Transforming Aotearoa New Zealand's mental health and addiction services requires sustained political leadership, an interim report by the Mental Health and Wellbeing Commission stresses.
Te Huringa: Change and Transformation - Mental Health Service and Addiction Service Monitoring Report 2022 monitored the performance of these services between 2016/2017 and 2020/2021.
Hayden Wano, chairman of the Mental Health and Wellbeing Commission, told Breakfast although the Government had made "significant efforts" in terms of investing in mental health services, pressures on specialist services continue and there has been no significant reduction in wait times.
"Surprisingly in some ways," he said of this, "but also knowing that when governments invest in new services it takes some time to filter out to whānau and people on the ground."
A $1.9 billion package for mental wellbeing was included in the 2019 Wellbeing Budget. It included $883 million over four years for mental health and addiction services.
Wano said the critical message from Te Huringa is transformational change is going to require sustained political leadership.
He said the commission is seeing small signs of hope and improvement, but said systemic change will take time and will require perseverance.
While there have been improvements at the primary care/GP level, the interim report noted more investment is needed in kaupapa Māori, peer, youth and other community-based specialist services.
Wano said these services required more sustained effort and leadership.
A total of 191,053 people had accessed specialist mental health or addiction services in 2020/2021, while 152,993 had accessed primary mental health services.
The report noted the number of people accessing DHB funded primary mental health services had increased by almost 30,000 people from 2019/2020.
Young people made up 18% of these figures, up from 13% in 2015/2016.
The report noted only 65% of young people aged 19 and under in 2020/2021 had been seen in the first three weeks of their referral, and 87% within eight weeks.
There has also been an increase in the number of antidepressants and antipsychotics dispensed to young people.
From 2019/2020 to 2020/2021, a 21% in the number of antidepressants dispensed to young people had been recorded. There is usually only a 7-9% each year. In comparison, there was an 8% increase for the total population.
For antipsychotics, an 18% increase was recorded, compared to 6% for the total population.
The commission noted the increases were likely due to increased stress from the Covid-19 pandemic and a lack of non-medical treatment alternatives.
The report further noted Māori continue to disproportionately experience community treatment orders and solitary confinement, which is also known as seclusion.
A community treatment order means people experiencing mental distress must receive treatment for up to six months.
They are four times more likely than non-Māori to be subject to a community treatment order. In 2020 they made up 39% of people subject to one. This was an increase on 2016 figures of 35%.
In 2020, 48% of people who experienced solitary confinement were Māori. This was an increase on 2016 figures of 44%. The report noted Māori are also 5.4 times more likely to be subjected to seclusion.
Also, a higher proportion of solitary confinement events in 2020 were longer than 24 hours for Māori (31%) and Pacific peoples (30%).
Wano also told Breakfast further work was needed to ensure tāngata whaiora - those with lived experiences of mental illness seeking wellness - are leaders in their own care.
Wano said his message is: "We really do need sustained leadership. Let's not take our eye off the ball. We have some wonderful opportunities coming up within the health reforms … There will be some uncertainty, so it's important we keep an eye and do not lose sight of the significance and importance of mental health and addiction transformation.
"We also want to see greater engagement of tāngata whaiora, people with lived experience, in the design of these new services and the new ways of doing things … It's not as if we have to start from anew and if we focus on those two things – leadership and bringing the voices of people with lived experience into the way we do things in the future – that would be a fantastic starting point."
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