Sitting in her Tarras home, Liz Carroll-Lowe treasures the precious memories of her husband.
“Steve was a really fantastic guy,” she says.
Steve Lowe suffered with depression, and after four suicide attempts, was committed to Wakari Hospital’s Ward 10A.
"He went in voluntary because he was actually scared himself, and he didn't trust himself to stay alive."
Ward 10A provides in-patient care for those with dual-diagnosis mental health and intellectual disabilities.
Liz still remembers the first day she visited the ward.
“This was a number of years ago and the impression is still with me.
“It was darkish, you know, there wasn't bright colours. It just felt oppressive, I think, was the word I would use."
“It was loud. There were people screaming everywhere; there was patients screaming at staff there was staff screaming at patients; there was staff yelling out to one another, one of the patients was threatening a staff member and so we were asked to leave that area for our own safety and, you know, that's frightening.
”I was well and I knew I could leave - Steve had to stay in that environment. I just can’t imagine how terrified he must have been. I just don’t know what that did to him."
Steve left the ward after just two weeks.
Liz says Steve was unwell after he left but said he could manage his mental health on his own.
She says he was too scared to ask for support, in case he had to go back to the ward.
“I wish I had pushed for him to re-engage with the system because eventually, he did take his own life and he's been gone now for four years.”
Ward 10A has recently come under scrutiny in a report by the Chief Ombudsman.
It outlines the findings of an unannounced inspection of the ward between March and June last year under the Crimes of Torture Act 1989.
Peter Boshier says this inspection has given him the most concern of any facility his office has inspected.
Issues raised in the report include a lack of gender separation, and the fact patients with complex needs are housed together.
“We're mixing in this facility - not just patients who are mentally ill and who need caring for - but we're mixing them with those who come from a different forensic stream who have been involved in criminal offending and who are there for a very different reason. It's not safe,” Boshier says.
He says he’s gravely concerned over the “volatile environment”.
"Normal good practice is that you supply facilities and treatment according to needs – that’s grade 101 of the way you undertake treatment for anyone.
"What they've done here is to mix up a complexity of needs for some who have low-functioning intellectual disability then you've got a second stream who have committed criminal offences but can't be tried and convicted because of their disability nature but who present a latent threat, that's why they're there.
"It's volatile because you've got people who don't mix in this sort of environment normally and who are there with people who present a risk."
Boshier says staff at Wakari Hospital describe the situation as "a disgrace".
"The staff were pretty open, more so than I would normally expect about what they're having to put up with. For staff to describe their own facility as a disgrace is something I have never encountered before, so that must say something about the level of frustration," he said.
"I do want to commend the staff; I do want to say that I am not putting the boot in here to the attempted level of therapeutic care by staff. My inspectors like to be balanced about this and they feel staff are doing everything they can given the mixture of needs and the complexity to try and make this thing work."
Liz agrees the staff are doing everything they can to provide a good environment for patients.
“The staff are fabulous. It's not the staff - they do the absolute best that they can do with such minimal resources - but those wards up there, they're just so outdated,” she says.
Another issue raised in the report was the ward not being fit for purpose and in critical need of an upgrade and redevelopment.
It says the current environment compromises patient and staff safety as well as patients' dignity.
“They put them all in together, lump them together in this one facility. My concern is, this is just third world,” Boshier says.
Boshier recommended that the ward be rebuilt or, at the very least, upgraded.
But there’s frustration, because this isn’t a new issue.
“We raised this in 2014 and it was acknowledged that this facility was not fit for purpose. The DHB knows it's not fit for purpose.
“It's extremely frustrating that the Ombudsman's given powers to inspect and comment to make recommendations which are accepted and then nothing's done to actually move the thing forward," he says.
“You'll understand why I begin to get irritated and want to speak out when the integrity of my office is being compromised in this way."
The Southern District Health Board’s executive director of mental health, addictions and intellectual disability services, Toni Gutschlag, accepts the 52-page report.
She says there were some positive findings in the report, including those who received their services felt safe and treated with dignity and respect; whānau reported positive treatment of their family members; and paperwork was accurate.
But she accepts there are issues that need addressing.
“We agree that the mental health buildings on the Wakari site are not of the standard we would like them to be,” Gutschalg says.
The SDHB says planning for refurbishment is underway, and it’s working with the Ministry of Health on short-, medium- and long- term options which include refurbishment and potentially a new build.
It says the most significant challenge in relation to the mixing of patients is a direct result of the layout of the building and the space available within it and “some of the recommendations tackle challenges that are complex and will take time to resolve".
While SDHB accepts the environment at Wakari is sub- optimal, it says the care it provides is not.
“We are committed to patients, their whānau, and providing the highest possible standard of care.”
For Liz, she wants to see urgent changes.
“It’s a long illness. Steve wasn’t sick for a year, 10 years - he was in the mental health system.
“It’s a long road and you just want them to have the best they can.”
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