Mental health service suicide numbers revealed in a medical mishap report are a "tragedy" which suggest the treatment regime for mental illness is not working, an Otago mental health spokesman says.
Mike McAlevey, of the Otago Mental Health Support Trust, said there was a perception mental health patient suicides were somehow "inevitable".
"If the same percentage of deaths was recorded against patients receiving [non-psychiatric] medical care there would be an outcry. Psychiatric disorders are not fatal."
The figures from last month's serious and sentinel events report 2009-10 suggested resources were not sufficient in mental health to aid recovery, he said.
An emphasis on drug therapy, which was cheaper than counselling or psychotherapy, appeared to be ineffective for many patients.
Drugs often had side-effects, such as weight gain, and some were shown to be clinically ineffective, yet doctors continued to prescribe them, Mr McAlevey said.
He did not believe the answer was allocating more resources to suicide prevention services, but finding and funding more effective treatments for mental illness.
About half of the 127 deaths outlined in the report were mental health service suicides, 12 of them in Otago and three in Southland.
Reporting changed this year to include patients who had contact with mental health services in the previous week, thus capturing community-based patients.
Mr McAlevey raised concerns about two review findings relating to the Otago deaths.
One finding said mental health staff did not realise the patient had access to a firearm, which suggested a wrong emphasis on the part of the reviewer, as the method was less important than the will to commit suicide.
If they were determined, people found other ways to end their lives, he suggested.
A review of another death found a patient's care, which was divided between two teams, was fragmented, with inconsistent communication between the teams.
"The difficulty communicating is increased by the practice of keeping records in different services or even in different folders in the charts," it says.
Mr McAlevey believed Dunedin mental health services and teams sometimes operated in isolation, or even in competition with each other.
Responding, Southern DHB mental health medical director Dr James Knight said suicides were taken extremely seriously by the service.
Each one was investigated to identify aspects of the patient's care that could have been improved.
He took issue with Mr McAlevey's assertion of a lack of counselling, saying patients were often prescribed a mix of drugs and some form of counselling or psychotherapy.
"Our ideas about what might benefit a patient are drawn from our knowledge of the relevant research, our clinical experience, and the opportunities we have to discuss the management of individual cases with our colleagues."
Of medication side-effects, he said the upsides and downsides of various treatments were considered before prescribing them, and it was "not news" that medication could have adverse effects.
Of the communication problems between mental health teams, Dr Knight said communication issues were inherent in a large organisation such as the DHB, especially with a number of "relatively self-contained [mental health] teams", but constant efforts were made to improve communication.
Dr Knight defended the service's position on firearms, saying that while people might find other ways to self-harm, firearms had a high fatality rate, so it was right to pay attention to patients' access to them.
