New Zealand's mental health system does not respond adequately to people in serious distress, the approach to suicide is "patchy and under-resourced" and teachers and school counsellors are overwhelmed by the number of students in distress.
The findings were revealed in the Government inquiry into mental health and addiction in New Zealand.
The report found a range of issues in New Zealand’s mental health system, including significant figures such as the 20,000 people who attempt to take their own life each year.
- The annual cost of serious mental illness and addiction is an estimated $12 billion
- New Zealand’s persistently high suicide rate a "major concern"
- Tougher rules needed around alcohol and the personal use of drugs should be treated as a health issue
- Mental health system failing those who are seriously distressed.
- Teachers and counsellors overwhelmed by number of students in distress.
It recommended an expansion to the number of New Zealanders who can access specialist services, the creation of a social wellbeing agency and a new commission, stronger action around alcohol and drugs, reforming the Mental Health Act and the transformation of primary health care. [Recommendations are at the bottom of this story].
"Our mental health system is set up to respond to people with a diagnosed mental illness. The system does not respond adequately to people in serious distress, to prevent them from ‘tipping over’ into crisis situations," the report said.
"Our approach to suicide prevention and the support available to people after a suicide is patchy and under-resourced. Our suicide rate for young people is among the worst in the OECD."
It also said there were unmet mental health needs for Pacific people, people with disabilities, the Rainbow communities, the prison population, and refugees and migrants.
"The estimated reduction in life expectancy of people with severe mental health or addiction challenges is 25 years."
It said New Zealand’s current mental health and addiction system was under pressure and unsustainable.
"Signs include escalating demand for specialist services, limited support for people in the community and difficulties recruiting and retaining staff."
It said a new system should provide a "good level" of access to mental wellbeing for every person and those who are experiencing mental illness and distress have resilience, tools and support.
"It’s time to build a new mental health and addiction system on the existing foundations to provide a continuum of care and support."
The Mental Health Foundation called on the Government to urgently transform the mental health system.
"We’ve had more than 10 years of neglect and erosion of mental health services and responses,” chief executive Shaun Robinson said.
"No political party can take the moral high-ground here, it’s time to stop trading insults and start working together, across parties, across government agencies and across communities and commit to doing better. Let’s get on with it."
Health Minister David Clark said the report charts New Zealand’s direction on mental health and addiction.
"It is clear we need to do more to support people as they deal with these issues - and do a lot more to intervene earlier and support wellbeing in our communities"
He said many of the issues would take years to fix.
"Reshaping our approach to mental health and addiction is no small task and will take some time."
Green MP Chlöe Swarbrick called the inquiry a "comprehensive blueprint to solve a crisis that is costing lives and hurting New Zealanders".
"I look forward to working with Labour and New Zealand First to ensure these recommendations are implemented in full and with urgency. We cannot sit on this report. New Zealanders have already been waiting too long."
AUT Public health professor Max Abbott said the review identified numerous gaps into mental health and addiction in New Zealand.
"The major challenge is translating all this into reality at ground level."
He also said behavioural addictions were not included in the review, despite research showing "harms associated with gambling disorder alone exceed those of drug abuse and come close to those of major depression".
Professor of Criminal Law Warren Brookbanks said in terms of legislative change for the Mental Health Act, "it would be naive to think that such a radical change could be effected speedily".
He said the report "disturbingly" noted that action on reducing harmful use of alcohol had staffed and it was "disproportionately impacting Māori and those in socioeconomically deprived areas".
- Expand access and choice - Only 3 per cent are able to access specialist services. Create a new target, with 20 per cent within the next five years an indicative target.
- Transform primary health care - Enhance primary care workforce so local communities can provide preventative help and respond to mental health and addiction problems.
- Strengthen NGO sector - Support NGOs in the shift to a community-based mental health and addiction approach.
- Whole-of-government approach to wellbeing - Proposal of a social wellbeing agency
- Facilitate mental health promotion and prevention - Create a new commission to provide leadership and oversight.
- Place people at the centre
- Take strong action on alcohol and other drugs - Stricter regulatory approach on sale and supply of alcohol, shift from treating personal drug use from a criminal issue to a health issue, replace criminal sanctions for the possession for personal use of controlled drugs with civil responses.
- Prevent suicide - Have a 20 per cent reduction in suicide by 2030
- Reform the Mental Health Act
- Establish a new Mental Health and Wellbeing Commission
- Refer to the Health and Disability Sector Review
- Establish a cross-party working group on mental health and wellbeing
Where to get help:
Need to Talk? Free call or text 1737 any time to speak to a trained counsellor, for any reason.
Lifeline: 0800 543 354
Suicide Crisis Helpline: 0508 828 865 / 0508 TAUTOKO (24/7)
Depression Helpline: 0800 111 757 (24/7)
Samaritans: 0800 726 666 (24/7)
Youthline: 0800 376 633 (24/7) or free text 234 (8am-12am), or email email@example.com
What's Up: online chat (7pm-10pm) or 0800 WHATSUP / 0800 9428 787 children's helpline (1pm-10pm weekdays, 3pm-10pm weekends)
Kidsline (ages 5-18): 0800 543 754 (24/7)
Rural Support Trust Helpline: 0800 787 254
Healthline: 0800 611 116
Rainbow Youth: (09) 376 4155
Safe to talk National Sexual Harm Helpline - 0800 044 334, www.safetotalk.nz
Victim Support National 24 Hour Helpline 0800 842 846, www.victimsupport.org.nz
Rape Crisis National 24 Hour Helpline 0800 883300
If it is an emergency and you feel like you or someone else is at risk, call 111.