Rochelle Carey says she absolutely loves and adore her children and she wants to stay mentally healthy for them.

Rochelle Carey tried to take her life twice in the same night in 2015. She ended up in Christchurch Hospital's emergency department (ED) both times.

The first time a doctor checked her and sent her home within 30 minutes. The second time she stayed until morning then was sent home with a pamphlet for a mental health organisation.

Carey is among the increasing number of Cantabrians seen by ED for urgent mental health issues. Since 2010, mental health presentations to ED have increased 72 per cent, new Canterbury District Health Board (CDHB) figures reveal.

ALDEN WILLIAMS/FAIRFAX NZ Solo parent Rochelle Carey has battled mental health issues for several years.

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Staff representatives and mental health advocates say patients do not receive appropriate care because services are under "extreme pressure".

The CDHB says ED staff follow a "rigorous process", which "might not always be apparent to someone who is in distress or anxious".

ALDEN WILLIAMS/FAIRFAX NZ Rochelle Carey at home with two of four children.

Carey first contemplated suicide at age 15 after she was placed into Child, Youth and Family (CYF) care.

She started cutting herself, drinking and using drugs.

"They assumed I was doing it to get attention, but I wasn't handling my head."

She had her first child at 16. A year later, she suffered post-natal depression with her second and could not bond with her.

Drug use got her in trouble with the law. She had her third child in 2014 and lost custody of her children shortly after.

Carey's mental health slowly deteriorated until her 2015 suicide attempts.

With help from her GP, friends and family, she got better. She regained custody of her children, but early last year, her mental health went downhill again after a miscarriage.

In March 2016, Carey went to a friend's house and told him she wanted to end her life.

He took her to ED after she became agitated and put her arm through a window as she tried to leave his home.

"They gave me a sedative [but] I ran away through the ambulance bay."

She passed out in a petrol station nearby and was taken back to the hospital in handcuffs.

"I lost it, I was confused, angry and scared."

Carey stayed at the hospital overnight. A mental health team saw her in the morning.

"They gave me four pamphlets and said I could get three sessions of free counselling and sent me on my way home."

Again, with a lot of help from family and friends, she got back on track. She was pregnant again a few months later.

"To this day I haven't been suicidal, I haven't cut. I've had my down days but I'm a lot better than what I was.

"Now I've got four beautiful kids. I absolutely love and adore them."

CDHB chief of psychiatry Dr Peri Renison would not comment on an individual case, but said when people arrived in ED, a triage nurse assessed them immediately. Staff alerted the mental health team if people said they wanted to self-harm.

A brief mental health assessment would usually be followed by a more detailed assessment by a trained nurse or psychologist, who may consult others.

If the team believed the risk of self-harm was low, patients were discharged for follow up in a community setting. If the risk was "clearly high", they could be admitted to hospital.

The CDHB's 72 per cent figure compared 2010 referrals to those in 2016.

While raw numbers were not provided, they showed community mental health services also faced unprecedented demand. Those organisations had a 36 per cent increase in adult community referrals and a 73 per cent increase for children and youth. As of March 2017, 700 new adult patients sought their services each month.

Public Services Association campaign organiser Simon Oosterman said ED staff around the country felt they did not have adequate resources to give people the care they needed.

Mental health patients were being pushed out too early and without proper follow ups because services were understaffed and under-resourced.

Psychotherapist and mental health advocate Kyle Macdonald said Carey's story illustrated long-standing issues.

"The system is under extreme pressure."

A suicidal person presenting to ED needed to be properly assessed and offered appropriate treatment.

Leaving it up to them to follow up with the services was not the way to manage "scarce resources", Macdonald said.

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

Samaritans (open 24/7) - 0800 726 666

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 Helpline (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).