Opinion: Stop letting mental health patients smoke unsupervised

Nicky Stevens
Nicky Stevens disappeared from an unsupervised smoke break in March 2015 (Newshub.)

OPINION: When my family and I heard the horrible news about Chelsea Brunton's death, it confirmed our worst fears.

Chelsea was found dead four days after stepping outside Palmerston North Hospital for a cigarette.

We just knew it was going to have a sad ending – because it was just so similar to what happened to our son, Nicky Stevens.

Nicky, who was under compulsory care with the Hamilton DHB, disappeared from an unsupervised 15-minute smoke break in March 2015. He was found dead three days later.

'One-size-fits-all' DHB policies forcing our loved ones to have their smoke breaks outside on the street, in an obviously unsafe environment, have to end.

Hearing about Chelsea almost makes us feel guilty – why didn't we push this issue harder over the last few years? It might've helped her.

It would be so easy to provide outdoor secure areas able to be used for mental health patients to have a smoke while being observed.

Instead they're being kicked out. In Waikato they're not even allowed to smoke in the carpark, they're literally kicked out onto the road.

Some of these patients are supposedly on suicide watch, they are at risk, and they are let to go outside on an unsupervised smoke break.

The DHBs have undertaken a box-ticking exercise and thought, "We have to have a policy in this area, let's make it a sweeping, blanket smoke-free policy, let's not worry about specific circumstances or anything like that."

I can recall at the time the policy was brought in at Waikato DHB, even the staff at the mental health unit here opposed it and said it was going to cause problems.

And look what happened.

Waikato DHB apologised for some aspects of their processes around my son's care but said the overall level of care he received as good, and there were no serious failings by any staff. Our family has never accepted that.

I used to call myself a militant anti-smoker, and I probably still am under normal circumstances.

But this is not about smokers' rights – it's about mental health patients' rights.

When someone is in severe stress and in danger of self-harm or harming other people, and they're being treated, surely it's not the most important thing to worry about whether they should be giving up smoking or not.

Where's the emphasis on treating their mental unwellness? It defies common sense.

There's quite a lot of evidence that people with severe mental illness are quite heavy smokers – far higher than the general population – in many cases because it reduces stress.

If you've got any empathy you've got to take account of that sort of situation.

By all means try and convince mental health patients not to smoke – provided you're not making that a priority over treating their mental illness.

Hopefully when they're feeling better in a mental sense they're going to be more responsive to the anti-smoking message.

The Minister of Health needs to either ensure the DHBs provide secure smoking areas, or provide enough staff to give one-on-one supervision to people that you do allow out for smoking.

Otherwise lives will continue to be put at risk.

If you or someone you know is in crisis and needs help, call Lifeline on 0800 543 354 or the Suicide Prevention Helpline on 0508 828 865.

Dave Macpherson is an elected member of the Waikato DHB and a Hamilton City Councillor.

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