Mental Health Bill

Overall, the MHF supports the Mental Health Bill, but it does not go as far as we had hoped. We support many of the new provisions, particularly those related to supporting and assisting people potentially subject to the legislation to understand and participate in decisions, express their decisions, have their rights upheld, and have their whānau and loved ones involved in their care. That said, the MHF is disappointed the Bill is not as transformative as initially envisaged in He Ara Oranga, the 2018 report of the Government Inquiry into Mental Health and Addiction. After over 30 years without review, many saw this repeal and replacement process as a once-in-a-generation opportunity to reimagine our response to people experiencing significant mental distress.

In our submission to the Health Committee, we make the following key recommendations: 

• Direct the Ministry of Health and Health New Zealand to clearly demonstrate how and when “the system” will support the fundamental shifts needed to achieve a reduction in compulsory mental health care, including through the 2025 Mental Health and Wellbeing Strategy.
• Direct the Ministry of Health and Health New Zealand to prepare and publish a detailed implementation plan for the new Mental Health Act, to give government, Parliament and the public an assurance the system is prepared to administer the new law as intended. 
• Reference the United Nations Convention on the Rights of Persons with Disabilities, and divide the Bill into separate civil and forensic/restricted pathways, to allow for the future merging of civil compulsory treatment processes into a "generic" capacity law.
• Significantly strengthen the provisions for Te Tiriti o Waitangi, including with a dedicated directive that the Bill will be interpreted and administered to give effect to Te Tiriti o Waitangi.
• Safeguard decision-making supports with more proactive obligations and clarity of roles in the Bill, supported by investment and infrastructure for delivery.
• Provide for a shift towards a collective care approach, where decision-making authority is held by services and supported by teams, rather than held by single practitioners.
• Include a sunset clause for solitary confinement (seclusion), prohibiting its use after a specified time, such as within five to 10 years of the law coming into force.
• Consider discontinuing community mental health care orders in most cases, given evidence they are not effective.
• Consider a tribunal-like process to determine applications for mental health care orders rather than the courts, and shorten second and subsequent extensions to mental health care orders to six months.
• Include more checks and balances for medications and treatments that carry significant risks (such as electroconvulsive therapy and sedating medications).
• Strengthen the provisions for the Director-General's five-yearly review of the policy and operation of the new law with a requirement for the Minister responsible for mental health to table the review report and respond to its recommendations within a reasonable timeframe.