Top mental health specialists warn that the number of psychologists and psychiatrists must double to meet patient demand.

Practitioners say New Zealand needed 15 psychologists per 100,000 people to meet demand - equating to 770 full-time workers. But Te Whatu Ora estimated the public sector currently employed about 350 workers.

Ashley Bertelson, 18, says her life was on hold until recently, due to lack of care.

"Anything you think of, it was hard for me to do," she says. "Whether that was walking, opening doors, picking something up or putting something down," says Bertelson.

She was diagnosed with obsessive compulsive disorder (OCD) four years ago. Unable to find treatment, her illness became debilitating. 

"There was very little that I could do. I couldn't even read because I might not have read the words right, or I might have 'thought the wrong thing' while I was reading a line, so I would have to go back and redo it," she explained. She became so paralysed by the disorder that she stopped attending school in person and ended up spending most of her days on the couch.

Bertelson sought help from several professionals, but most were not taking new patients, had long waiting lists, or lacked the expertise needed to treat OCD.

Eventually Bertelson travelled to the United States for treatment. She participated in a three-week intensive course and learned to manage her compulsions. She says her entire life changed, but she was disappointed it took so long.

"I feel like the country that you live in should be able to provide treatment."

Her experience is not unusual. College of Clinical Psychologists strategic adviser Paul Skirrow says there was a severe shortage of specialist staff to treat people with mental illnesses.

For people to get the care they needed, primary care needed to be able to treat individuals with mild to moderate mental health issues, and specialists were needed for people with more severe illnesses, says Skirrow.

He had not seen any recent investment at the specialist end of the sector. 

Skirrow says changes to the sector needed to be carefully planned in consultation with professionals. 

Recent initiatives for primary care - such as the access and choice programme that put mental health resources in GP's offices - harmed those who needed specialist care, he says.

The National Party has announced that, if elected, they would boost training by adding an additional 13  psychiatric registrar placements and doubling the number of clinical psychologists trained each year. 

New Zealand College of Psychiatrists chairperson Hiran Thabrew also says adding mental health resources to GP services had not helped.

"The staff needed to come from somewhere, and the easiest place to get them was from the existing mental health service," he explained. "It was like robbing Peter to pay Paul - some staff actually moved into primary care, because the conditions were better, pay was better and there was less stress - leaving the specialist mental health services even more short staffed."

Attention deficit hyperactivity disorder (ADHD) is one of the conditions that falls under specialist care, with only paediatricians, psychiatrists, psychologists and specially trained nurses qualified to diagnose it. Medications can only be prescribed by paediatricians and psychiatrists. 

ADHD NZ chief executive Suzanne Cookson says when it came to accessing diagnoses and treatments, ADHD patients had not benefited from the recent primary care initiatives.

A recent survey found 80 percent of the organisation's members had experienced difficulty accessing specialist support.

To better serve the community, additional funding for training specialists was important, Cookson says. But it would take time before new recruits were ready to work, and in the interim authorities needed to make better use of primary care. 

Providing GPs with additional training and supervision to diagnose ADHD patients and offer prescriptions would improve access and free up the specialist services, says Cookson.
 
Thabrew says concerns about the sector's capacity were widespread and professional bodies had been vocal about them, but they could be addressed.

"We don't believe that they're insurmountable, we just need some collaboration with government to make effective change," says Thabrew.

No matter who won the election, Skirrow and Thabrew say they would be working hard with leaders to improve outcomes in mental health.

- Emma Ricketts/RNZ.