An Auckland teenager says inadequate mental health help in New Zealand has robbed her of years of her life.
Bridgette, now sixteen, was a happy but shy child. She had a close group of friends and enjoyed socialising.
But by the time she was 11, she was struggling with severe anxiety and was referred to the Kari Centre for help.
Things went from bad to worse when she developed anorexia and was transferred to Starship Children's Hospital after she lost 26 percent of her body weight in just four weeks.
This was, she says, the only time her mental health problems were treated with any real urgency.
"I've never at another point in my life been given help or referred or sort of seen by anyone that fast before and since getting better or improving it's never been that way again," she said.
After 17 days in hospital she was discharged and offered outpatient care through Tupu Ora Eating Disorder Services.
Eventually, she was discharged completely and told to get another referral if her eating disorder returned.
For years after she was discharged, she continued to struggle with her mental health but things only got worse after she was recently sexually assaulted.
She repeatedly asked for extra support but found it impossible to access.
"I had a really low quality of life and it was just affecting everyday things. I had to leave school because of it, I couldn't keep up my job and I crashed my car. Everything was just getting far too overwhelming," she said.
She's desperate for long-term counselling and is sick of endlessly being referred, getting six sessions of therapy before being discharged and starting again.
"How sick do I have to be? At what point do I have to be before I am bad enough? How many more steps are there?
"I feel like I've been robbed of my happiness for years. I feel like every issue I've voiced just doesn't get treated. It doesn't get the proper attention it deserves," she said.
Struggling mentally and worried she was relapsing in her eating disorder, Bridgette asked her doctor to refer her to the public system for help. But her doctor was initially reluctant to do so because she wasn't underweight. Bridgette pushed back and was eventually referred to Marionoto West - which is a mental health service for children and young people who live in the Waitematā District Health Board area.
She was filled with hope because up until this point she had been bounced between service to service and was hoping to get long-term care and support.
Her excitement only grew when a clinical coordinator called her and gave her a rundown of what to expect from the appointment.
"She made me feel like someone would help and finally cared. She gave me a positive mindset."
But her hopes were dashed as soon as her appointment started with her doctor weighing her and saying her weight was fine.
"The psychiatrist brought me into a little room and he weighed me. From the moment he saw the number on the scales, he said, 'Right, food isn't going to be something that we need to talk about today' - referring to my eating disorder.
"That in itself is so frustrating because the number on the scale doesn't mean anything. And when you're constantly taught and told by psychiatrists and therapy teams, the number on the scale doesn't mean anything… Then to be not listened to or not treated because of the number on the scale, it feels like it doesn't correlate."
And things went from bad to worse when the doctor told her she didn't meet their criteria for help and her only option was to go private - something her family can't afford.
Not being able to access help because she wasn't underweight was invalidating and frustrating for Bridgette.
"I said, 'I really need something. I really need one on one help. I need a way to work forwards'. [But] he sort of said, 'We don't have anything here. We treat schizophrenia and psychosis and that's all. So looking forward, you can go private if you want something like that'."
Early intervention is key
Bridgette's story sadly isn't unique. Mental health advocate and Voices of Hope co-founder and general manager Genevieve Mora told Newshub thousands of Kiwis face the same struggle.
Mora spent her teen years battling mental illness and eating disorders before moving into advocacy work as an adult.
She said the longer people wait for help with their eating disorders, the worse they tend to get.
"There are lots of people unable to access evidence-based treatment in a timely manner for an illness which is treatable. An illness that if left untreated often worsens," Mora said.
She added denying people help for their eating disorders because they aren't considered sick enough is invalidating and "reinforces the eating disorders beliefs".
"One of the hardest (and most important) things to do is ask for help and so when you're met
with, 'We'll add you to a waitlist' or 'You don't meet criteria' it can be incredibly invalidating.
"Early intervention is key and unfortunately I have and continue to hear stories of people being unable to access help until they're medically compromised. Eating Disorders are mental illnesses. The earlier we intervene the better so this must change."
Mora also urged people who are struggling not to stop asking for help.
"Being unable to access support isn't a reflection of you, it's a reflection of how under-resourced the system is. Do not stop reaching out for help and using the people around you for support," Mora told Newshub.
A spokesperson for Te Whatu Ora - Health New Zealand said they can't provide details about Bridgette's care because their clinicians consider it "inappropriate to discuss this matter publicly".
"We are not always able to comment on the specifics of individual cases or provide details about an individual's care to media for ethical and privacy reasons – even if a valid "privacy waiver" is provided," the spokesperson said.
"We understand, in this instance, the young person would like to discuss their case and has
consented to us sharing details with you about an appointment had with Marinoto Child and Youth Mental Health Services. However, our clinicians consider it would be inappropriate to discuss this matter publicly.
"The young person, who is currently not under our care, has reached out to us directly and a meeting has been arranged for early next week to discuss their concerns in a more appropriate setting."
The spokesperson said patient safety is Te Whatu Ora's top priority and urged anyone unhappy with their care to share their concerns directly or make a complaint to the Health and Disability Commissioner.
Private care not the cure-all
Bridgette isn't the only patient who has been urged to seek private care because they can't access it through the public system.
But clinical psychologist Dr Annie Talbot told Newshub private care isn't a substitute for wrap-around public mental health services.
Dr Talbot said a lack of staff and huge demand means more and more people are seeking help privately - and it's putting huge pressure on private practitioners.
"There is a tsunami of need," she said. "For me as a private practitioner, we're meant to be working with mild to moderate difficulties but I'm no longer doing that. I'm working with moderate to severe problems… [People] who should really be having wraparound support and long-term, good-quality therapies," she said.
Dr Talbot said private practitioners are overrun and can't get help for their clients when they need it.
"As a private practitioner, I've made 26 referrals to DHB services for crises or for longer-term work and only three have been accepted."
She said while staff in the public sector are doing the best they can, they're overworked and doing too much with too little - which means people like Bridgette fall through the cracks.
Let down again
Getting help for her eating disorder wasn't the only challenge Bridgette faced. As a survivor of a sexual assault, she said the support she received in the aftermath was also lacking.
The assault further exacerbated her mental health issues and she was struggling. Thankfully when she reported the assault to police she was referred to the organisation Family Action for counselling.
But she said her assessment appointment was condescending and left her with no trust she would get the help she desperately needed.
Bridgette said her counsellor started the session by telling her she used to work at a fast food chain but did a "short course" and was here now. The counsellor continued saying working at the fast food chain was her favourite job and she wished she still worked there.
Bridgette was then asked to pick a toy and when she did the therapist asked why she picked that specific one.
"She had a whole shelf full of toys and she made me pick a toy off the shelf. I picked one because I was like, 'What the f**k?' Then she was like, 'Why do you like this toy?' I was like, 'I had to pick one and it's got flowers on it'. And she's like, 'Oh, do you like gardens?' and I said 'No' and that was what we talked about for the rest of the hour session, why I picked the toy.
"How does that relate to sexual assault trauma? You know, a garden gnome toy. How does that correlate?"
Bridgette admitted she didn't attend any further sessions because she didn't feel she was going to be given adequate help for the trauma from her sexual assault.
Family Action CEO Michelle Clayton told Newshub all their therapists "hold tertiary qualifications and are registered with the appropriate NZ registration board".
"Family Action specialises in supporting survivors of family harm and sexual harm and as such all staff receive ongoing professional development in this space," Clayton said.
"This interaction sounds like sand tray therapy which is a commonly used, evidence-based therapy. The non-verbal approach of sand tray therapy is particularly effective in working with both adults and children with trauma.
"Staff often share about themselves to build a sense of whanaungatanga and rapport between counsellor and client, which is critical to the therapeutic process. "
Clayton said clients who are unhappy or have any concerns about their care should raise them directly with Family Action.
But for Bridgette, it was one of the last straws. Battling to get help has caused her more distress than simply trying to manage things alone and she's defeated.
"I'm getting to the point where mum and I are ready to give up on the public health system and try and manage things on our own.
"It actually does so much damage going into those appointments, feeling hopeful and being able to be vulnerable and talk about what you're going through and then to just be shut down or told that you're doing great or told there's nothing for you… That does so much more damage, it adds to the trauma."
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 talk@youthline.co.nz 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
