By now, we are sure that you are all aware that wellbeing and mental health are high on the agenda of many people in New Zealand following the government’s announcement about their response to He Ara Oranga, the Mental Health and Addiction Inquiry. Expectation for change is high. Funding has been significantly increased and the first ever ‘Wellbeing’ budget is receiving global attention.

 

This should be music to the ears of thousands of nurses who have seen the distress of people and who have known for many years that they could do so much more if there were the resources available. But we are only part of the solution. The Inquiry report clearly signals that a whole of society response is needed to best support people and their families and whānau.

 

It is time to act now. In 2018 we lost 660 people to suicide, a very sad and tragic reality. The urgent attention now being paid to addressing suicide is long overdue and must include high investment in culturally effective approaches that can reach a person in that darkest moment when they are wrestling with their own will to live. Support must be easily accessible and available from a range of people as we know that many lost to suicide have had no contact with mental health services. The immense value that families, whānau, friends or colleagues play in being with people in times of despair should be highly valued by employers, educators and the wider communities. Loneliness and disconnection cannot be cured with medication, it may be part of the solution, but more is needed. This electronic age of gaming and social media can both connect and disconnect us all. It is time to value and make the time to be with people in need. One suicide is indeed one too many.

Reshaping primary care is long overdue. Ensuring people can receive support early and be supported with their health needs will require a major overturn of the funding models applied to primary care to fully release the untapped potential of nurses. The Inquiry findings noted that the Health and Disability Review due to be completed in 2020, may provide some guidance on this issue. Preliminary outcomes from the recent Treaty of Waitangi claim against the Crowns Health Ministry clearly signal that funding models must change if we are to support the health and wellbeing of Māori people. Over the coming years we expect to see that the findings from this Treaty of Waitangi claim will be part of reshaping how mental health and addiction services are delivered in Aotearoa, New Zealand.

More time to be with people in distress is needed to ensure we provide the least restrictive care in Aotearoa and specifically so for Māori people.  Work has been underway for several years on reducing restraint and seclusion and is decreasing. However involuntary treatment orders remain high. The revision of the Mental Health Act is long overdue. Investment in primary care and the rapid development of more, early culturally responsive approaches will go a long way in paving the way for the very limited future use if any of involuntary treatment. Increasing the range of options and choices for people is a must.

It really is time to return to having an independent Mental Health and Wellbeing Commission. This must survive changes in government and be resourced to both ensure changes are made and result in people receiving the care and support they need to live well. We trust that it goes without saying that the Treaty of Waitangi principles will underpin this new Commission.

Nurses will stand the test of time. Being with people is what we as nurses have always been good at. Being with vulnerable people, children and their families and whānau, people in distress, people who see things that we do not see, people who live in tunnels of darkness where there is no light, people whose lives become too chaotic. People like you and people like me perhaps. People in our families and people in our neighbourhood.

It is time for this government to invest in ensuring we have a healthy and well workforce.  The workforce will need to grow therefore it is imperative that worker wellbeing must be a valued and an integral part of all services. This will go a long way to recruiting and retaining the people needed to deliver services. Change is ever present in health care and can be overwhelming. The many years of under-resourcing in health has resulted in high demand for services and we know that many nurses are feeling stressed and overwhelmed at times. Over the coming years the transformation in our mental health and addiction system will bring opportunities and challenges. Our own resilience will help get us through but the system must ensure that it supports the wellbeing of people providing services so they can do their best for the people needing and wanting support with their wellbeing and recovery. It is also time to take care of yourself.

 

It is time for us all to pause and reflect on our own ability to be culturally responsive. After all, we are all practicing in Aotearoa, New Zealand; we are here to serve the people who want and need support with their wellbeing; we are here to serve their families, whānau; we are here to serve our communities.

It is time to reflect and consider our own roles in how we can transform services

  • What more could we be doing to help prevent suicide?
  • How can we contribute to the reform of the Mental Health Act?
  • How will the new Mental Health and Wellbeing Commission impact on my work as a health professional?
  • How can I contribute to the Health and Disability Sector Review?
  • How can I take stronger action on alcohol and other drugs?
  • What role do I play or what role could I play in expanding access and choice to people in need of support with their mental health and addiction problems?
  • How can I get involved in developing new ways of working?
  • How can I play a part in transforming services?
  • How can I work more with consumer advisors and family and whānau advisors to meet the expectation of codesign and codelivery of services? What I am doing now?
  • How can I advocate for a cross-government involvement and leadership to support the national co-design process for mental health and addiction services?
  • How can we more actively confront unconscious bias, discriminatory language that lead to missed opportunities to maximise the inclusion of people and their families and whānau in the decisions about their care?.
  • How can I advocate for a cross-government involvement and leadership to support the national co-design process for mental health and addiction services?

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