For crisis nurses, exposure to aggression, intimidation, and violence has become disturbingly routine.
What is most concerning is that much of this behaviour is not driven by mental illness.
Instead, crisis teams are increasingly responding to presentations shaped by methamphetamine harm, entrenched antisocial behaviour, social deprivation, and complex life circumstances that do not meet the threshold for specialist mental health care.
These situations are being reframed as mental health problems by default, despite originating in system gaps across justice, addiction, welfare, and housing.
This shift has been compounded by changes in police practice. In the mid-2000s, NZ Police positioned themselves as compassionate partners in supporting vulnerable people, symbolised by campaigns such as He Ain’t Heavy, he’s my Brother.
Over the past year, however, a new narrative has emerged, one in which police are ‘returning people with mental health concerns back to health’.
While the phrase implies collaboration, its practical effect has been a significant retreat from public safety roles and a redirection of people affected by drug harm, domestic violence, homelessness, and social instability toward mental health services, regardless of clinical appropriateness.
Crisis teams are increasingly being asked to carry risks that belong elsewhere and the violent behaviour we are expected to now manage is next level.
At the same time, reductions in mental health FTE resulting from holds on recruitment and budget cuts and a lack of forward workforce planning within Te Whatu Ora has weakened the sector’s ability to respond effectively.
Underfunded primary care, resource-stretched NGOs, and diminished community mental health capacity mean that many people now present to emergency departments (ED).
ED teams, already under immense strain, often default to redirecting these presentations to crisis services with the shorthand “one of yours”.
This reflects both workload pressure and a persistent stigma surrounding mental health in acute hospital settings.
For the wellbeing of both the workforce and those in need of responsive and holistic specialist mental health assessment and treatment plan, a system reset is urgently required.
Four actions are essential.
- First, a clear national agreement on roles and responsibilities between police, mental health services, addiction providers, and social support agencies is needed. Crisis nurses must not remain the default responders to non-clinical or criminal risk.
- Second, Te Whatu Ora must restore and grow mental health FTE while committing to long-term, culturally and clinically informed workforce development. Crisis nursing requires advanced assessment, relational practice, and safety skills; these cannot be substituted or diluted.
- Third, investment in primary care and NGO services must be strengthened to rebuild community capacity and reduce preventable escalation to crisis.
- Finally, EDs require targeted training and organisational support to address discriminatory attitudes, ensure safe triage, and foster shared responsibility across services.
Crisis nurses are deeply committed to supporting people with mental illness.
But the system must be rebuilt so we can provide safe, timely, therapeutic care, without absorbing the consequences of failures in other sectors.
A coordinated, well-resourced, and clearly defined crisis response is essential for the health and safety of both the workforce and the communities we serve.
— Stacey Wilson is a registered mental health crisis nurse based in Manawatū.