The second phase of the police's staged retreat from responding to mental crisis call-outs has been delayed after discussions with health officials.
As of 4 November police have started cutting back on time spent escorting voluntary mental health patients to emergency departments and between hospitals, and attending incidents at mental health facilities.
The move has been widely criticised by front-line mental health workers, who have said the sector had not been adequately prepared to fill the vacuum left by police.
According to a PSA survey, 90 percent of mental health workers said they and their patients would be less safe as a result of the changes.
The fact staff only received the standard operating procedures (SOPs) a few days days ago showed how ill-prepared Te Whatu Ora was for this, Nurses Organisation chief executive Rob Goulter said.
"It's been a disaster - the police said months and months ago this was going to happen.
"Clearly Te Whatu Ora has been so absorbed with its own internal problems that this one sailed straight past them.
"To be at the last minute still trying to sort it out at this critical juncture, when it's a critical health and safety risk for patients as well as for staff... it's not acceptable."
Unions had been pushing for a plan for months, Goulter said, but when it was finally presented to them, it was not adequate.
"They should just slow it all down until they have a workable system in place."
Te Whatu Ora says it's listening
However, Health NZ clinical chief for mental health and addiction, Dr Murray Patton, said the procedures were developed in consultation with front-line staff.
"Not all staff obviously, but there has been a working group with representatives from ED, mental health and security, meeting weekly for some months and working up all the changes, which are summarised in those SOPs."
Last minute changes were required after police advised "some of the documentation they were asking to be completed as part of the request for transport or non-urgent assistance was no longer needed".
Health NZ was listening to staff concerns and would continue to adjust the draft SOPs based on feedback about "what is and isn't working", he said.
In addition to the working group, there was a fortnightly governance group with members of police, the Ministry of Health and Te Whatu Ora to work through the changes being made and keep each other informed.
"We know already the next phase won't be happening at the time originally forecast to happen from January to March," Patton said.
"It's accepted January is too soon for that to happen, and it's more likely to be March, but the date has not yet been confirmed."
Phase 2 involves the handover of patients under the Mental Health Act (compulsory care) at emergency departments, and also the procedures for people being assessed in police custody.
Patton said overall, the changes were about bringing a more "structured" approach to what was already happening.
Under the new system, police would call ahead to an emergency department and mental health services to check firstly whether ED was "the best place for that person", and secondly that appropriate staff would be there to receive them.
"This isn't changing the way in which people are working, it's simply saying that police will continue to bring people to the ED if that's agreed to be the right place and we'll have a more structured process."
Police would not leave anyone in ED before checking it was "safe" to do so, he said.
When asked whether the health system had sufficient staff and resources to do the job, Patton said "the job remains the same job as it was before this programme of change".
"Our staff have been doing this for a long time, we've had crisis teams for a long time, community teams. This doesn't mean we're going to be doing a whole lot more work, we're just going to be doing it slightly differently."
Patton conceded there were long-standing staff shortages in mental health.
"The health system is doing all it can to address its workforce issues - that's a long term programme, that's what the Workforce Plan set out and there's quite a lot of activity to increase the numbers of nurses, allied health workers and also medical staff.
"But it's not something that's going to change overnight."
Phase 3: April - June 2025
Mental Health services requests for police assistance.
Missing persons from health facilities - including AWOL and walkouts of patients
Phase 4: July - September 2025
Detained persons 15-minute handover at ED.
Welfare checks: Public and other agency requests to police.
