Report is just the beginning

By all accounts, attending one of the 26 public forums held as part of the Mental Health Inquiry – which delivered its report, He Ara Oranga, to Health Minister David Clark yesterday – was a confronting experience. Frustration, exhaustion, relief at being able to tell their stories were among the many emotions on display as the lived experience of the mentally ill and their families was laid bare.

So the report’s delivery is welcome. But that is the easy part. Now the pressure is on to ensure it translates into meaningful, concerted change.

Already the Mental Health Foundation has called for decisive action in implementing the recommendations. ‘‘The foundation believes that delays in implementing past recommendations have had a significant human cost and urges the Government to start acting today,’’ chief executive Shaun Robinson said.

In truth, significant problems with the system were anticipated in the strong campaigning of Labour and other parties on the state of the country’s mental health and addiction services in the build-up to the 2017 general election. The inquiry, kicked off in January by Prime Minister Jacinda Ardern, was a pledge from her Government’s 100-day plan.

The six-strong team, led by former health and disability commissioner Ron Paterson, makes the point more than once that it saw the inquiry as a ‘‘once in a generation’’ opportunity for change. ‘‘All over the country, people told us they wanted this report to lead to real and enduring change . . .’’

The last national mental health inquiry was held in 1995-96, though the report points out that numerous other inquiries and reviews have taken place in the intervening 22 years.

This inquiry featured some important differences, the report says; for one, it was mandated to look at ‘‘mental health problems across the full spectrum from mental distress to enduring psychiatric illness’’.

That is significant, because the conclusions include finding the present system is ‘‘set up to respond to people with a diagnosed mental illness’’ but does not respond adequately to others ‘‘who are seriously distressed’’. Even its response to those with an illness takes place through ‘‘too narrow a lens’’. ‘‘The system does not respond adequately to people in serious distress, to prevent them from ‘tipping over’ into crisis situations.’’

With data suggesting, in Clark’s words, that ‘‘one in five people experience mental health and addiction challenges at any given time’’, the current target of 3 per cent of the population being able to access ‘‘specialist services’’ naturally means many people, from what the report calls the ‘‘missing middle’’, are not getting access to help.

The 200-plus page report is full of promise, with talk of repealing and replacing the Mental Health (Compulsory Assessment and Treatment) Act 1992 ‘‘to reflect a human rights approach’’, establishing a Mental Health and Wellbeing Commission, and creating a ‘‘continuum of care and support’’.

The real work starts now, and the foundation is understandably frustrated that the Government says it will not respond until March. Given that Robinson says there’s been ‘‘more than 10 years of neglect and erosion of mental health services and responses’’, that’s no surprise.

The conclusions include finding the present system is ‘‘set up to respond to people with a diagnosed

mental illness’’ but does not respond adequately to others ‘‘who are seriously distressed’’.