Understaffing, high turnover, communication issues and interpersonal conflicts are putting children's mental health services on the West Coast at risk, an internal report suggests.

The report into the region's Child and Adolescent Mental Health Services (CAMHS), released to Stuff under the Official Information Act, warns children will suffer if the service's culture does not change urgently.

Some children had to wait up to six months for help this year as chronic recruitment and management problems plague the West Coast District Health Board (WCDHB) service.

The latest provisional suicide figures shows the region already has the second highest suicide rate in the country.

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The October report, written by a mental health clinical nurse specialist, said CAMHS was facing huge challenges. It had about 100 clients, but was at least two clinical staff short and struggling to attract new staff. It could no longer provide all treatment options, including an adventure therapy group and parent-child interactive therapy.

There had been six temporary or interim managers within the last 13 months, and some of the staff still there were confused about who they were meant to report to.

"Historical issues resulting in the imploding of the service are well known and documented ... Communication issues abound at all levels. Often nobody actually knows where people are or what they are doing.

"Communication problems are exacerbated by interpersonal tensions ... CAMHS staff remains uncertain about the future and feel undervalued and frustrated. While some are overworked and tired, others are underutilised," the report says.

SANDRA COX The West Coast's Child and Adolescent Mental Health Services are based at Grey Base Hospital.

It recommends a five-month action plan – including introducing a robust training programme, clarifying reporting lines, starting regular child-focussed morning meetings, and implementing a communication plan – but it is all dependant on getting more clinical staff.

"We have an opportunity to change the culture right now ... If we don't we will not be able to attract or retain staff, our reputation will continue to slide and poor client outcomes will eventuate."

A former staff member, who did not want to be named, said she left because she felt it was a toxic workplace where staff members were not supported by the DHB.

The service had been good under the last permanent manager, but went downhill since a series of temporary managers were put in place, some of whom were from the adult service and had no experience with childrens' mental health, she said.

The service had also moved from a purpose-built building into the adult service at Grey Base Hospital, which did not have special play rooms or family therapy space.

"It's basically defunct but they won't say that. They are doing the bare minimum. The community will suffer," the ex-staffer said.

"It takes some time for mental health issues to come to the surface so in years to come we will see the effect on children in schools with huge issues that aren't being dealt with."

WCDHB Mental Health Services clinical director Cameron Lacey said the service was well on the way to achieving the report's recommendations, but was still struggling to recruit staff.

Recruiting for the mental health sector was a national issue, he said.

CARYS MONTEATH/STUFF West Coast Mental Health Services clinical director Cameron Lacey says recruitment is an issue for the region's health system.

"Since the resignation of our previous manager we've had a variety of interim managers – all of which have been temporary roles – so we're not getting the progress we would have wanted at this point.

"We've been monitoring this quite carefully because we've been conscious of the need to provide a good and safe service. We haven't seen any change in the number of presentations to emergency or acute services for children with things like suicidality or thoughts of self-harm. We are reassured by those figures," he said.

The focus was on getting the right clinicians in the the right jobs.

"What we've seen in the past when we put in interim managers in order to fill a gap that's when the problems have been prolonged rather than being addressed."

The service was being supported from visiting clinicians from Christchurch and Blenheim, he said.

"Our biggest worry is that people will ... [think] 'well don't go to CAMHS because they're not in a position to be able to help' and that would be a disaster for our community if people will choose not to access help because they didn't think it was possible."

WHERE TO GET HELP

Lifeline (open 24/7) - 0800 543 354

Depression Helpline (open 24/7) - 0800 111 757

Healthline (open 24/7) - 0800 611 116

Suicide Crisis Helpline (open 24/7) - 0508 828 865 (0508 TAUTOKO). This is a service for people who may be thinking about suicide, or those who are concerned about family or friends.

Youthline (open 24/7) - 0800 376 633. You can also text 234 for free between 8am and midnight, or email talk@youthline.co.nz

0800 WHATSUP children's helpline - phone 0800 9428 787 between 1pm and 10pm on weekdays and from 3pm to 10pm on weekends. Online chat is available from 7pm to 10pm every day.

Kidsline (open 24/7) - 0800 543 754. This service is for children aged 5 to 18. Those who ring between 4pm and 9pm on weekdays will speak to a Kidsline buddy. These are specially trained teenage telephone counsellors.

Your local Rural Support Trust - 0800 787 254 (0800 RURAL HELP)

Alcohol Drug Help (open 24/7) - 0800 787 797. You can also text 8691 for free.

For further information, contact the Mental Health Foundation's free Resource and Information Service (09 623 4812).