Mental health sector needs a road map
The number of New Zealanders seeking, but not receiving, mental health support is on the rise.
As part of New Zealand’s wellbeing budget in 2019, the Government announced an unprecedented $1.9 billion increase in funding for the mental health sector.
But almost two years on, there are no tangible signs of improvement and statistics show the number of New Zealanders seeking, but not receiving, mental health support is on the rise.
The funding boost came on the back of He Ara Oranga, a 2018 report of a year-long inquiry into mental health and addiction services in New Zealand, which called for an expansion of access and increased choice of services.
For the sector, it brought hope and expectation that mental health would finally be funded properly and services expanded to all who needed them, not just the most severe 3 per cent of the population. That hope has turned to despair.
The Covid-19 lockdowns brought a silent increase in the number of young people developing eating disorders, such as anorexia nervosa and bulimia nervosa, which are among the most serious and potentially lethal mental health problems a person can develop.
We need accurate assessments and skilled treatments to help sufferers overcome eating problems. Yet access is almost impossible, with waitlists of four months or more to see a psychologist.
Access to regionally funded mental health services for children and adolescents seems equally impossible. Figures released recently by the National Party show the wait time can be up to 72 days.
These services are set up to support only young people with the most severe and complex mental health needs.
Unsurprisingly, those whose needs don’t meet the strict criteria of a district health board (DHB) mental health service are even worse off. Although attention deficit hyperactivity disorder (ADHD) is one of the most common disorders, services for adults with ADHD are almost non-existent.
The same applies to mental health support for people who experience psychological trauma — such as those who witnessed the Christchurch mosque shootings. Although the Accident Compensation Corporation system provides excellent support for people with physical injuries, it leaves those suffering solely psychological trauma out in the cold.
The number of people seeking psychological support is increasing, likely due in part to the groundbreaking and tireless efforts of mental health campaigners such as former rugby player Sir John Kirwan, former comedian Mike King and 2021 Young New Zealander of the Year Jazz Thornton.
This increased public demand can be seen in a positive light, as it indicates people are more willing to acknowledge and seek help for their mental health. But it has quickly outstripped supply.
Mental health services outside those funded by DHBs are either running long waitlists or no longer accept new referrals. A 2018 survey by the NZ College of Clinical Psychologists showed that New Zealand was short of almost 1000 psychologists at the time.
The Government has acknowledged the workforce shortage and that increasing the mental health workforce is a long game. Health Minister Andrew Little said the workforce shortfall was being addressed through programmes such as postgraduate training in cognitive behavioural therapy and child and adolescent mental health.
But government investments thus far are doing little more than shuffling deck chairs on the Titanic. Most of these programmes are simply upskilling or moving workers already employed in the mental health system, not increasing the total number of staff.
It takes several years to train psychologists, mental health nurses, psychiatrists and social workers to provide evidence-based, culturally appropriate assessment and treatment. An obvious answer would be to increase funding for mental health training programmes to allow them to expand the number of people who enter these professions.
Is the Government daunted by the scale of change required to bring about meaningful improvements in our mental health system? In response to calls to expand ACC funding to include psychological injury, Little said the Government had no intentions to make the necessary law change. Surely, such systemic change is exactly what is needed if we are to implement the recommendations of the inquiry report.
The Government should at least tell the public if and how it plans to implement the recommendations the He Ara Oranga report made. Laying out a road map for change would provide vision, show leadership and perhaps allow us to hope again. At the moment it feels like we’re in the dark on a road to nowhere.
Dougal Sutherland is a clinical psychologist at Te Herenga Waka, Victoria University of Wellington