Where did our mental health system go?

Analysis: The shortfalls of our mental health system were a constant topic of discussion at the dinner table, in the House, and in the media last year. After the new Government announced a national mental health and addiction inquiry, the subject disappeared from headlines.

There will be no significant action, an apparently decreased budget, and barely any comment, from the Government until the review is completed in October, at the earliest.

Journalists are banned from reporting on the inquiry’s public meetings and people attending are asked to stay off social media. Members of the public have also complained they haven’t been given the chance to air their concerns.

Meanwhile, those at the coalface remain stretched.

Is this inquiry the saving grace that the community was hoping for, or more of the same?

Last year, there were thousands of articles about mental health published in New Zealand. Stuff’s stocktake of the mental health system, Through The Maze, was among them.

It was common to hear the system described as ‘‘broken’’, or ‘‘in crisis’’, and as the number of suicides rose to more than 600, the calls for change became louder. Google searches for mental health over the last year peaked in early October — shortly after the general election.

Labour and the Green Party campaigned strongly on fixing the mental health system, starting with a national inquiry — something the former National Government refused to do.

Former health minister Jonathan Coleman at the time told us the National Government knew what the problems were, and just wanted to get on with fixing them.

Those sick of waiting held their own review, called the People’s Mental Health Review. Based on 500 crowd-sourced stories, it came back with five key recommendations: increase funding; provide a wider range of treatment options; treat clients with respect; involve families more; and conduct a national inquiry.

In January, it seemed those calls had been answered, with Prime Minister Jacinda Ardern announcing the details of a ministerial inquiry into mental health and addiction. The move was part of the Government’s 100-day plan, along with the longerterm Labour-NZ First coalition agreement promise of re-establishing an independent Mental Health Commission.

Where’s the money?

The Government delivered its first Budget last week, and while health was the overall winner, there was little for mental health. The previous government’s ring-fenced $100 million for mental health was placed back into the wider pool of health funding.

In response to criticism about a lack of funding in Budget 2018, Health Minister David Clark at the time said he expected at least $50m more to be spent on mental health by District Health Boards across the country, which would come from their general allocation. However, the minister isn’t in a position to tell the DHBs how to spend that money, if it hasn’t been ring-fenced specifically.

The extended nurses in schools programme, cheaper GP visits, and a pilot programme giving those aged 18 to 25 free mental health counselling and therapy, were expected to help, Clark said.

‘‘There are quite a few smaller initiatives that will add up in this Budget for mental health … Of course, there will be more to do but I’m really proud of the start we’ve made.’’

Any additional mental health funding has been deferred until the inquiry reports back.

National Party mental health spokesperson Matt Doocey said the Government had ‘‘shortchanged the sector’’.

‘‘The Ardern-Peters Government, who once called for change in the mental health system, has denied New Zealanders progress for at least another year.’’

Reluctant to talk

It’s hard to say how the inquiry is progressing, given public meetings are closed to mainstream media and even ‘‘social media reporting’’.

In the inquiry’s preliminary stages, Clark told us he wanted consumers, emergency services, and experts to weigh in, and for the inquiry to look at prevention, primary care, and secondary care.

But since the official announcement, more than four months ago, we’ve heard very little on the subject from Ardern or Clark.

When asked to comment for this story, Clark’s spokesperson said the minister was overseas.

Meanwhile, from consumers and service providers alike, there are concerns the Government is ‘‘rushing through a process that needed to be allocated more resources’’, as one woman, who asked not to be named, said.

She requested a face-to-face meeting with the panel (one of four ways to engage — the other three being to write, attend a public meeting, or telephone) but was refused.

‘‘Unfortunately, due to the timeframe we are working on and the number of people wanting to connect, it won’t be possible to arrange for every individual to address the panel,’’ a spokeswoman emailed her.

‘‘There may be an opportunity for you to speak with a panel member at the public meeting – this will depend on how the meeting goes on the day.’’

Advocate and former mental health commissioner Mary O’Hagan says the strength of the inquiry will depend on ‘‘the people who submit their views to it and the Government’s response’’.

Changes can’t come soon enough

Those dealing with the consequences of a stretched system, and a society facing a raft of mental health and addiction issues, say changes can’t come soon enough.

In the last financial year, more than 170,000 people used mental health and addiction services.