Policy positions and submissions

The MHF does not support the use of restraint in mental health services, and we advocate for:

• In the short term, additional scrutiny and improved national reporting to stop the inequitable use of restraint practices on certain population groups, particularly tāngata whaiora Māori.
• In the long term, the absolute minimisation of restraint practices within ten years of the forthcoming new mental health legislation coming into force. 

The Mental Health Foundation (MHF) advocates for the end of solitary confinement (seclusion) in mental health services across Aotearoa New Zealand.

This prohibition needs to be supported by adequate resourcing of services and changes to delivery models and practice approaches, building on the decade- long Zero Seclusion project and success of services that have eliminated solitary confinement at times.

Ending solitary confinement can result in better outcomes for tāngata whaiora, whānau and health workers.

This paper sets out the Mental Health Foundation’s (MHF) position on support decision-making as it relates to the Mental Health (Compulsory Assessment and Treatment) Act 1992 (the Mental Health Act).

The MHF recommends:

• All services and supports should enable tāngata whaiora to make their own decisions about their mental health care, treatment and recovery.
• Aotearoa New Zealand’s legal frameworks should embed support decision-making within our mental health system.
• Legal reform must be supported by clear national policy and adequate resourcing and guidance to support service and practice changes over time. 

The Government accepted the recommendation from He Ara Oranga, the report from the 2018 Mental Health and Addiction Inquiry, to repeal and replace the Mental Health (Compulsory Assessment and Treatment) Act 1992. The development of a new mental health law for Aotearoa is a once in a generation opportunity to reframe our response to mental health, providing a powerful lever to reconstruct our approach to supporting people with severe mental distress based on best practice, human rights and appropriate resourcing.

In our submission to the Ministry of Health we make a number of recommendations, including:

• The complete and immediate end to seclusion practices/solitary confinement under the new law.
• The absolute minimisation of compulsory treatment and restraint, reducing these practices to the barest of minimums by a date no later than ten years from the new legislation passing into law.
• A legal requirement for a plan to implement supported decision-making and the full range of service development and practice changes necessary to enable the absolute minimisation of compulsory treatment and restraint over 10 years.

The Act and Code were established to ensure that people are treated as partners in their care and have help to resolve issues, and hold people accountable when this doesn’t happen. 

The Act sets out what the HDC can do, including how complaints can be resolved, and the Code sets out people’s rights when using health and disability services. Everyone who uses these services has rights, and everyone who provides a service must uphold these rights.

Our submission outlines MHF's overall support for the intention of the review. However, we make several recommendations regarding:

• supporting better and more equitable complaint resolution,
• making the Act and Code work better for tāngata whaikaha | disabled people (especially around supported decision-making and the right to an advance directive), and
• making the Act and Code more effective for, and responsive to the needs of, Māori.

The MHF recommends strengthening pokies regulations to minimise the harm these cause and to put the wellbeing of individuals, whānau and communities first. We urge the government to listen to experts on this kaupapa, tāngata Māori and taiohi Māori.

Our submission focuses on our expertise and concerns related to our work in suicide prevention and postvention, antibullying, and preventing mental health related stigma and discrimination. The MHF believes it is timely and necessary to update Aotearoa’s approach to regulating media and online content, to ensure our approach is applied consistently, better protect users and audiences from harm, and make it easier for the public to protect themselves and access effective reporting and complaints processes. We recommend the new system embed Te Tiriti o Waitangi and representative advisory and decision-making processes, fully define unsafe and harmful content and the communities most affected, ensure there are effective prevention and takedown measures and incentives for compliance, and better educate consumers, creators and platforms on potential harms from content and how to manage them.

Perinatal mental distress can affect women and birthing parents significantly with Māori, Pacific and women of Asian descent being disproportionately affected. The MHF supports this Amendment Bill as it will provide new mothers and birthing parents an opportunity to rest and recover after having a baby which will support positive mental health outcomes for new parents and their wider whānau. The MHF recommends that the infrastructure to support this law change be applied and that workforce pressures in the maternity sector are addressed to ensure this law change can be implemented. The MHF also recommends that this Bill includes options for the same level of care to be provided for women and birthing parents after late pregnancy loss and still birth.

The MHF are pleased the government is planning to implement a social cohesion strategy and appreciate the work already underway to support our diverse communities, tackle harmful behaviour and discrimination and keep New Zealanders safe. We recommend a targeted and focussed approach to social cohesion is adopted so the government can deliver outcomes to priority groups that are at heightened risk of exclusion.  

This Review is held every five years and assesses New Zealand’s progress on a broad range of human rights issues. Our submissions focus on Aotearoa New Zealand’s progress on mental health and wellbeing-related human rights issues.

The MHF sincerely thanks the whānau who shared their stories and experiences with us to inform the October 2023 submission to the United Nations Human Rights Council.

Our May 2024 submission to the Ministry of Justice is a response to their targeted stakeholder engagement to support the Government’s consideration of the recommendations resulting from the UPR.