Thousands of ambulance callouts for mental health non-urgent study shows

Source: Radio New Zealand

A study into thousands of ambulance callouts for mental health shows most were non-urgent, and should have been managed in the community.

It found “most callouts [89.8 percent] were of low acuity, with a notable proportion of repeat callouts, suggesting unmet need for mental health care”.

That, and the fact that many – 32.8 percent – did not need to be taken to hospital, “suggest that many mental health callouts may be managed outside emergency settings”.

The study, published in the NZ Medical Journal on Friday, analysed 26847 mental health callouts – that was 5.7 percent of total callouts between July 2022 and June 2023 – before police began to retreat from mental health callouts.

Events which counted towards the study included attempted suicide, self-harm and anxiety.

The study also showed inequalities based on ethnicity. Māori accounted for 22.1 percent of these callouts, and Pacific people for 4.6 percent.

There is a disproportionately high rates of mental health related callouts among younger Māori and Pacific people compared to younger non-Māori or Pacific people, and higher proportions of callouts in areas of lower socio-economic deprivation.

Nearly a third (30.8 percent) of mental health callouts occurred in the most deprived areas (quintiles 9 and 10), with the highest proportions among Māori (47.7 percent) and Pacific peoples (49.9 percent).

Female patients accounted for over half of these callouts across all ethnicities.

“Continued reliance on emergency services suggests inadequate access to or insufficient community-based support,” the report says.

One of its authors, Gabby Harding, a lecturer in paramedicine at Auckland University of Technology and a paramedic herself with Hato Hone St John, said the low number of people taken to hospital means many would have been referred to community-based care.

“So it suggests that people are seeking support when other services aren’t available. As we know, people ring 111 when they are at a crisis point or in distress.”

Repeat callouts, where people called back within the year, suggested there may be a gap in continuous, accessible and culturally safe care, she said.

She said it was an opportunity to develop links between ambulances and community-based mental health services.

Ambulance services could refer people back to community services, but people’s access would still rely on those services being available, which was different by area.

Recommendations from the report

The study says future mental health policies should make it a priority to ensure appropriate systems, services and support for Māori and Pacific peoples were in place.

It also points out that addressing socio-economic determinants of mental health, like financial strain, unemployment and poor access to healthcare services, could improve people’s mental health.

“Addressing these issues requires comprehensive policy changes and a targeted approach to mitigate stressors such as racism, socio-economic inequities, stigmatisation and systemic barriers to healthcare,” the study says.

Wellington City Mission says sometimes people just need to talk

Pip Rea from the Wellington City Mission said people experiencing mental health distress could be having suicidal thoughts or a panic attack, and at that point, “they don’t know where to go, they don’t know what to do”.

“Something that’s ingrained in us as New Zealanders is to call 111, ask for an ambulance, and they will help us, they will know what to do – and so that’s what people do.”

Often by that stage, people had tried places like their GP or talking to someone, and had reached crisis point.

She said the City Mission had a good relationship with Wellington Free Ambulance, meaning people could be redirected to their Crisis Cafe, which was open all hours.

“A community, peer-led response – that’s what works, not a clinicalised model such as ED.”

It also meant repeat callers had somewhere else to go, rather than calling 111 in future.

Their service was “not over capacity, but we definitely are busy”, with numbers increasing month-on-month. In the Crisis Cafe’s first 11 months of operation, they had had more than 750 people through the doors, she said.

Minister says people reach out for loneliness and stress – issues which are ‘serious’ but ‘non-urgent’

The Minister for Mental Health, Matt Doocey, said his office’s own work had shown similar trends to this recent study.

“When we started working toward a mental health response to 111 calls, we started by examining the data. What we found was that a significant number of calls were being coded as “1M” by police, a category used for mental health,” he said.

People were reaching out, some repeatedly, for issues like loneliness, stress about housing or finances, or other social challenges.

“While these are serious and important issues, they are not always situations requiring an immediate response,” Doocey said.

He said this data backed the need for the government’s rollout of mental health co-response teams, which would work alongside police or ambulance staff to respond to 111 calls.

“I recently visited a co-response team who spoke about the value of having a joined-up response, particularly in dealing with repeat callers, as they know the person well and can respond accordingly,” he said.

Health NZ says more work to do, but investment is being made

Health NZ national director for mental health and addiction Phil Grady said the agency was committed to providing faster access to primary and specialist mental health and addiction services while growing the mental health workforce to meet increasing need.

Investment so far included:

• The $10 million Mental Health Innovation Fund, aimed at supporting faster access to a greater range of community-led support, like Ki tua o Matariki to run peer support groups for expectant mothers aged 15-24 in Auckland.
• A $61.6m investment, announced in late 2025, to expand crisis recovery cafés and peer support in emergency departments.
• Money from Budget 2025 was being used to roll out co-response teams and expand telehealth capacity.
• $3.5m annual funding boost to specialist mental health services for infants, children and teens in Tairāwhiti, Counties Manukau, and Waitematā.

Uptake was increasing for community-based services, with the Access and Choice programme having provided more than a million sessions since it began in 2020.

An additional 6072 people had received specialist services compared to the previous year, Grady said, and an additional 557 full-time-equivalent mental health workers had been recruited since March 2023.

“This is promising – but we know there is more to do, and we remain committed to improving services to meet the needs of communities,” Grady said.

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– Published by EveningReport.nz and AsiaPacificReport.nz, see: MIL OSI in partnership with Radio New Zealand