Action required, not more words

Jessica McAllen sat in on public meetings of the Mental Health and Addiction Inquiry. She gives her take on this week’s report of the inquiry.

At the Dunedin meeting of the mental health and addiction inquiry, a man told the panel: ‘‘You can’t be mentally healthy if you’re dead.’’

Sure, he was objecting to the pre-meeting stop, drop and hold earthquake advice, but his words applied to the official inquiry report, which was published on Tuesday.

The report, which mentioned the word ‘‘wellbeing’’ 200 times before I gave up counting (it had started to blur into ‘‘warbling’’), laid out New Zealand’s bold new future to help people in distress. It had a strong focus on prevention in its 40 recommendations.

Hopefully, the Government doesn’t cherry pick the easy solutions at the expense of the sometimes messy truth of longterm mental health and addiction.

The background

During the 2017 election campaign, many health professionals were concerned about the prospect of another mental health inquiry if Labour won. But their voices were drowned out by vocal campaigners – some of whom have gone very quiet this year – and labelled as bureaucratic stiffs. Even one of the panel members, former mental health

commissioner Barbara Disley, was sceptical. Earlier this year she told me she changed her mind because the panel was tasked with a short timeframe.

In 2017, Mental Health Commissioner Kevin Allen appeared before a select committee stating an ‘‘urgent need for action’’ rather than another costly review. We already know the solutions, he said.

In a letter backing up his submission, he said: ‘‘Funded treatment and care options for the approximately 17 per cent of people with mental health needs who do not qualify for specialist services are limited.’’

He should be heartened to see the panel recommended specialist services – which cater for 3.6 per cent of the population – be expanded to cater for 20 per cent. Although, maybe he will be annoyed that this is something people already knew needed to be changed. We could have spent the intervening year figuring out a plan to increase the workforce to deal with such a change.

An inquiry is an easy promise because it stalls time – it will be 17 months since Labour came into power by the time the Government formally responds in March.

While we waited for the results of the inquiry, it would have been useful to increase funding to Mental Health and Addiction Services, but the Government opted to wait until the inquiry was released. It would have been useful to test out pilot programmes.

The irony that the report recommended a police and mental health worker response to emergency callouts (instead of solely police, a process that can be traumatising) won’t be lost on those who were dismayed to see a proposed pilot cut this year.

Many organisations also held back on planning, waiting to see what direction the inquiry was going to follow. In the meantime, our suicide rate jumped to its highest since 1999.

Labour inherited a broken mental health system, so perhaps it’s unfair to be too critical. But National inherited one too. Then Labour before that. This has long been an under-resourced and ignored area until a particular tragedy ignites public outrage.

There are many people to take into account when discussing mental health. The 3.6 per cent who use specialist mental health services and often have a longterm mental health issue; those whom the inquiry calls ‘‘the missing middle’’ who don’t qualify for mental health and addiction services, but can’t be adequately helped by the free 6-8 sessions that primary health organisations offer.

There are people who won’t have a mental illness but, due to a life circumstance – bereavement, job loss, and other stresses – find themselves in significant distress.

Health Minister David Clark will be feeling immense pressure right now. But this can’t be a surprise. Labour campaigned on mental health, particularly youth suicide. Former health minister Jonathan Coleman was called ‘‘the doctor of death’’ by Labour’s Kelvin Davis.

There was even the odd linking of immigration to youth suicide on the Labour Party Facebook page. Jacinda Ardern made headlines when attending the PSA’s ‘‘Yes we care’’ campaign, which toured the country to raise awareness of suicide. She said she wanted to bring the suicide number down to zero: ‘‘Because anything else suggests we have a tolerance for loss to suicide in New Zealand.’’ The report recommended a 20 per cent reduction by 2030.

I’m not defending National here. It’s a testament to how much it pretended suicide wasn’t an issue that there is such a level of excitement about Labour simply having an inquiry. But you can’t campaign on mental health and suicide, raise people’s hopes – people who are often ignored – and not bring in truly meaningful change.

For many, the incessant politicking and moral panic about teenage suicide was not helpful. Multiple stories a day, multiple social media posts – these can become overwhelming when you are already depressed, especially if you see people with similar life stories. For others,