Content warning: This story discusses the sexual and physical abuse of children and young people.
Survivors of abuse in New Zealand's psychiatric system say they were tortured by state employees at state-owned and -operated institutions, and they want the government to recognise it.
Since 2012, the Ministry of Health has made hundreds of apologies to people for their treatment at almost 30 psychiatric hospitals and units around the country, from Whangārei to Invercargill.
On 24 July, as the Royal Commission of Inquiry into Abuse in Care's final report was made public, Prime Minister Christopher Luxon acknowledged on behalf of the state - for the first time - that the experiences of some children and young people at Lake Alice Psychiatric Hospital amounted to torture.
It followed a report by the Royal Commission, which in December 2022 found the survivors and victims of the Lake Alice child and adolescent unit were subjected to torture, particularly electroconvulsive therapy (ECT) and the sedative paraldehyde given as punishment; serious sexual, physical, emotional and psychological abuse; were disbelieved when they tried to tell what was happening; and were neglected, threatened, degraded and humiliated.
But RNZ has spoken to survivors of other psychiatric institutions who said what happened at Lake Alice was abhorrent, criminal and cruel - but not unique.
They told RNZ that as children or young people they suffered abuse amounting to illegal detention and torture, including the use of uncontrolled electric shocks under the guise of electroconvulsive therapy and paraldehyde injections, as well as physical, sexual, and clinical violence.
Cooper Legal principal partner Sonja Cooper, whose firm has acted for hundreds of abuse survivors and victims, backed the call from survivors and said it was clear that torture was a feature of Aotearoa's psychiatric system.
Cooper has written to Erica Stanford, the minister leading the government's response to the Royal Commission, outlining what her firm had uncovered at 14 institutions from 1963-1991.
"Some of the allegations are particularly brutal - electric shocks on teenage boys' penises and on teenage girls' nipples and vagina, women being given paraldehyde and ECT as punishment while pregnant, and 14-year-olds being given paraldehyde as punishment," the letter said.
"This was particularly common at Porirua Hospital where a large number of our clients were sent, by the state, once they had come into 'care'."
The survivors wanted the government to acknowledge torture was widespread and systemic in institutions beyond the Lake Alice child and adolescent unit.
'I was spitting out teeth'
Terry Kingi had suffered a lifetime of abuse even before he was admitted to Ngawhatu Hospital, near Nelson, as a teenager.
But while in the hospital he was subjected to sexual and physical violence at the hands of staff as well as uncontrolled ECT - electric shocks applied to the head without anaesthetic or muscle relaxant.
"I remember back answering a nurse and saying I wasn't going to do that. It was a really mundane thing. So they dragged me off and next thing I knew I was down getting strapped to the table and clamps on and I thought 'oh, this is going to be it'. And I do remember one day coming back blood pouring out of my mouth and I was spitting out teeth."
The electric shocks were given as punishment and resulted in him needing dental plates by the age of 15, Kingi said.
Joan Bellingham received ECT more than 200 times at Princess Margaret Hospital, as her psychiatrist wanted to cure her homosexuality.
The shocks left her with burns to her head and caused long-term memory loss.
Bellingham believed the weeping sores left by the burns to her head led to her contracting Hepatitis C.
She also received painful and immobilising injections at the hospital and believed the drug was paraldehyde - a carcinogenic sedative.
"I can remember the pain; the horrific headaches afterwards; vomiting continuously; going blind sometimes; severe burns to my head, and they'd be seeping, and then they'd still give me shock treatment again the same day," she said.
'Antiquated, brutal, institutionalised violence'
Jim Mahoney spent six months in Porirua Hospital in 1970.
Deputy superintendent David Clouston had been responsible for holding the then-20-year-old in the institution.
Mahoney described the environment as "violent, punitive and extraordinarily harsh".
"The staff would grab somebody - grab an arm or a leg each, so four nurses would have a hold of an arm or a leg and throw the person into the ceiling," he said.
"That was one of their punishments. That was for stepping out of line."
Mahoney was taken to the hospital by his father, as his parents were growing increasingly worried about his drug use.
But he spent much of his six months in the hospital behind locked doors on a ward, without ever agreeing to being admitted.
It was tantamount to kidnapping and illegal detention, he said.
While there he was subjected to physical violence, paraldehyde injections and ECT.
He recalled one occasion being forced into a lock-up ward.
"I took it badly and started kicking on the door and this nurse came in and head-butted me and then some more came in and held me down and injected me with paraldehyde," Mahoney said.
"It's unbelievably painful and then you pass out completely."
The electric shocks were also terrifying.
"There were bars on the headrest and footrest [of the bed]," Mahoney recalled.
"I was 6'1, my ankles went through the bars and the nurse said to me 'Pull your feet out of there, you might break an ankle when you convulse'. So you lay down on the bed and they injected you with a mixture of a muscle relaxant and an anaesthetic and sometimes the muscle relaxant would hit you first.
"I'm an asthmatic and my chest would cave in and I couldn't breathe and I'd go unconscious struggling for breathe, thinking I was dying and then wake up semi-amnesiac with pain in my temples and stumbling around."
He believed Clouston should have been a patient rather than a clinician.
"It very much was a case of the lunatic being in charge of the asylum," Mahoney said.
"You either got [the antipsychotic medications] Largactil or Stelazine or ECT. You either got a chemical straitjacket so you were shut down and looked like a shuffling, drooling imbecile, or you got shock treatment, so you were a shuffling, drooling imbecile."
But many suffered worse treatment than him and what occurred at Porirua Hospital amounted to torture, Mahoney said.
"Antiquated, brutal, institutionalised violence backed by the threat of criminal garden violence," he recalled of the hospital and its clinicians.
Clouston also played a role in Grant West being admitted to the hospital in 1970, when West was just 8 years old.
West also spent time in the hospital as a teenager, while a state ward.
He said he suffered sexual, physical and psychological abuse at the hands of staff, and had been given electric shocks, including to his genitals.
"If you screwed up you knew what you were going to get," he said.
"If you misbehaved, didn't take your medication, swore at them, didn't eat meals or didn't take your plate back over to the kitchen area, then you're getting electric shock treatment or you're getting a beating and I prefer the beating to the electric shock - I can tell you that much. They were nasty and they didn't care."
West referred to the treatment as "horrendous torture".
"We were treated as subhuman. It was soul destroying, mentally, physically, it's not just something that happened on the spot there and then, it's something I have to live with for the rest of my life."
Equal treatment requires equal justice
Sonja Cooper said abuse amounting to torture had "definitely" happened at psychiatric hospitals and units other than Lake Alice Hospital's child and adolescent unit.
She had raised it with Erica Stanford during a meeting on 12 September and followed it up with a letter outlining the steps she believed the government needed to take.
"I said to her then, 'you need to be aware that there were many other psychiatric hospitals . . . where exactly the same thing happened'," Cooper told RNZ.
The government had focussed on the punitive use of ECT and paraldehyde at the Lake Alice child and adolescent unit.
However, punitive use of ECT and the application of electric shocks to the genitals of children had been documented as other institutions, including Porirua Hospital, Cooper said.
Two reports in 1972 and 1982 had also detailed the overuse of paraldehyde at Oakley Hospital - also known as Auckland Mental Hospital, Auckland Psychiatric Hospital or Carrington Hospital - particularly by unqualified staff, Cooper said.
"I said to [Stanford], we settled 320 claims in 2012 and multiple of those claimants were adolescents in psychiatric hospitals - and were dumped there, typically by the state, they were often state wards - and suffered exactly the same abuse, and that includes in other parts of Lake Alice Hospital or other periods at Lake Alice Hospital.
"We had, for example, a 16-year-old client who was at Lake Alice Hospital but was placed in a different ward and suffered the same things, the same abuse."
But because he did not fit within the government's limited criteria, he was only eligible for the smaller settlements offered to survivors outside of the Lake Alice Hospital child and adolescent unit.
Those who suffered the most serious abuse at psychiatric institutions other than Lake Alice Hospital were entitled to up to $18,000 before 2012.
There were 330 settlements made under that process.
After 2012, survivors were only entitled to up to $9000 and 376 people had been offered an apology or settlement.
Separately, 203 people had received settlements under the Lake Alice child and adolescent unit process since 2001.
Cooper said her clients' experiences had spanned from 1963 to 1991.
"Our own databases showed us that the allegations were across the hospitals and I was very clear to the minister, you can't just single out this small group [of Lake Alice survivors] and treat others - who had identical experiences but just happened to be at other psychiatric hospitals - differently," Cooper said.
"She tried to respond to me at that stage by saying 'ohh well, the UN made a finding that this was torture'. And I said to her 'well, are you inviting me then to collect together the full cohort of the former clients that we acted for and make complaints on their behalf to the UN so that there can also be similar findings?' and she kind of backed off at that point.
"But is that what we're left with? Do we have to now find all those 320 clients, some of whom we know already have committed suicide or died - do we really have to go through that, given the Royal Commission and its multiple reports which made findings of torture. So it's frustrating because it seems to me that they've picked a very small discrete group of claimants."
Cooper said she accepted the children of Lake Alice were entitled to every dollar they had received and it was only a step towards reasonable redress, but they should not be separated from other survivors, who suffered similar abuse.
Selwyn Leeks, the former lead psychiatrist at the Lake Alice psychiatric hospital's child and adolescent unit, should also not be held out as one bad egg, Cooper said.
"That is such a Crown narrative - that it's a few bad eggs. No, it was a whole system that was rotten," Cooper said.
"And in terms of children in care is still not functioning and should be just destroyed and started all over again. It is just not palatable or feasible for the state any longer to try and argue that these were a few bad eggs. The Royal Commission has completely debunked that myth, and made it very clear that across all aspects that they investigated - and that is psychiatric hospitals, psychopaedic hospitals, it is the complete ambit of state care, foster care, family homes, residences - these were systemic issues starting right at the top and that's right from government, all the way down."
While Leeks died before facing criminal justice, Cooper said there were other figures from other psychiatric hospitals and units who perpetrated abuse and were still alive to face prosecution.
College of Psychiatry responds
RNZ requested interviews with Stanford and Minister for Mental Health Matt Doocey.
Neither made themselves available for an interview and the government was not able to comment on the wishes of the survivors who spoke to RNZ.
RNZ also asked the Royal Australian and New Zealand College of Psychiatry if it accepted children were tortured at Lake Alice Hospital and if it believed torture took place at the hands of other clinicians at other institutions.
The college did not directly respond to those questions, but president Dr Elizabeth Moore said: "Selwyn Leeks and some of the unit's staff inflicted extreme physical, sexual and emotional abuse, neglect and degradation on the children and young people in their care from 1972 to 1980. The abuse changed, shaped and stole lives.
"For many, the harm and trauma is still felt deeply today. It was an abject and systemic failure of duty. Too many organisations did too little, too late. The horrific actions were enabled and protected by a lack of transparency and accountability and working under a shroud of secrecy and isolation.
"In recent years we've seen more scrutiny on abuse within institutional care, across a range of sectors. The reviews look at the actions of individuals, but they also look at the systems, processes and context that surrounds them. The secrecy and isolation surrounding Leeks is also seen at other institutions where abuse has occurred.
"We see similar patterns in every sector where harm goes unchecked or falls through cracks because the system is weak or complicit. This happens when the system doesn't - intentionally or inadvertently - do enough to prevent, recognise, report, and respond to harm.
"One of the most important parts of being safe is constantly learning, and that means learning from the good and the bad. It's a process of constant scrutiny, reflection, and adjustment. Today, psychiatrists work collaboratively and are expected to work with a mindset of continuous improvement. It's an important part of safety and learning and deeply embedded in training, supervision and ongoing professional development. Peers, multi-disciplinary teams, and communities hold us to account to prevent issues, but also respond to any issues appropriately with robust reporting channels.
"Respecting patient autonomy and dignity is fundamental to modern psychiatric practice. Individuals have the right to be informed and actively participate in their healthcare decisions, including the right to refuse unwanted treatments if they are able to do so."
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