Repeal and replacement of the Mental Health Act

The Mental Health Act needs to be reformed - join the public conversation

What is the Mental Health Act?

The Mental Health (Compulsory Assessment and Treatment) Act 1992 is the law that is used when someone is mentally unwell and is believed to need treatment but does not agree to that treatment. The Act covers that patient’s rights, how they are assessed and how they receive compulsory treatment.

Currently, people can be placed under the Act if they do not consent to treatment but experience mental health symptoms that a mental health clinician deems serious enough to cause the person to pose a risk to themselves or others. A mental health clinician and a Director of Mental Health Area Services (DAMHS) initially decide whether someone should be placed under the Act, and if they are, whether that person will receive compulsory mental health treatment in a mental health facility, or in the community until the Act is lifted. 

Who is affected?

Over 5,600 New Zealanders are subject to the Act right now and as a result, must receive mental health treatment in a mental health facility or in the community. 

Why change the Act?

The New Zealanders who are subject to the Mental Health Act deserve to feel supported and cared for as they recover. Unfortunately the evidence is clear that, for far too many people, this is not the case. Misuse of the Act can be distressing, traumatising and inhibit recovery. In fact, rather than help people return to wellness, far too many people have had experiences with the Act that have actively increased their unwellness. 

We have a duty to make sure the thousands of people who are subject to the Mental Health Act are given the best possible path to recovery. The Act should be about supporting people back to a place where they can make their own decisions about their mental health and wellbeing. Instead, the current Act is over thirty years old, has never been comprehensively reviewed, and is not adequately serving the people it is meant to serve.

Some people in Aotearoa have been under the Act for many years, under what is called an indefinite treatment order (ITO). Under an ITO, people will receive compulsory mental health treatment in the community or mental health facility until a judge, mental health clinician or review tribunal decide that they no longer need to. It is not always easy to have the Act lifted in these cases, which can have a long term impact on people and their whānau.

The Act is also used disproportionately against Māori. In 2019, Māori were 3.8 times more likely than non-Māori to be placed under the Act, and 2.7-2.9 times more likely to be subject to indefinite treatment orders than non-Māori. 

For all these reasons and more, what the Mental Health Act looks like, and how it is used, is fundamentally a human rights issue. The current Act’s detrimental impact on the lives of those who experience it, as well as their family and whānau, means that it needs to be repealed and replaced. We need to work together towards new mental health legislation that keeps people safe, supported and protects people’s human rights. 

What is happening now?

He Ara Oranga, the report of the independent Inquiry into Mental Health and Addiction, has recognised that the Act has not kept pace with the shift towards a recovery and wellbeing approach to care. It came into force over 30 years ago and has never been comprehensively reviewed.

The report recommended that the Act be repealed and replaced, so that it:

  • reflects a human rights-based approach; 
  • promotes supported decision-making; 
  • aligns with the recovery and wellbeing model of mental health; and
  • provides measures to minimise compulsory or coercive treatment.

Public consultation is now open

The Ministry of Health has created a discussion document and is inviting people to give their feedback on it.  It’s important to know that:

  • You can give as little or as much feedback as you like 
  • You do not need to give feedback on the whole discussion document - you can choose to just respond to the parts you are most interested in or impacted by
  • You might have other views and concerns not listed as well, and you are encouraged to talk about these
  • You can give feedback any way you wish, such as by email, video or a letter. 

In their discussion document, the Ministry of Health has outlined a number of key topics within the Act they are particularly wishing to receive feedback on, including: 

  • Embedding Te Tiriti and addressing Māori cultural needs
  • Defining the purpose of mental health legislation, including considering a human rights approach and whether compulsory mental health treatment should ever be allowed
  • Defining why, when and how compulsory mental health treatment, if permitted, might be appropriate
  • Making sure people are able to use appropriate tools to support them to make decisions about their care and treatment
  • Considering the use, or prohibition, of seclusion, restraint, or other restrictive practices
  • Addressing the needs of specific populations: people from different cultures, family and whānau, children and youth, disabled people, and people from the justice system
  • Ensuring people’s rights are protected and monitored.

Any feedback you can give - on these topics or otherwise - will help the government to develop new mental health legislation. It’s a great opportunity to share your vision for the mental health system in Aotearoa. What do you think our mental health system should look like? 

How do I have my say?

Consultation is open until Friday 28 January 2022.

You can provide feedback by:

  • sending an email to mhactreview@health.govt.nz 
    • submissions can be in any format, including voice memos or video submissions
  • you can answer the questions in the discussion document, or just offer your feedback or experiences
  • making an online submission at consult.health.govt.nz 
  • answering the questions in the consultation document and sending a hard copy to:

Consultation: Transforming mental health law in Aotearoa New Zealand 
Ministry of Health
PO Box 5013
Wellington 6140.

There’s no wrong way to get involved. All your views and experiences are important and valuable to create an Act that works, and helps people to access the care and support they need when, where and how they need it.

If you need support immediately, helpline services are available right now in New Zealand that offer support, information and help for you and your parents, family, whānau and friends. All the services listed here are available 24 hours a day, seven days a week unless otherwise specified.

Need help?

If you need support immediately, helpline services are available right now in New Zealand that offer support, information and help for you and your parents, family, whānau and friends. All the services listed here are available 24 hours a day, seven days a week unless otherwise specified.