Amicus Curiae: Health Care or Health Couldn't Care Less? Examining New Zealand's Mental Health System
Content Contributor, Claudia Russell
Early in 2015, New Zealand made headlines worldwide for our shocking suicide rates. Despite the government attempting to respond to this issue, our mental health statistics continue to paint a dark picture. One in six adults are diagnosed with a mental illness at some point in their lives, and 564 lives were lost to suicide in this country last year – the highest in the OECD.
However, these statistics do not cover those who may be suffering without a diagnosis, or the many suicides recorded as ‘accidental’ or ‘undetermined’. For the vast majority of New Zealanders, private sector therapy at a rate of $120 - $240 and hour is simply not an option. Most rely on community-based or DHB services which can have unbelievably long waiting lists. Unfortunately for many individuals, by the time they are seen their illness may have completely taken hold.
Suicidality does not wait for a convenient time. Often those who realise they are in danger must turn to the police and emergency services. Mental health-related calls to police have more than doubled over the last two years despite an existing crisis line. Many suggest that people are being turned away even on the verge of suicide due to a lack of inpatient beds and lack of staff. Our system seems to be playing hot potato with patients - emergency services unable to meet the specific needs of a mental health patient, and crisis lines without adequate resources to deal with the number of calls.
While we have low-cost systems in place, they often lack the capacity to meet the needs of so many struggling citizens. University counselling services, DHB funded programmes and community NGO counselling facilities all offer excellent treatment with trained and caring professionals. However, the waiting lists are long, with waiting periods sometimes extending into months, and often this is far too late.
Reports have become more desperate every year, and the government response has been minimal. The mental health sector desperately needs funding but it is often pushed to the background of political debates. However, over this last year, a few changes have been made and a number of policies have been proposed.
One of those policies is the National Party’s proposed social bonds scheme last year, (link to Rebecca’s article) which has since been criticised for being ineffective. The scheme would essentially have encouraged third-party investors to assist with the mentally ill in the hope of monetary compensation.
As of August 2015, the Coroner’s Act 2006 has also been amended in lieu of the Law Society’s recommendation that the scope of suicide-based media reporting be widened to include low-risk suicide reporting. Currently, we are the only country with any laws regarding the reporting of self-inflicted death. Originally, the Act strictly prevented any form of suicide reporting to avoid “copycat suicides”. However, the Law Society proposed that some openness may be helpful and encourage necessary conversations within the community. The amended Act comes into force on the first of July 2016, with important changes to section 71, allowing journalists to report on suspected and confirmed self-inflicted deaths. Although many have called for a complete loosening of restrictions, the new amendments seem to strike a balance between openness and prevention against potential copycats.
Another legislative response is the Health and Safety at Work Act 2015, which came into effect last month. It includes “mental and physical health” under its definition of “health” within the Act. While this appears minor, with hope this may set an example for future legislation to recognise that psychological distress can be just as debilitating as physical ailments.
Earlier this year, there was also a $20 million cash injection to aid stressed and over-worked mental health workers in Canterbury. Counselling sessions in the area have doubled since the 2010 earthquake hit, and this financial boost was an attempt to address that.
All the above approaches are steps in the right direction. Such changes indicate that our government has acknowledged the importance of mental health in New Zealand. As a country of staunch individuals, involving mental wellbeing in political discourse may well be the influence we as a society need to start having our own conversations with friends and family who may be suffering.
Experts suggest that attention is still desperately needed in local DHB and NGOs to make sure that mentally ill people are treated. A recently released Waikato DHB report suggests that staff are few and over-worked, resulting in unexpected resignations. Spokeswoman Scout Barbour-Evans states that low staff coupled with a lack of inpatient beds means that people are only getting help when they are in absolute crisis.
Furthermore, NGOs account for one-third of the national mental health and addictions expenditure; they have the ability to make a significant impact. Many of these organisations involve community-based care which promotes early detection and intervention. Frontline services urge that the community is the best place for the mentally ill and their families to be treated, as such services are in the best place to collaborate with local policymakers across a range of areas. Progress at the community level can make a huge difference, but not without financial and political support. Looking ahead, the expertise of professionals specialising in mental health and the development of policy around it will be instrumental in guiding New Zealand’s socio-medical approach in the right direction.
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