Speech to Canterbury Mental Health Education & Resource Centre Trust AGM, 25th October 2012, 4.30pm

Lianne Dalziel | Friday, October 26, 2012 - 09:52

Canterbury Mental Health Education & Resource Centre Trust AGM

Oxford Tce Baptist Church lounge, Christchurch

25th October 2012

4.30pm

It is just over 3 years since John Key appointed distinguished scientist Professor Sir Peter Gluckman to be the first Prime Minister’s Chief Science Advisor. He said at the time, that the appointment delivered on the Government’s goal of including science at the heart of their decision-making. It was a great decision. Evidence is really important when you are dealing with social and economic policies – it’s government’s version of harm minimisation.

On the 10th May 2011, Sir Peter delivered a briefing paper called “The psychosocial consequences of the Canterbury Earthquakes”. It stated that the potential exists for the emotional effects of disaster to cause as great a degree of suffering as do the physical effects such as injury, destruction of infrastructure and loss of income. It goes on to say:

The earthquake was a disempowering event – an event that individuals had no control over and leaves them essentially with no control over how they live. The need to regain some sense of control over one’s life is central to the recovery process. Disempowerment essentially reinforces the initial trauma.”

Sir Peter warned the government that things like more aftershocks, delayed responses to the provision of key needs and a lack of local community participation in the recovery planning process would impede the recovery process. He warned of the similarity with other processes – bereavement and post traumatic stress syndrome. He identified the high-risk groups, like women (especially mothers of young children), children and teenagers, as well as adults with pre-existing vulnerabilities. People with mental health issues can find themselves in more than one of these high-risk groups.

And that’s why connectedness is so vital in recovery. Not everyone is the same. Some cope better than others. Some cope better than they thought they would. Some can draw on previous experience of recovery from adversity to find an inner-strength that enables them to cope very well.

Others cope poorly and may resort to coping mechanisms like alcohol or other recreational drugs. This is not restricted to people with a pre-existing mental illness either. My point is that everyone is different and we need to identify those individuals who need support to develop that inner-strength that will help them in the future.

As far as communities go, Sir Peter provided a helpful check-list for the government to follow:

Recognising that the situation is distressing and not easy for the affected population;
Being explicit about how the governance arrangements will facilitate local engagement and empowerment;
Recognition by the community of the conflict that is inherent between the desire for rapid physical recovery and the difficulties the planners face. This conflict is inevitable and real – the key is to involve the community openly in resolving it;
Providing information on expected post-disaster emotions;
Providing community monitoring and good information on access to support services;
Providing clarity over reconstruction and rehabilitation plans:
It is better for those in decision-making roles to be truthful and say ‘we do not know’ rather than obfuscate;
It is important to set timelines for when things will clarify and information will be provided, and to meet those timelines;
Those involved in the managing the recovery process must understand that recovery in the end is about people’s lives, not just buildings, although clearly getting a functioning house, infrastructure and workplace are core to recovery. They must be credible in demonstrating that understanding and they must be willing to activate community empowerment and engagement;
Recovery planning must be broad-based and on-going. For example, re-establishing community services such as sports clubs is important.

I assume you have noticed the lack of connection between the advice and what is going on. This is despite the fact that if we followed the advice, then the vast majority of people will make a good recovery and will develop resilience to future challenges as individuals and as communities.

People need to understand that all their emotions, whatever they are, are natural responses to what we have experienced. And the government needs to understand that all of its processes have a direct impact on how people are coping and how well they will recover.

The lack of governance, community engagement and empowerment are critical omissions in a recovery strategy that ignores the advice Sir Peter provided a year ago.

My colleagues and I have been raising these issues since the first earthquake, because we have seen first-hand the emotional trauma that is associated with leaving people to struggle alone with EQC and insurers, trying to cope with land zoning announcements that they are neither prepared for nor fully understand and having no say in the decisions that are being made around them – including the central city decisions, which may not be top of mind for everyone right now, but will be when people see just what has been lost.

Options should not be destroyed before people are even ready to engage – this applies especially to our built heritage like the Cathedral. This is a category 1 Heritage building, to which our city owes its status as a city. It is the image that graces the Christchurch City Council logo and countless photos taken by tourists as their memory of their visit to Christchurch, New Zealand.

It is also disgraceful that the Cramner Courts have been allowed to be demolished – also a Category 1 Heritage building – does that mean nothing? Does private ownership take precedence over our heritage? What was the rush?

Why couldn’t the government provide bridging support to the residents who needed paying out, while alternatives were explored?

The government has had Sir Peter’s advice for a year and yet they have failed to take it into account. There is a collective state of shock that pervades the city and some areas feel it more acutely than others. Acts of kindness continue to inspire me on a personal level, but the government is failing in its duty to the people and they are dividing the city. That is why I am meeting people whose emotions range from abject despair to incandescent rage. And I am meeting people who say, why don’t people just get over it and move on?

I honestly believe we need to find a way to unite New Zealand around Christchurch’s recovery.

The government cannot separate the economic recovery of the city from the social recovery. They don’t even see the harm they are doing with the Central City Development Unit’s blueprint for the CBD, sending the unintended message that we have money to burn for a brand new convention centre and covered stadium, but nothing to give the people certainty about their own future. It isn’t an either/or, but it must be people first.

There is no need for top down decision-making; in fact Sir Peter says that it is disempowering. Engaging with the community doesn’t waste time; it strengthens the decisions. The aftershocks and the land issues have given us the gift of time. .

The pressure of time actually comes from the anguish that we have had expressed by our constituents – otherwise competent professionals reduced to tears by an insurance call-centre, an 88 year old covered in shingles from anxiety, the recently widowed uninsured red zone resident who has lost everything, people living in garages because they fall through the net of an artificially inflated rental market, the zoning decisions and now the shake-up in education. It cannot go on.

I have written letters to the Minister of Earthquake Recovery, the Prime Minister and now the Minister of Education highlighting how damaging this approach is.

I referred each of them to Professor Sir Peter Gluckman’s briefing paper. A specific quote I used in one of my letters to Mr Brownlee was:

“It would appear that key to minimising this phase [of anger and frustration] is the promotion of local empowerment and engagement by working closely in a collaborative way with the affected population in co-coordinating and co-leading the response effort. If the population do not sense this is happening, then the phase may well be longer and the symptoms of anger and frustration more intense. A feeling of self-efficacy and community efficacy assists the population in reactivating their coping mechanisms. Local governance, empowerment and ownership have been shown to facilitate recovery. The inevitable tensions and conflicts in achieving this are obvious (long-term versus short-term, public versus private, local versus national interests) and cannot be avoided – rather, they have to be openly handled with sensitivity.

It follows that, from the psychosocial perspective, those involved in directing the recovery should create governance structures that understand and actively include community participation and enhance individual and community resilience. Such approaches will be most likely to be effective in re-establishing coping and functioning communities”.

I copied the Prime Minister into this correspondence, because he publicly accused me of “playing politics with emotions in Christchurch”.

The reason I am referring to this is that this is the political reality my colleagues and I have had to face on a constant basis. We raise the issues directly with the government and when they do not respond and the issues become public we are accused of playing politics.

As I said in my letter to the Prime Minister, the true story about the ‘politics’ of what has happened in Christchurch will be told one day, but the time for that is not now.

The decisions that are being made by the government are too important to let up in my determination and that of my colleagues that international best practice is understood and followed.

The work that your organisation is doing is exactly what best practice dictates. You have identified the needs of your communities and you are responding in a real way. I know the pressure you are under as many of you are coping with your own earthquake issues and for the consumer-led services the challenges can be incredible. I have total respect for what you are doing and what you have achieved.

You are genuinely helping people to understand what affects their sense of wellbeing and how they can cope.

For me it was easy – I just needed to understand as much as I could about what had happened – finding out about earthquakes, liquefaction and lateral spread – and then moving onto the wider recovery issues and how to build resilience.

This took me back 25 years to the Ottawa Charter, which said: “Health promotion is the process of enabling people to increase control over, and to improve, their health. To reach a state of complete physical, mental and social well-being, an individual or group must be able to identify and to realize aspirations, to satisfy needs, and to change or cope with the environment. Health is, therefore, seen as a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities. Therefore, health promotion is not just the responsibility of the health sector, but goes beyond healthy life-styles to well-being.”

The Charter goes on to describe the fundamental conditions and resources for health as being: peace, shelter, education, food, income, a stable eco-system, sustainable resources, social justice, and equity. Improvement in health requires a secure foundation in these basic prerequisites.

We like secure foundations in Christchurch, and ours were rocked in more ways than one by the earthquakes. All these basic prerequisites were affected in one way or another over the past year – sometimes all at once.

This is why I do not diminish the scale of the challenge we face as we recover from this disaster.

Where I part from the government is that they don’t need to shoulder the burden alone. In fact their determination to do so is positively harming the recovery.

It is only through shared decision-making in partnership built on trust that will restore this city’s sense of well-being and without that, what have we got?