Breaking the law title image

CONTENT WARNING: This feature covers topics including severe mental distress, addiction, self-harm and suicide. Please take care while reading, and reach out to one of the contact numbers below if it triggers any distress.

Tristan Locke and mother illustration.

Tristan Locke’s mother cannot be identified due to a court order. She says she has struggled - and failed - to get Tristan the right mental health treatment since he started going to school.

Tristan Locke’s mother cannot be identified due to a court order. She says she has struggled - and failed - to get Tristan the right mental health treatment since he started going to school.

Tristan Locke’s mother believes her son would have never seen the inside of a prison cell if he’d received mental health treatment as a child. “If Tristan had gotten the help he needed, he would not be there today.”

The 31-year-old Tristan, from Christchurch, stabbed his neighbour, Mark Cowling, in September last year during a dispute sparked by noise complaints over Tristan’s loud music. Cowling bled to death, leaving behind his grieving partner and a baby who was not even 1 at the time. Tristan was sentenced to life in prison with a minimum non-parole period of 10 years. He is appealing his conviction.

His mother, who cannot be named due to a court order, knew Tristan’s untreated mental health issues were taking him down a worrying path. “I just knew something bad was going to happen one day; I actually thought that he would one day succeed in taking his own life. I could see my son was miserable. He was developing this huge sense of hopelessness and frustration, and eventually a hatred of life and disillusionment with humanity.”

Years of going from one psychiatrist to the next, begging doctors for answers, and fighting a system that did not cater for her son, has left her disillusioned herself. “When he was a child, he was the happiest little boy. That’s what breaks my heart now. These systems let him down and they broke him. It is like I lost my son.”

Tristan was born in the USA (his father is American) and moved with his mum to New Zealand when he was 4. His problems began when he started school. While he was a calm and happy boy at home, he became hyperactive and overstimulated in the classroom, leading to complaints from teachers.

“They told us he had ADHD, but I knew that wasn’t it because he wasn’t like that at home,” his mother says. “Everyone was going at me all the time, treating me like it was my fault my son was not behaving as he should.” She fought for help for years, but no-one could ever give her a clear explanation for her son’s behaviour. She felt the clinicians refused to listen to her.

Olive branch
Tristan Locke in court, wearing a collared shirt. He has longish hair.

Tristan Locke was convicted of murder and sentenced to life imprisonment in July this year. He is appealing his conviction. JOHN KIRK-ANDERSON/STUFF

Tristan Locke was convicted of murder and sentenced to life imprisonment in July this year. He is appealing his conviction. JOHN KIRK-ANDERSON/STUFF

“They just kept slapping labels on him: oppositional defiant disorder, obsessive compulsive disorder. They treated him like he was being wilful, and I knew that he wasn’t.”

When Tristan was a teenager, bipolar disorder and schizophrenia were considered, but dismissed. One psychiatrist suggested he enrolled in the military. “We came up against a terrible amount of arrogance in the mental health system. They think they know everything and they are not willing to consider anything else outside of what they know.”

Finally, Tristan was diagnosed as being on the autism spectrum but even then, there was little help available. “People didn’t understand autism and the systems didn’t cater for it. Tristan just kept being punished and getting all this negative feedback. It was very, very damaging to his self-esteem.”

By 17, Tristan was depressed and drinking heavily. He had tried to kill himself three times. Tristan believed the system was broken and there was no point engaging with medical professionals any longer, his mum explains. He was tired of telling doctors he was depressed and suicidal, only to hear he didn’t tick all the boxes of depression and therefore couldn’t be depressed.

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Generic aerial photo of Christchurch.

The significant staff shortage across mental health services has been further affected by the Covid-19 vaccine mandate. ALDEN WILLIAMS/STUFF

The significant staff shortage across mental health services has been further affected by the Covid-19 vaccine mandate. ALDEN WILLIAMS/STUFF

“When he told one psychiatrist he was contemplating suicide, they just looked at him and said: ‘People who are trying to commit suicide eventually succeed,’” his mother says. “Tristan just got up and walked out.”

Her son spiralled deeper into alcohol abuse - “trying to drink himself to death”. When she heard he had been arrested for murder, her heart stopped. She couldn’t believe her son would attack someone. “Tristan is not the kind of person that would ever deliberately antagonise someone or confront people. He just lives by himself and internalises it all.”

Now, after years of fighting the mental health and education systems, she is waging another battle. Against a prison that does little to help people like her son. Tristan is once again stuck in a system that doesn’t cater for him.

Doug Sellman, white-grey hair.

Addiction expert Doug Sellman says being in prison can be a trauma in itself, and often when people are released from prison, they need to first deal with the trauma of being in prison before starting to deal with the problem underlying the reason for why they ended up behind bars. ANDY JACKSON/STUFF

Addiction expert Doug Sellman says being in prison can be a trauma in itself, and often when people are released from prison, they need to first deal with the trauma of being in prison before starting to deal with the problem underlying the reason for why they ended up behind bars. ANDY JACKSON/STUFF

Addiction and mental health treatment in prison can be tough. Or as addiction expert Doug Sellman puts it, “very very far from ideal”. 

“Prison itself is a trauma. Many people who come out of prison actually need treatment to address the trauma of having been in prison, before starting to deal with the problem underlying the reason for their entry into prison. Going to prison actually gives them a new problem, a new trauma, which drives drug [and alcohol] use.”

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Illustration of Clara and her son, Nathan.

Clara (not her real name) says there is inevitably a stigma that goes along with her son’s schizophrenia diagnosis. He has lost a lot of his friends since being diagnosed.

Clara (not her real name) says there is inevitably a stigma that goes along with her son’s schizophrenia diagnosis. He has lost a lot of his friends since being diagnosed.

Clara* watches her son pace up and down, muttering to himself. It's 3am and they’re in a hospital emergency department. It’s a familiar scene for them. Nineteen-year-old Nathan* walks back and forth while Clara sits. And waits. The chair is uncomfortable. The chairs in ED are always uncomfortable.

Most uncomfortable of all though are the looks. The mum with the asthmatic baby sitting across from them watches Nathan pacing, concerned. A few chairs down, the man with his arm in a cast stares intently at the floor, the walls, the ceiling. Anything to avoid eye contact.

At least the staff have given up asking for her son to stop “being so disruptive”. Maybe they’ve finally realised there’s no point.

For Clara, these ED visits at impossible hours have become a regular occurrence since Nathan was diagnosed with schizophrenia.

Clara and Nathan are not their real names. Clara requested pseudonyms. Battling a mental illness like schizophrenia is hard enough without having to deal with the stigma that inevitably goes along with it, she says.

She has been told by more than one person working in the public mental health system that she should just kick Nathan out of her house. What a ridiculous suggestion, she says. He would never be able to fend for himself and would likely end up behind bars. Or worse.

Mental illness figures are significantly higher in prison than in the general population. According to the Ministry of Justice, while one in five New Zealanders experience mental issues in their lifetime, more than nine out of 10 inmates have had a diagnosis of mental health or substance use disorder at some point in their lives. Often, it goes undiagnosed or untreated.

The Department of Corrections has estimated that 62 per cent of those in prison in the last year would meet the diagnostic criteria for either a mental health or substance abuse disorder. Ninety-one per cent would meet the criteria at some point in their lives.

Generic aerial photo of Wellington.

Clara has had to take Nathan to the emergency departments of hospitals in the Wellington region countless times when his mental illness became too difficult to manage at home. ROSA WOODS/STUFF

Clara has had to take Nathan to the emergency departments of hospitals in the Wellington region countless times when his mental illness became too difficult to manage at home. ROSA WOODS/STUFF

Nathan, who lives with his family on the outskirts of Wellington, was diagnosed with a mental illness after a significant psychotic episode in May last year. He spent several weeks in a mental health youth ward.

He was tentatively diagnosed with schizophrenia, along with drug and alcohol dependence, and prescribed medication before being sent home. The medication helped, but was no silver bullet, Clara says. Nathan needed psychological treatment such as cognitive behavioural therapy, but a months-long waiting list stood in the way.

He was not always willing to accept help though, Clara says. Nathan was “bull-headed, impulsive and mentally very unwell”.

“Every time Nathan said he was willing to see a psychologist, he was put on the waiting list. When his name finally bubbled to the top and they rang him to set up an appointment, things had deteriorated again and he didn’t want to do it anymore.

Then they would say, ‘Oh well, he doesn’t want to engage, we’re going to remove him from the list’. CLARA

“And when he was well enough again to be willing to see a psychologist, his name would go back to the bottom.”

Each climb up the waitlist takes four to six months, Clara says. Nathan has still not accessed treatment yet.

She believes the pressure on the overloaded mental health system is why reluctant patients are so quickly set aside. Resources are too limited to waste on convincing a seriously ill but unwilling patient to participate in treatment.

Despite seeing a psychiatrist about once a month and being assigned a caseworker who checks in on him periodically, there have been a few occasions where Nathan’s mental health deteriorated to such an extent that he had to be admitted to hospital. Each time, he spent a few weeks in a mental health unit where his medication was increased or adjusted until he was well enough to be sent home. He received no psychological treatment.

At the end of last year, Clara left her job to care for Nathan full-time. She had no other option, she says.

A stint in mental health accommodation was unsuccessful as there were not adequate support services for a high-needs person such as Nathan. Private psychological treatment is too expensive, more so now that the family has to survive on a single income.

Clara believes society’s dim view of addiction contributes to the lack of urgency in supporting mentally ill people.

It is common for mentally ill people to self-medicate with narcotics or alcohol, but society uses this as an excuse to absolve itself from caring for them. CLARA

“They just say, ‘Well, it’s their own fault, we’ve told them not to do it and they don’t listen’, and that gives them an out to not do everything they can to help these people.”

Mental Health Foundation chief executive Shaun Robinson says there are many reasons why someone who is mentally distressed might end up in trouble with the justice system, but it’s often due to substance abuse problems. “People who are despairing will often abuse alcohol or drugs, and if anybody abuses alcohol or drugs, it raises the risk of negative behaviour.”

However, he says, people who live with mental illness are statistically far more likely to be the victims of violence than the perpetrators.

“The mental health system is not there to coerce or punish people. It cannot, and never should be responsible for keeping our community safe from crime. That's the job of police and criminal law.”

When someone is distressed, Robinson says, their behaviour can often be confronting. “They can often be victims of violence due to their confronting behaviour, or police can intervene with all their biases on race and social standing.”

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Shaun Robinson standing, hands in the pockets of his jeans, wearing a navy blue jacket.

Mental Health Foundation chief executive Shaun Robinson says people who live with mental illness are statistically far more likely to be the victims of violence than the perpetrators. CHRIS SKELTON/STUFF

Mental Health Foundation chief executive Shaun Robinson says people who live with mental illness are statistically far more likely to be the victims of violence than the perpetrators. CHRIS SKELTON/STUFF

He recalled a time in his own life when he couldn’t cope with his thoughts and feelings sparked by bipolar disorder, which culminated in him being drunk in public. “But probably because I am Pākehā and male, I was not arrested. Had I been Māori or Pasifika, I might well have gotten arrested.”

Doug Sellman says many addicts who are unable to access publicly-funded treatment cannot afford to pay for private help either. The consequences for those who go untreated are dire. “People who can’t get the treatment suffer, die or go to prison.”

The prison population fluctuates daily, so determining exactly how many inmates receive mental health treatment is tricky. On October 29, the total prison population was 7945, but that number could look quite different today.

Stuff asked the Department of Corrections how many people sentenced to community-based sentences were ordered to complete court-mandated mental health treatment each year since 2014. The department said it kept no central record of this, so was unable to answer.

“Corrections currently manages almost 30,000 people on community-based sentences and orders at any one time. The conditions and activities for individuals on community-based sentences that relate to mental health treatment are not centrally recorded, and instead are held on the files of the individuals. In order to provide this information, we would be required to manually review a large number of files,” it says.

Corrections was also unable to say how many people had been ordered to complete a drug and alcohol treatment programme as part of their sentence. Here, data collection did not differentiate between those ordered by the courts to undergo treatment and those doing so voluntarily.

It was able to say that between 2013-14 and 2020-21, 34,470 people serving community sentences were involved with addiction treatment programmes - an average of 4434 people a year.

After months of waiting, Nathan has now been admitted to a drug and alcohol treatment programme that allows him to see a counsellor once a week. Things have been going “really well”, Clara says. But she is realistic about the nature of Nathan’s mental illness. A good day today does not guarantee a good day tomorrow.

While Nathan’s former friends (they disappeared quickly when he became ill) are all going to university, starting their first jobs, and getting into relationships, Nathan’s life has stalled. Clara fears he will end up on the street the day she is no longer there to care for him. “New Zealand just doesn’t have what it takes to address our mental health needs, and it is only going to get worse. We are in for some bad times.”

*Names have been changed to protect the family’s privacy

CHAPTER FOUR: WHEN HELP COMES TOO LATE

Click the image to read the story

Research and words Mariné Lourens
Design and illustration Kathryn George
Development Sungmi Kim
Editors Nicole Mathewson and Michael Wright

This project was created with financial support provided by a nib Health Journalism Scholarship.

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