Watch: Summary of the Government Inquiry into Mental Health and Addiction’s final report.
Boosting access to services, reforming mental health and drug legislation, introducing a suicide target and re-establishing a Mental Health and Wellbeing Commission are among the 40 broad recommendations in the Mental Health and Addictions Inquiry report.
The 200-page report released today was handed over by Inquiry panel chair Ron Paterson last week to the Minister of Health Dr David Clark, who has said the Government will not formally respond until March and that it will take more than one Budget to address all the “strong and coherent recommendations” raised in the “once-in-a-generation” report (see summary of recommendations and rationales below).
The report is titled ‘He Ara Oranga –Pathways to Wellness’ and the inquiry panel recommends major reform saying the mental health and addictions system is under pressure and unsustainable in its current form.
“This is not simply a report calling for more money for mental health and addiction services – though it is clear further investment is needed in Budget 2019 and in the future,” says the report. “It is a whole new approach to mental health and addiction in New Zealand. It sets out he ara oranga – pathways to wellness.”
The report says that currently key components of the system are missing – in particular it doesn’t respond adequately to people in serious distress to prevent them from ‘tipping over’ into crisis situations.
“It’s time to build a new mental health and addiction system on the existing foundations to provide a continuum of care and support. We will always have a special responsibility to those most in need. They must remain the priority. But we need to expand access so that people in serious distress – the ‘missing middle’ who currently miss out – can get the care and support they need to manage and recover.”
It is the first major report into mental health services since the Mason Inquiry of 1996 which lead to the formation of the Mental Health Commission (disestablished in 2012) and the 1998 Blueprint for Mental Health Services in New Zealand.
This latest inquiry was given much broader terms of reference to look at the full spectrum, from mental distress to enduring psychiatric illness, and a mandate to look beyond the health sector to other sectors and social determinants that influence mental health outcomes, as well as addiction.
The resulting report proposes major changes in current policies and laws, supported by significant increases in funding. The 40 recommendations are grouped into 12 broad areas.
SUMMARY OF MAIN RECOMMENDATIONS AND THEIR RATIONALES
Expand access and choice to mental health services
- Expand services from current target of 3% of population being able to access specialist mental health to ensure access to the ‘missing middle’.
- An indicative access target may be 20% within the next five years.
- A new explicit target must be supported by funding for a wider range of therapies, especially talk therapies, alcohol and other drug services and culturally aligned services.
- Direct the Ministry of Health, in partnership with the new Mental Health and Wellbeing Commission, to facilitate and commit to funding a national co-designed service transformation process for mental health and addiction services.
Transform primary health care
- Enhance the capability of the primary care workforce, with additional mental health and addiction training for general practitioners, practice nurses and community health workers.
Strengthen the NGO sector
- Factors such as short-term contracts, high compliance costs and reporting requirements, multiple funders and contracts and a power imbalance are impacting on the sustainability of NGO providers in the community.
- Recommends a clear stewardship role within central government to support NGO development and sustainability and improve commissioning of health and social services with NGOs.
Enhance wellbeing, promotion and prevention
- Take a whole-of-government approach to wellbeing to tackle social determinants and support prevention activities that impact on multiple outcomes, not only mental health and addiction.
Take strong action on alcohol and other drugs
- Take a stricter regulatory approach to the sale and supply of alcohol, informed by the recommendations from the 2010 Law Commission review, the 2014 Ministerial Forum on Alcohol Advertising and Sponsorship and the 2014 Ministry of Justice report on alcohol pricing
- Replace criminal sanctions for the possession for personal use of controlled drugs with civil responses (for example, a fine, a referral to a drug awareness session run by a public health body or a referral to a drug treatment programme).
- Support the replacement of criminal sanctions for the possession for personal use of controlled drugs with a full range of treatment and detox services.
- Urgently complete and implement a national suicide prevention strategy, with a target of a 20% reduction in suicide rates by 2030.
- Establish a suicide prevention office to provide stronger and sustained leadership on action to prevent suicide.
Reform the Mental Health Act
- Repeal and replace the Mental Health (Compulsory Assessment and Treatment) Act 1992, to reflect a human rights approach, promote supported decision-making and align with a recovery and wellbeing model, and minimise compulsory or coercive treatment.
Establish a new Mental Health and Wellbeing Commission
- There has been a general lack of confidence in leadership of the mental health and addiction sector over many years, since disestablishment of the original Mental Health Commission.
- Establish a new Mental Health and Wellbeing Commission to act as a watchdog and provide leadership and oversight of mental health and wellbeing in New Zealand.
- Direct the Mental Health and Wellbeing Commission (or interim commission) to regularly report publicly on implementation of the Government’s response to the Inquiry’s recommendations, with the first report released one year after the Government’s response.
Establish a cross-party working group on mental health and wellbeing
- Mental health is too important to be a political football.
- A cross-party working group would provide an opportunity for members of the House of Representatives to collaborate and advocate for education, leadership and legislative progress on mental health and wellbeing.
Place people at the centre
- Strengthen consumer voice and experience in mental health and addiction services.
- Support families and whānau to be active participants in the care and treatment of their family members.
Where to get help:
If you are worried about your or someone else’s mental health, the best place to get help is your GP or local mental health provider. However, if you or someone else is in danger or endangering others, call police immediately on 111.
Need to talk? Free call or text 1737 any time for support from a trained counsellor.
Or if you need to talk to someone else:
Asian Helpline – 0800 862 342
Lifeline – 0800 543 354
Suicide Crisis Helpline – 0508 828 865 (0508 TAUTOKO)
Youthline – 0800 376 633 or free text 234
Kidsline – 0800 54 37 54 (for under 18s)
What’s Up – 0800 942 8787 (for 5–18-year-olds 1pm–10pm weekdays and 3pm–10pm weekends)
Depression Helpline – 0800 111 757 or free text 4202
Samaritans – 0800 726 666
OUTLine NZ – 0800 688 5463
Healthline – 0800 611 116