mental health and alcohol treatment services have increased markedly since the period of the earthquakes.9
The CDHB is reportedly struggling to meet its budget due to a surge in mental health expenditures. CDHB mental health figures for 2014 show child and youth cases up by 67 percent, rural adult cases up by 80 percent and emergency adult psychiatric assessments up by 102 per cent from their 2012 rates.
Inpatient child and youth rates increased by 92 per cent.10. CDHB member Andrew Dickerson expressed his frustration with the Ministry of Health’s funding arrangements by commenting in June 2015 of being “staggered that the soaring rate of mental illness doesn’t appear to be ringing alarm bells in Wellington.” Dickerson described the pressures on the CDHB’s provision of mental health services as ‘unsustainable’. It is therefore no surprise to learn of mentally ill people receiving inadequate support or struggling to nd suitable accommodation, especially in a region with reduced housing stocks and increased rents.
Counselling services have also experienced increased demand. By way of example, the local agency Petersgate received funding from the Ministry of Social Development for free earthquake related counselling sessions. Approximately 1,200 sessions have been offered under this scheme.
Relationships Aotearoa (formerly Marriage Guidance) closed operations in mid-2015 after funding negotiations with the Government broke down. It had offered earthquake- recovery counselling to 30,000 Cantabrians.11 It remains to be seen how Relationships Aotearoa’s services are reallocated across the other approved agencies, namely Barnados, Family Works, Lifeline, Stands Children’s Services and Vitae. The New Zealand Association of Psychotherapists expresses concern about the impact of trusted therapeutic relationships being terminated by the restructuring of counselling provision.12
Compounding the effects of the earthquakes is a forecast deterioration in rural mental health. The prospect of an El Niño weather pattern drought and volatile returns are two factors that are likely to place farmers and their families under increased work and nancial stresses in 2015 and 2016. Initiatives put in place by the Government, Federated Farmers and other agencies recognise the issue. Sir John Kirwan has toured rural New Zealand extensively promoting his free self- help resource, The Journey. Of note is that the most recent statistics on suicide in New Zealand reveal a twenty percent higher rate in rural areas (14.6 per 100,000 people) than in urban areas (12.0 per 100,000 people).13
With all of this in mind, it is worthwhile examining how Catholics might react to the mental health crisis and its victims. Two CST principles provide sound guidelines.
The overarching principle of CST is the dignity of the human person. Being made in God’s image, every individual “possesses the dignity of a person, who is not just something, but someone”.14
All people share this essential dignity equally, as described in Scripture: “There is neither Jew nor Greek, there is neither slave nor free, there is neither male nor female; for you are all one in Christ Jesus”.15 As a result, it is important to recognise that however impaired or disturbed a person might seem, he or she is a creation of God who deserves love and respect. Pope Benedict XVI reminds us that “every Christian, according to [their] speci c duty and responsibility, is called to make [their] contribution so that the dignity of these brothers and sisters may be recognised, respected and promoted”.16
Indeed, it is well recognised that Jesus’ crown of thorns symbolised his compassion and empathy for victims of mental anguish and illness.
The second relevant principle of CST is the universal destination of goods. This principle af rms that the “poor, the marginalised and in all cases those whose living conditions interfere with their proper growth should be the focus of particular concern.”17 To this end, we are called to imitate Christ in our personal interactions with vulnerable people by exercising a special regard for their material welfare, which is the sub-principle of the preferential option for the poor.
A practical application of the preferential option for the poor is to strive for an end to discrimination against people with mental illness. This discrimination can be obvious or subtle and can be seen in schools, the workplace or in healthcare provision.
Sadly, a US Department of Justice study has found that the largest providers of mental health services in that country are the prisons and jails.18 In addition, the mentally ill are over- represented amongst the homeless.19 They face an undeserved stigma and are often the victims of misunderstanding.
These findings and the myths and stigma around mental illness should serve to warn us that as individuals and a Church we need to be vigilant for the plight of people with a mental illness. This is especially so because they might lack the ability or resources to voice their own concerns.
Worthy of discussion at this point is a recent political development in New Zealand – the introduction of social bonds in the area of employment for people with mental illness. The Government proposes to contract out these services to private providers who will receive a dividend related to the achievement of specified outcomes.
The Government considers that establishing incentives to these providers will enhance performance. Finance Minister English commented at the announcement of the bond scheme that the “Government is focused on achieving better results for individuals and families in highest need”.20 Opponents question whether it is wise to trial a social bond scheme on the mentally ill, the objectivity of the success measures and the extent to which employment will supersede treatment for victims of mental illness. Media commentator James Robins writes that “such abrasive commoditisation produces only one thing: human beings with very real and genuine sensations become statistics. Their reality is ignored in favour of slotting them into a spreadsheet which might earn an investor a nice five percent return on their cash.”21
A comment from John Paul II provides a perfect summary of this article’s sentiments. He wrote in 1996 that “it is everyone’s duty to make an active response: our actions must show that mental illness does not create insurmountable distances, nor prevent relations of true Christian charity with those who are its victims. Indeed, it should inspire a particularly attentive attitude towards these people who are fully entitled to belong to the category of the poor to whom the kingdom of heaven belongs”.22 Although written a generation ago and half a world away, this message is particularly relevant to us right now as followers of Christ in Canterbury.
- http://www.stuff.co.nz/national/christchurch- earthquake/8495604/Worry-despair-plague-Christchurch- residents.
- http://www.nzherald.co.nz/nz/news/article.cfm?c_ id=1&objectid=10879246
- Ministry of Health, The New Zealand Health Survey2011-2014
- Canterbury mood disorders up post quake, boozing halved. The Press, 25 May 2015.
- All Right? is a CDHB and Mental Health Foundation of New Zealand initiative.
- Ministry of Health, The New Zealand Health Survey 2011-2014
- http://www.stuff.co.nz/national/health/9414027/ Canterbury-alcohol-use-masks-quake-troubles.
- Canterbury mood disorders up post quake, boozing halved. The Press, 25 May 2015.
- http://www.stuff.co.nz/the-press/news/69306332/cuts-to- mental-health-services-possible-without-extra-funding
- Relationships Aotearoa, Relationships Aotearoa – Our Story (Press release, 19 May 2015)
- New Zealand Association of Psychotherapists – Canterbury Branch, Relationships Aotearoa closing devastating for Canterbury (Press release, 29 May 2015)
- Ministry of Health (2015) Suicide Facts: Deaths and intentional self-harm hospitalisations 2012
- Compendium of the Social Doctrine of the Church, para. 108
- Gal 3:28
- Message of His Holiness Benedict XVI for the 14th World Day of the Sick”, December 8, 2005
- Compendium of the Social Doctrine of the Church, para. 182.
- Department of Justice study, 2006.
- Substance Abuse and Mental Health Services administration.
- http://www.nzherald.co.nz/nz/news/article.cfm?c_ id=1&objectid=11457938
- http://www.newstalkzb.co.nz/opinion/how-to-privatise-the- most-vulnerable/
- Mentally ill are Also Made in God’s Image. L’Osservatore Romano, 11/12/1996