The letter from the mental health and addiction network, signed by chairman John MacDonald, of Queenstown, says the DHB’s insistence that changes happen within the existing budget was risky.
The November letter was released to the Otago Daily Times under the Official Information Act.
"Our concern is that after several years of concerted, detailed planning ... we are now ready to move to a new model of care, which will provide safe, quality outcomes for people ...
"We want to ensure that transition to a new system will not leave people stranded or at risk of falling through the gaps without a sound transition plan to mitigate this risk.
"Our biggest concern is that without some front-end funding this confidence will be compromised," the letter says. Nationally, mental health was in the "spotlight", and the group was "keen to ensure that services [in the South] are not subject to this criticism". The letter warns against repeating the experience of the United Kingdom.
"We also don’t want to end up with unexpected outcomes as were experienced in the UK, where they regretted their lack of [adequate] funding and haste to disinvest.
"Now several years down the track, they are experiencing a critical shortage of inpatient services ...
"We were asked to look for savings from within the existing services, however, I do not believe we have the mandate ... to review existing mental health and addiction service spending," the letter says.
The network, a joint venture between the DHB and the primary care sector, is charged with shifting more mental health services to the community and addressing service gaps.
When contacted, Mr MacDonald said the network had now accepted that changes had to be from within existing funding, but he remained unsure about how it would work. The total mental health and addiction spend was $87million per year.
"There is a lot of money spent in mental health. I don’t believe every dollar is spent where it should be," Mr MacDonald said.
SDHB chief executive Chris Fleming told the ODT the group was "moving forward" after its initial disquiet.
"It intrigues me that there was a very black and white letter but when we raised the challenge back, the network did come up with a solution that we’re moving forward on," Mr Fleming said.
Last week, the DHB sent mental health staff a copy of the plan, Stepped Care Action Plan 2016-20, along with a message from Mr MacDonald.
"We will be travelling across [the] district in the coming weeks and plan to meet and talk with the geographic networks and key stakeholders during this time," Mr MacDonald’s message to staff said.
Public Service Association organiser Julie Morton said there appeared to be a major change on the horizon, and she was unhappy that the union had not been consulted yet. Staff were feeling anxious about the overhaul. Corinda Taylor, chairwoman of the Life Matters Suicide Prevention Trust, said she supported the plan, but it had to be properly funded.
"The plan could help to support many people in distress. Nobody should ever fall through the gaps, but currently this is reality for many."
