Health/mental health systems and strategy

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.

This submission is to the Health Committee on the Pae Ora (Healthy Futures) (Improving Mental Health Outcomes) Amendment Bill.

The Bill seeks to mandate a national mental health and wellbeing strategy. Our submission outlines MHF’s overall support for mandating a strategy of this nature in law. However, we make several recommendations for strengthening the Bill, including naming ‘addiction’ in the title of the strategy, requiring the strategy be developed in partnership with Māori and those with lived experience of mental distress and addiction, and in consultation with all entities that contribute to mental health and wellbeing (not just health entities). The submission also addresses various drafting concerns and implications and suggests how to maximise the impact of this Bill.

The MHF are supportive of the intention of the code and make a number of recommendations to clarify its scope and application, better integrate Te Tiriti o Waitangi with the other values, name accountability structures and implementation pathways, and strengthen the language of the code.

The MHF outline concerns the overall structure, aspirations and outcomes in the draft framework reflect and reinforce the dominant medical model of mental health. The MHF recommend He Ara Āwhina include visible and clear aspirations and outcomes for tāngata whaiora and whānau to be supported to apply strategies to live well, and to experience positive mental wellbeing; and to clarify the scope of the framework in this regard. 

We recommend the strategy be strengthened by:

• Be inclusive of all disabled people in definition and scope
• Clarify how the strategy will progress existing government commitments and action relating to people with psychosocial disabilities
• What pae ora (healthy futures) looks like to people with experience of mental illness/distress 
• Prioritise the mental health of people with disabilities, particularly young people with disabilities
• Disabled people who experience mental health and addiction-related needs have been caught between disability and mental health sectors, often resulting in them unable to access the support they need.

The MHF supports the intentions of this Bill to extend ACC cover to a specified list of maternal birth injuries. Birth injuries can cause anxiety, depression and post-traumatic stress disorder, and perinatal mental distress has far reaching and life-long consequences for pregnant people and parents, their tamariki and whānau.

The MHF recommend the Bill provide for ACC cover to mental injuries suffered as a result of physical birth injuries. We also acknowledge that all pregnant people and birth givers have the right to access to safe, timely and effective mental health services and support, regardless of whether they meet the criteria for ACC cover.

The Mental Health Foundation welcomes the draft Disability Strategy's focus on improving outcomes for disabled people, and its role in giving effect to Te Tiriti o Waitangi and the United Nations Convention on the Rights of Persons with Disabilities.

We recommend the Strategy be strengthened by:

• Showing clearer support for people with long-term mental health challenges, neurodivergence and other cognitive impairments
• Detailing explicit actions to improve the mental health and wellbeing of all disabled people
• Adopting the Enabling Good Lives principles
• Strengthening its commitments to Te Tiriti o Waitangi, and
• Providing clarity on how its proposed actions will be assigned, resourced and measured.