Mental Health Foundation 2023 General Election statement

Our wero to political parties
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' Mehemea ka moemoeā ahau, ko ahau anake. Mehemea ka moemoeā tātou, ka taea e tātou. '

– If I dream, I dream alone. If we dream as a collective, we can achieve our dream.

The wero (challenge)

This election, people across Aotearoa need to hear how your party will transform our mental health and addiction system to better protect and improve the mental wellbeing of all people.  

What actions will your party take to empower people and communities to build positive mental wellbeing, and ensure everyone has equitable access to timely, safe, effective, culturally responsive mental health care, which is informed by Te Tiriti o Waitangi and the expertise and experiences of people with lived experience of mental illness or distress? 

What’s your investment strategy to put these actions into practice over the long term, and how will it make life better for the 1 in 5 New Zealanders who will experience mental illness and/or addiction this year?  

To help your party meet our wero, we offer our vision for change, backed by strong evidence and consultation from people with lived experience of mental distress or illness. 

The moemoeā (vision)

We all want Aotearoa to be a place where people enjoy a good level of mental wellbeing, where people who experience mental distress1 or addiction2 are treated with dignity and given the choice of holistic, effective support, when and where they need it to recover and regain their wellbeing. Family and whānau will have the support and information, and services have the flexibility and resourcing, to meet these needs. 

What’s stopping us?

The report from the 2018 Inquiry into Mental Health and Addiction, He Ara Oranga, offered recommendations for positive change, but we’re still waiting on a plan of implementation for many of the recommendations.

Meanwhile:  

  • Nearly 1 in 4 adults experience poor mental wellbeingi – this number is risingii and inequities exist with Māori, Pasifika, and those living in hardship more likely to experience mental distress.iii 
  • Mental distress is highest among young people,iv and rangatahi Māori are more than twice as likely to die by suicide than non-Māori youth.v  
  • Despite increased investment, access to specialist services has remained stagnant for the past five years.vi Access to primary mental health services is increasing but there are gaps for Māori, Pasifika, and rangatahi.vii 
  • Our services are not set up to address the drivers of mental distress such as poverty, racism, whānau violence, loneliness, prejudice and discrimination, unemployment, and insecure housing.viii
The cold reality is that things at the coal face of mental health have not changed for many New Zealanders since He Ara Oranga was first published. Our most vulnerable people are still waiting, and more people are tipping into that vulnerable category. That is not acceptable.

- Shaun Robinson, Mental Health Foundation CE.  

The cost and investment

The shortfalls in our system are costing us all. People using mental health services in Aotearoa have more than double the risk of premature death (before the age of 65) compared to the general population, including from preventable and treatable healht issues.ix The annual cost of serious mental illness and addiction is high at $12bn per year (5% of GDP).x 

Mental health investment must be commensurate to need. The majority of DHB and Ministry of Health expenditure is on servicesxi but it must be spread across prevention, promotion and effective support and services. Doing so is estimated to produce large costs savings.xii 

Change is overdue. People in New Zealand deserve better, and we can do better. What is your plan to make it happen?  

Creating a safe, strong, supportive mental health and addiction system

To make meaningful change, we must invest in growing a strong, empowered, community-driven, and culturally safe workforce, which includes and resources peer support in every service.

The mental health workforce and system must: 

  • Be guided by lived experience and whānau leadership.  
  • Be representative of, and effective for our diverse communities, including Māori, Pasifika, Asian, refugee and migrant, people with disabilities, rainbow communities, and those across the life course spectrum.  
  • Reflect whānau, hapū, and iwi aspirations by including kaupapa Māori approaches and Māori-led solutions and being responsive to people’s holistic needs. This is key to reducing inequitable health outcomes for Māori. 
He aha te mea nui o te ao? He tangata, he tangata, he tangata.

- What is the most important thing in the world? It is the people, it is the people, it is the people. 

12 actions to create meaningful change

The MHF believes there are four priority areas for change, backed by clear evidence, that should guide your plan. We offer examples of 12 tangible actions that can be adopted – we acknowledge this is not an exhaustive list.  

Prevention, early intervention, and mental wellbeing promotion

“Investing in wellbeing promotion now prevents people from needing more acute support down the line, it boosts our personal and community wellbeing – it’s the smart thing to do and it’s the right thing to do.” – Shaun Robinson, MHF CE 

There is strong evidence that prevention and early intervention is the most beneficial and cost-effective strategy. Often mental disorders are recognised only after they become severe and harder to treat. Half of all lifetime cases of mental disorders begin by age 14 and three-quarters by age 24.xiii 

Mental health promotion makes a differencexiv and a national investment strategy is needed to  ensure mental health promotion is safe and effective, and funding is appropriately and equitably directed across communities. Empowering communities and whānau to adopt behaviours that build resilience to life’s challenges and positive mental health will reduce the pressure on services and support recovery. Wellbeing is not just a luxury for those already well. 

Examples of actions for change include:

Effective crisis response and supports

The system should empower people to make decisions for themselves, encourage and support them in this process and journey. – Lived Experience Advisor 

People experiencing a mental health crisis deserve a compassionate, timely, and effective response that enables them to stay connected with their community supports and access the full continuum of mental health services. Whānau need support so they, in turn, can provide meaningful support to their loved one experiencing mental health or addiction challenges. 

Examples of actions for change include:  

Support recovery and wellness

Don’t forget about people in recovery, it is not a straightforward or easy journey and those of us in recovery still need support.- Lived Experience Advisor  

Too many people are discharged from inpatient services with no place to stay and no plan for their ongoing recovery. We must support people to recover from mental illness and distress in our communities by ensuring they have access to post-discharge follow-up support, meaningful employment, education, and healthcare.

Examples of actions for change include:

Change mental health laws

The Mental Health Act should lead to better mental health and wellbeing, not creating more distress and anguish. We should feel empowered in our treatment and be in the driver’s seat. Our voices should be heard. - Lived Experience Advisor  

Honouring our Te Tiriti o Waitangi and international treaty obligations – such as the UNCRPD and UNDRIP – in law and practice will uphold people’s mana, dignity, and rights. It will give people more autonomy and partnership over their care and treatment, increase alternatives to compulsory treatment, and foster community inclusion, recovery, and the ability to live full and meaningful lives.xxviii  Examples of actions for change include:   

We all have mental health. Our next government will be charged with protecting, maintaining, and growing our mental health system and the mental health of New Zealanders to ensure our collective and individual mental health is strong and ready to support us through the challenges and opportunities ahead. New Zealanders are listening now to hear how you will do that. More than ever, they understand the importance of investing in and protecting their mental health and the mental health of those they love.  

We look forward to hearing how you will answer this wero. 

' '

References

i Health Promotion Agency, & Kvalsvig, A. (2018, February). Wellbeing and Mental Distress in Aotearoa New Zealand: Snapshot 2016 (No. 978–0-47844-920–4). Health Promotion Agency. https://www.hpa.org.nz/sites/default/files/Wellbeing-And-Mental-Distress-Snapshot-2016-Final-FEB2018.PDF

ii Statistics New Zealand. (2021). 2021 General Social Survey. https://stats.govt.nz/information-releases/wellbeing-statistics-2021/; Statistics New Zealand. (2022). New Zealanders’ mental wellbeing declines. https://www.stats.govt.nz/news/new-zealanders-mental-wellbeing-declines/.  


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