Mental health watchdog: We're 'losing ground' for most vulnerable

Those with the highest mental health and addiction needs are falling further behind, the mental health watchdog warns in its latest report card.

By Moana Ellis of Local Democracy Reporting

Te Hiringa Mahara, the Mental Health and Wellbeing Commission, says young people remain in crisis and mental distress among Māori is rising despite expanding services.

"For the people who need it most, we are losing ground," Te Hiringa Mahara chief executive Karen Orsborn said ahead of a report on the state of the mental health system.

Improvements must come faster, Orsborn said.

"Although access to services is improving overall, it is not improving fast enough for young people, who continue to face rising psychological distress and persistent gaps in age-appropriate support."

The Commission is calling to end youth admissions to adult psychiatric wards and says human rights for young people need further investigation.

In addition, Māori are missing out on mental health support and funding for Kaupapa Māori services is "not keeping up", Orsborn said.

The System Performance Report released on Tuesday assesses whether people can get help early, access support equitably and receive safe and effective care in crisis.

It says Māori are still subjected to the highest rates of seclusion and coercive mental health treatment.

Maraea Johns, director of Māori health at Te Hiringa Mahara, said the Commission is demanding a national plan to eliminate seclusion in mental health services by next year.

The health system must "find better ways", she said.

Addressing the inequities required "continually calling out" where services were inequitable or unfair to certain populations.

"Māori have experienced that over many, many decades. It is calling for that to stop."

Johns said a cross-agency coordinated response was needed to address drivers of distress, such as housing insecurity, poverty, social wellbeing, discrimination and racism.

For young people, online harm could lead to some of “the most terrible impacts” including social disconnection and barriers to education, employment and justice.

"It's not just a health problem. All agencies coming together would be much more meaningful, useful and helpful, and would make a lot more improvement [for] whānau who need support and help," Johns said.

Wheturangi Walsh-Tapiata, mātaiwhetū/chief executive of hauora Māori agency Te Oranganui, told Local Democracy Reporting providers on the ground were seeing "an absolute escalation of mental health and addiction".

Kaupapa Māori providers were not being funded at the scale needed to meet escalating demand and were working well beyond what they were contracted for.

"That’s the immensity of the issue we’re seeing. You’re going to see increasing issues which are going to be a lot more noticeable in our communities because we can’t provide services to everyone."

The iwi-governed provider was established in 1993 to improve access and service delivery of health services to Māori in Whanganui and neighbouring regions.

Walsh-Tapiata said changes in policy including the withdrawal of police from mental health-related callouts were adding additional pressure for organisations that did not have the capacity to cope with rising demand.

A greater focus on prevention was needed.

"We should invest a lot earlier and not wait until it’s so extreme that it’s a crisis and therefore we end up with increased suicide rates and increased admissions to mental health institutions," Walsh-Tapiata said.

Carole Koha, chief executive of Te Waka Whaiora Trust in Porirua, said the country was failing Māori in mental health care. The drive to develop "for Māori, by Māori" services had been diminished by Government policy, she said.

"This is why we’re facing the tragic mess that we are in 2026. We got Te Aka Whai Ora (the Māori Health Authority) for one year. We have to ask ourselves why."

Te Waka Whaiora was the only Kaupapa Māori agency offering mental health and addiction services between Kapiti and Wellington, Koha said.

Unless the Government invested more in services that Māori would access, Māori would "end up in ED or non-Māori services".

Koha said Kaupapa Māori services received only a small per centage of mental health and addiction funding and it was nowhere near enough.

"Māori are the only ones that are going to be able to turn the ill-health, mental health and homelessness statistics around."

The Te Hiringa Mahara report reissues a recommendation first made in 2024 for Health New Zealand to develop a Māori mental health action plan.

Te Hiringa Mahara board chairman Hayden Wano said the first report a year ago identified a system under immense pressure and outlined six system shifts to improve outcomes.

The 2026 report says despite some improvement, five of the six goals are off track.

"We are concerned about the widening gaps for some, which will ultimately cost everyone," Wano said.

The Commission is calling for renewed effort to improve system performance and address inequities.

"Aotearoa New Zealand needs a system that supports young people before distress escalates, ensures equitable access to help early and responds effectively in crisis."

Mental Health Minister Matt Doocey said he welcomed the report but acknowledged there was more work to do for young people and Māori. He said he was committed to eliminating seclusion.

"Eliminating seclusion is an issue I have been closely looking at since coming into office and one I care strongly about addressing. In the meantime, I have been very clear that seclusion should be used only as a last resort.

"The Mental Health Bill currently before Parliament seeks to further reduce the use of seclusion. This includes requiring the person in charge of a service to report annually to the Director-General on the steps taken to eliminate the placement of people under compulsory care in seclusion.

"The Bill as it currently stands will limit the use of seclusion and strengthen safeguards. It also prohibits the use of seclusion for people under the age of 18."

Doocey acknowledged inequitable mental health outcomes among Māori, particularly in suicide rates.

"I am committed to working with community groups and Health NZ to ensure we are improving outcomes for all New Zealanders, including Māori. That is also where the mental health and addiction targets come in. If there’s a region and group not meeting the target, I expect additional focus to be put into that area."

Doocey said overall the report supports that New Zealand was starting to turn the corner in delivering faster access to support, more frontline workers, and a better crisis response.

– LDR is local body journalism co-funded by RNZ and NZ On Air