This interview aired last Monday, the 28th April, 2025 on RNZ click here to see the original story…

Listen to the interview below  

For decades Segar House has helped people in Auckland experiencing self-harm, early life trauma, long-standing depression or chronic suicidality.

It offers a publicly-funded, intensive psychotherapy day programme – the only one of its kind in the country.

But under a change proposal from Te Whatu Ora-Health New Zealand the programme is set to be disestablished; its resources and staff “re-invested” elsewhere.

The proposal cites low participant numbers, transport barriers to access and Covid having an impact on a revamp of the day programme.

But Kyle MacDonald, a psychotherapist who worked at Segar House for a number of years, says the closure is short-sighted – the programme was always designed to be resource-intensive up front, to prevent people needing further therapy down the line.

He joins Kathryn, along with a former patient who says the Segar House programme helped save her life.

To email Minister of Mental Health Matt Doocey, click here…

Last week it was announced to the clinical team at Segar House – Rauaroha – the specialist psychotherapy service in Auckland, – that they were to be shut down.

What is Segar House? It’s a highly skilled team of therapists that provide treatment for the most chronically suicidal clients in the Auckland and Waitemata districts. These are people that generally have horrific trauma backgrounds, and have not been able to be helped by standard community based, one appointment a week type mental health treatment.

Instead, Segar House offers a five day a week, group based programme using the most up to date, and empirically supported treatment approaches for people with Borderline Personality Disorder, and complex post traumatic stress disorder.

And it works. It works for the clients, whose lives are improved, who can move onto living a life with meaning and purpose.

It works for the system as people who are as highly distressed as the people who wash up at Segar House use a lot of health services – inpatient hospital care, crisis services, and emergency department time.

And it works for the therapists, who get to do meaningful, effective therapy with people who absolutely need it, without the revolving door approach of a community, crisis driven service.

So if it works for the clients, the system and the staff, why is it being shut down?

Because the assessment of Te Whatu Ora is fatally flawed, and driven only by the austerity mindset of our current government. A mindset that can only see the total number of clients seen as numbers on a spreadsheet to be maximised. And having reduced people down to a number, then declare, based on no knowledge (or conversation with the experts either for that matter) that the numbers aren’t good enough.

Te Whatu Ora is proposing to simply shift the existing staff team (less than four full time equivalents, this place runs already on the smell of an oily rag) and reallocate them to community services. They also make the bold claim this will enable the clinicians to be better utilised, and that the clients will still receive the same treatment approach in the community. Which is utter rubbish.

It’s a bit like claiming we could just shut down the cardiac unit at Auckland hospital, put the cardio-thorassic surgeons into GP’s clinics, and there would be no change to the service people received. Oh, and GP’s see more patients, so the cardiac specialists should also up their case load!

We have our first ever Mental Health Minister with this Government, and of course I have been keenly following the various creative and necessary ways the Minister’s Innovation fund has been spread around to genuinely good pilot programmes.

To email Minister of Mental Health Matt Doocey, click here…

But given the relatively paltry amounts of money required to keep this service going and the incredible return on investment- financially and morally – Segar House provides, surely this service cannot just be allowed to slide into oblivion?

So I’m calling on Mental Health Minister Hon. Matt Doocey, who has repeatedly said that no frontline mental health and addiction jobs will be lost throughout any change process, to step in and direct Te Whatu Ora to halt this proposal and guarantee Segar House’s funding.

And, I’m asking everyone (including you!) to email the Minister and let him know you oppose the closure as well. Now is the time to keep the pressure up and get him to stop this closure NOW.

Simply click on this link, and tell him what you think (be polite!) To email Minister of Mental Health Matt Doocey, click here…

Interview aried Monday the 28th of April, 2025

To download and view the Segar House Change Proposal click here…

Story by Anna Whyte, from the Post. Click here for original story (paywalled)….

The proposed closure of an intensive mental health service is “insulting nonsense”, according to one advocate, and news to the minister in charge, who found out on the day The Post put in a request for comment.

Te Whatu Ora – Health NZ proposed earlier this month to close Segar House ‒ its Auckland-based tertiary level specialist psychotherapy service ‒ and redistribute the services and funding.

Mental Health Minister Matt Doocey had not been told of the proposal until Thursday.

In the change document, which was leaked to psychotherapist, broadcaster and former Segar employee Kyle MacDonald, it proposes to disestablish the programme, re-invest the resources into community mental health teams and redeploy staff.

“It’s insulting nonsense,“ MacDonald said. ”Frankly, I think it’s going to put people’s lives at risk.“

The document states there were “very few such services available in Australasia” and “the day programme is the only one in New Zealand“.

It said that “since 2019 admissions to the programme have steadily declined”.

“Whilst there have been impacts from the pandemic, the ongoing low volumes of people admitted onto the programme do not make this a sustainable model of care.”

It said that there were currently 11 people doing the day programme and one admission in 2024, and three others in process.

“Based on the service description, there is unused capacity within this highly skilled workforce.”

MacDonald said that based on conversations and his understanding of how the programme works, he disputed that.

“There’s actually quite a long pathway in, there’s the programme, and then there’s a pathway out.

“It’s a long-term treatment. It’s generally done in six-month blocks. Most people will do around 12 months. Some do 18 months.”

MacDonald said the proposal “doesn’t address anywhere … that it’s a specialist intensive programme that’s actually generally for people who aren’t able to be contained and treated effectively in community mental health centres”.

“Some of the clients they see were chronically suicidal patients,” he said.

“This particular group of clients, which attract a diagnosis of borderline personality disorder, tend to have a chronic suicidal presentation ‒ so they’re chronically suicidal, and they’re often chronically bouncing around from things like self harm to addictive behaviour, to being sexually reckless, driving, gambling.

“There’s a lot of self destructive behaviours, and it’s a pattern over time.“

In response, Health NZ’s Auckland group director of operations Michael Shepherd said the proposal would not see any reduction to frontline mental health staff “and in fact would result in mental health expertise being available to more people”.

Within the document, it says the full time equivalent staffing roles were 2.7 psychologists, 0.4 psychiatrist, 1.8 psychotherapists and 0.5 for an administrator. There was also 2.64 under ‘vacancy and funds’.

MacDonald said from his understanding, they had struggled to hire for vacancies, which was a common problem across the mental health workforce, “and now they’ve got standing vacancies which they can’t advertise, so it does sort of seem a bit rich on the back of all of that, for Te Whatu Ora to turn around and say actually you’re not seeing enough clients”.

Shepherd said Segar House had very low numbers of people accessing the programme and the proposal “comes from a need to utilise the clinical expertise of staff to meet the needs of more people”.

“In all other districts tangata whaiora (person seeking health) with similar presentations are treated with individual therapy or group-based programmes, which is what we are proposing.

“The consultation process is still under way and no decision as to the proposal has been made. While the consultation process is occurring tangata whaiora will continue to receive the same service and support that they are currently receiving.”

Doocey said he “had not been made aware of the proposed changes to Segar House until [Thursday], I have informed Health NZ I expect to be updated on the proposal at our next officials meeting on Monday”.

“I have been assured by Health New Zealand, and it is my expectation that the people who use this service will continue to be seen and supported. My understanding is that no final decisions have been made.”

Doocey said he had been very clear with Health NZ his priority was to increase timely access to mental health and addiction support, and he had set a “very clear expectation with Health NZ that no frontline mental health and addiction jobs will be lost throughout any change process”.

Released August the 10th click here for where you can buy your copy…

Have you ever wondered why you react the way you do to stressful situations? Or why some people seem to fall apart while others become controlling?

We are all shaped by our childhood and our life experiences— good or bad. We can’t control the sh*t life throws at us, but we can learn to control how we respond to it.

Even if you feel things have gone well for you, there’s still grief, breakups, and accidents — not to mention global pandemics — to navigate. The limited nature of life, and the fact we all stare down death — at one time or another — means no one finds this being alive business a walk in the park.

In Sh*t Happens highly regarded psychotherapist Kyle MacDonald explains the concepts he uses in his practice that will help you understand the behaviour patterns you (or your loved ones) fall into — especially under stressful circumstances.

“This isn’t really a “self-help” book,” Kyle explains. “From the point of view of therapy ‘self-help’ is an anathema. We only get so far on our own before we need someone else. In life ‘shit’ unavoidably happens. It is then up to us what we make of it. All of us have habits, built up over many years, of what we do with the ‘shit’.”

Kyle hopes readers will instead think of the book as a map.

“It contains a smorgasbord of helpful things I’ve learnt along the way. Hopefully, this map that I unfurl in front of you will show you some things that people learn in therapy, and then help you be more selective in the ways you approach your emotional world.

Regardless of the responses you may have developed to this point, you are not locked into these behaviours – your past doesn’t have to dictate your future. Drawing on over twenty years of clinical experience, Kyle outlines the key concepts, and how you can use the theories of psychotherapy to change your life for the better.

Each chapter discusses problems that people experience as they traverse life’s ups and downs: from childhood to relationships to parenting. It also touches on some of the more recent phenomena, including our responses to the pandemic and the increasing political polarisation, particularly in the online space.

And Kyle does it in a readable, accessible and at times humorous way.

Here is an overview of the topics covered in the book:

Chapter 1: Are we all a bit mad?
Chapter 2: Surviving childhood and parenting
Chapter 3: Trauma in childhood: Bad things do happen Chapter 4: Depression and low mood
Chapter 5: Mindfulness and the benefits of quieting the mind Chapter 6: How to calm our emotions
Chapter 7: How to care (but still look after yourself)
Chapter 8: Exploring love — and hate
Chapter 9: How to find yourself — and know where to look Chapter 10: Are we getting angrier?
Chapter 11: If life has a meaning — what is it?
Chapter 12: Bringing it all together
Chapter 13: What next? How to put it into practice

To arrange an interview or request an extract or review copy, please contact:

Gemma Finlay, Notable PR
Phone: 027 628 9695 Email: gemma@notablepr.co.nz