Canterbury health officials are concerned about an increase in mental health issues in the region.

Concerns are mounting over the scale of Canterbury's mental health problem, as suicide-related emergency calls double in the last year.

It comes as documents reveal discussions between Canterbury health officials and the Government have stalled over a discrepancy over the size of the problem.

Two top clinicians have challenged the Ministry of Health's "dogged determination to deny any earthquake related increase in mental health needs".

Canterbury police district commander Superintendent John Price said "calls for service" relating to attempted suicides had steadily increased since 2011.

READ MORE:

* Outpouring of support for Christchurch's mental health clients

* Canterbury residents most vulnerable five years after the quakes

* Boy with OCD can't get mental health help

* Christchurch woman Mandy Richardson: 'I was ready to kill myself'

* Tory Jones finds light at the end of the tunnel after a decade of depression

* Christchurch family affected by mental illness: 'We're normal people too'

* Business collapse after Canterbury quakes blamed for substance abuse

By 2015, the number had risen almost 100 per cent, and was likely the highest in New Zealand.

While those type of calls spiked before and after Christmas, the increase was likely still due to Canterbury's earthquakes, Price said.

"It's a hidden story, where there's a lot of work going on with the rebuild, but you've got to rebuild your people as well as your buildings.

"That's what I'm concerned about, is the people have also got to be well."

Domestic violence call-outs now had a "huge mental illness component", as people reflected their moods and behaviours onto those around them.

A disagreement between the Canterbury District Health Board (CDHB), the Canterbury Earthquake Recovery Authority (Cera), and the Ministry of Health had left authorities no closer to solving the problem.

Canterbury Hospitals Medical Staff Association chair Ruth Spearing wrote to Health Minister Jonathan Coleman in August, urging the government to "take our concerns very seriously".

"We are acutely aware that trust is not something that is present in the Ministry of Health at present – indeed the concerning feedback from colleagues working in the Ministry is the very dysfunctional interactions within that organisation at many levels," she said.

"At present, the ongoing time-consuming, negative interactions with the Ministry leaders is sapping the time and energy that we should be using to innovate and plan for best patient care."

A paper was then sent to the Ministry on September 2, from the CDHB and Cera, intending to finalise an agreement between the three parties about the "on-going monitoring of the priority area of 'improving people's wellbeing'".

The CDHB would take over as the lead agency for Christchurch's psychosocial recovery when Cera came to an end in April.

The paper suggested using the 'Health of the National Outcomes Scale' (HoNOS) to measure the CDHB against other large DHBs.

Ministry chief medical officer Don Mackie rejected the use of HoNOS data, despite it being touted on the Ministry's website as a useful measure of clinical and therapeutic mental health outcomes.

He suggested the increase in mental health issues could be due to a delivery model change, and that more people were using secondary mental health services "because they are more accessible, rather than as a consequence of quake-drive stressors".

CDHB mental health general manager Toni Gutschlag and chief of psychiatry Sue Nightingale responded by saying the CDHB did not dramatically change the delivery model until after demand for mental health increased.

"Within the New Zealand Ministry of Health there appears to be a dogged determination to deny any earthquake related increase in mental health needs and an absence of practical support to assist us," the letter said.

Gutschlag said she had had no formal communication with Mackie since he wrote to assure them he would continue to work with Cera on measuring recovery in November.

Last week, she alerted the Ministry that the acute inpatient service was full on several days in November.

"This may be in part because it's leading up to Christmas, but it looks different than it has in previous years," she said.

"Our community has been able to access the services they've needed, and our staff have done an incredible job to respond the way they have, but yes, I'm concerned about the sustainability of that."

Gutschlag stressed that although there was pressure on the service, support was available and people should not be deterred from seeking help.

Director of mental health John Crawshaw said their concern was "around how to best measure ongoing psychosocial recovery in Canterbury".

In rural Canterbury, mental health continued to be a big issue for stressed and drought-stricken farmers.

In the last year, six farmers had committed suicide in Waimakariri, as well as one in Selwyn and one in Ashburton.

Rural Support Trust chairman Doug Archbold recently fielded a call from an international farm equipment firm concerned about "people's demeanours" when they called their helpline.

"They're ringing up to deal with things to do with their farm equipment and after having a conversation with these people, it becomes obvious they were quite stressed," he said.

Archbold was asked to provide training for the firm's staff, to teach them how to speak with stressed farmers, or those dealing with depression or anxiety.

He acknowledged there were more farmers "presenting with stress or depression than they did in normal times", and it was "concerning".

WHERE TO GET HELP:

The Mental Health Foundation's free Resource and Information Service (09 623 4812) will refer callers to some of the helplines below (all available 24 hours a day):

Lifeline - 0800 543 354 (

Depression Helpline - 0800 111 757

Healthline - 0800 611 116

Samaritans - 0800 726 666 (for callers from the Lower North Island, Christchurch and West Coast) or 0800 211 211 / (04) 473 9739 (for callers from all other regions)

Suicide Crisis Helpline (aimed at those in distress, or those who are concerned about the wellbeing of someone else) - 0508 828 865 (0508 TAUTOKO)

Youthline - 0800 376 633, free text 234 or email talk@youthline.co.nz