This article deals with addiction, eating disorders and suicide.
Mental health and addiction services are struggling to keep up as a record number of Kiwis seek help amid the COVID-19 pandemic.
Addiction services specifically were overrun during the first lockdown in March as peoples' alcohol and drugs consumption increased.
Physical barriers to care such as non-essential surgeries being cancelled also took a toll on Kiwis, with support services fielding calls from people suffering mental health problems as a result.
Women with conditions such as endometriosis were among many who faced cancellations, forcing them to live in extreme pain until their surgeries could be rescheduled post-lockdown.
Endometriosis causes tissue similar to the lining of the uterus to grow outside the womb and can cause painful symptoms such as debilitating period pain, lower back pain, IBS symptoms, abnormal menstrual bleeding and pain with sex.
As a result Endometriosis New Zealand (ENZ) saw a huge influx in women who were suffering severe mental health issues.
And ENZ isn't alone, eating disorder support services have also seen a huge surge in demand.
Eating Disorders Association of NZ chairperson Nicki Wilson told Newshub they have seen an "incredible increase".
"We are receiving contacts from people needing help, or advice and information at four times the level that we experienced previously at the same time last year."
And Wilson says "overburden services" aren't keeping up, leaving sufferers with long waitlists.
"Waiting lists and waiting times at the moment in the services are just dreadful, absolutely dreadful.
Wilson says no one should be put on a waitlist for a life-threatening illness like an eating disorder. Anorexia has the highest mortality rate of any mental disorder.
Other eating disorder services including charities, private providers and some DHB teams are all seeing increased demand as well.
"It is really stretching them… I cannot stress how hard they are working and how dedicated they are but the system is not coping," Wilson said.
"I would go so far as to say it's a scandal. It's just dreadful."
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Wilson is begging for extra support and more education about eating disorders for GPs and medical staff.
"We really are asking for attention to be paid to this sector. We have seen a huge increase and just terrible suffering and an inability to access services and it's just not acceptable."
'The perfect storm'
Eating disorder advocate Jess Dyson says the lockdown has been "the perfect storm" for developing an eating disorder.
"It's intensified the struggle… for a lot of people and made things a lot worse."
Dyson said her coaching service has been inundated with people in need.
"I've seen a lot of people seeking out help. Even existing clients who I would normally see once a week need to see me three times a week at the moment."
A spokesperson for the Ministry of Health said mental health and addiction providers were considered essential services during the lockdown but the way these services were provided may have changed.
"Due to these restrictions and the need to prepare for a possible surge in COVID-19 positive cases at that time there may have been restrictions, or a higher threshold to gain access to some essential services, including mental health and addiction services."
The spokesperson said the Ministry is not aware of particular concerns or issues with accessing eating disorder services post-lockdown.
They said the Ministry is in conversation with EDANZ to monitor and respond to needs as appropriate.
Not a lone issue
Endometriosis New Zealand chief executive Deborah Bush said 568 women contacted them in a state of despair during the lockdown. She said some of the women were suicidal and had no hope.
"Some were completely broken due to their long-awaited surgeries being cancelled with no rescheduling date in sight," she said.
During the level 4 lockdown endometriosis surgeries were often cancelled or postponed which Bush acknowledged was "understandable and unavoidable".
However, she said it has been made worse by a lack of Government and Ministry of Health action in the past, citing a "failure to support the implementation of long-awaited clinical guidelines for the treatment of endometriosis".
People with endometriosis often face long wait times and struggle to get diagnosed. But even with a diagnosis, they can spend years waiting for life-altering surgery.
One woman says she has had endometriosis symptoms since 2005 but wasn't diagnosed until 2019 because her hospital referrals kept being rejected by Manukau DHB. She says despite having extreme pain the DHB was too under-resourced to see her.
When she was finally diagnosed in September 2019, her endometriosis was so severe that it was recommended she be seen by a specialist within 6 weeks.
However, despite following up in December and February she didn't meet with a specialist until March 2020. The specialist recommended advanced surgery.
But by September she still hadn't had the surgery and her pain was so bad she couldn't walk.
The specialist couldn't give a timeline for when she might get surgery leaving her so desperate that she considered refinancing her mortgage or selling assets so she could afford private care. Thankfully in late September, she was finally able to get surgery.
The Ministry of Health said it published the clinical guidelines in March and shared them with "relevant medical staff"
"The Ministry strongly encourages all relevant healthcare professionals to familiarise themselves with the guidance so they can incorporate them into their care," a spokesperson said.
"The guidance is intended to inform local clinical pathways and referral guidelines to improve the quality and consistency of clinical practice in the diagnosis and management of endometriosis."
The spokesperson said there was a "considerable decrease" in the number of services delivered during the lockdown from March to May but DHBs are now working hard to reduce growing waiting lists and backlogs.
They acknowledged that many women suffer silently with endometriosis for years before being diagnosed.
However, Bush said the Ministry hasn't followed through leaving 130,000 women and girls "living with this debilitating disease".
Where to find help and support:
- Shine (domestic violence) - 0508 744 633
- Women's Refuge - 0800 733 843 (0800 REFUGE)
- Need to Talk? - Call or text 1737
- What's Up - 0800 WHATS UP (0800 942 8787)
- Lifeline - 0800 543 354 or (09) 5222 999 within Auckland
- Youthline - 0800 376 633, text 234, email firstname.lastname@example.org or online chat
- Samaritans - 0800 726 666
- Depression Helpline - 0800 111 757
- Suicide Crisis Helpline - 0508 828 865 (0508 TAUTOKO)
- Shakti Community Council - 0800 742 584