Depressed and anxious New Zealanders make up the two biggest groups on sickness benefits - higher than those off work for arthritis, heart disease and back injuries combined.
Blam Blam Blam's classic 1981 song There is No Depression in New Zealand has never been more darkly ironic.
More than 20,000 people are off work for mental health reasons, including stress, according to the latest figures obtained by the Herald on Sunday.
Auckland University psychiatry professor Rob Kydd said depression was the biggest cause of illness worldwide.
"It is a huge problem worldwide and the statistics show it is one of the biggest reasons of morbidity - if not the biggest," said Kydd. "It is bigger than heart disease."
Latest figures from the World Health Organisation Mental Health Atlas indicate that one in four people in the developed world will require mental heath care at some time in their lives.
Hugh Norris, of the Mental Health Foundation, said high numbers could be explained by the acceptance people had of mental health problems and greater willingness to seek help.
He said websites including All Black legend John Kirwan's online journal and thelowdown.co.nz for younger people, featuring celebrities such as Sonia Grey, Dave Gibson and Jane Yee, had helped people seek support.
"Seeking help for depression is definitely more common and acceptable," Norris said.
The Ministry of Social Development said the condition varied in severity and New Zealanders affected spent anywhere from a couple of months to more than two years on the sickness benefit.
The introduction of Future Focus reforms placed emphasis on getting people back to work.
"The changes refocus our attention to what clients receiving a sickness benefit can do, rather than what they can't do," said Work and Income deputy chief executive Janet Grossman.
"We believe that paid work is the best route to independence and wellbeing for most people because it increases self-esteem, provides financial independence and gives our children positive role models."
After a year, case managers carried out a work assessment similar to that done for long-term unemployed people. A patient would then be referred to a designated doctor for a second opinion.
Clinical psychologist Stephanie Allison said more was needed at the primary level to reduce the number of depressed people unable to work.
"The problem with anxiety and depression is that if they are not well treated they become chronic and incredibly debilitating," Allison said. "People can often get over a medical condition quite quickly but with anxiety and depression it is not so easy. It is not surprising people end up on a benefit because of these conditions, and the tragedy is, they are so treatable."
Allison said changes that enabled general practitioners, as well as mental health services, to refer patients in the early stages of depression and anxiety to psychologists was a huge step in the right direction.
Patients who showed signs of depression and anxiety were able to have four sessions with a psychologist.
"It's a great start but it's not quite enough," Allison said.
"To get anywhere in just four sessions is a big ask but it is surprising what you can achieve in four one-hour sessions."
Routine aids path to recovery
Not too long ago Veronica Linfoot couldn't get out of bed, let alone work. Suffering from major depression after a mental breakdown at 16, she spent three years on an invalid's benefit.
"I couldn't even get out of bed to go to the toilet - you just can't function really."
Childhood trauma and unresolved issues led Linfoot into a depressive episode and she was in hospital for four months.
"I would alternate between sleeping forever or being awake forever. I couldn't get up, wash my sheets, or have a shower. It's hard to remember how bad it was."
Linfoot said there was no quick fix for her depression. Time on an invalid's benefit, which is more long-term than the sickness benefit, gave her time to get well. "The financial support was important and I was also assisted in getting into study so I could get into the workforce."
Linfoot now works fulltime and is in control of her life. She has just finished a job at the Heart Foundation and is temping while looking for another fulltime role.
Getting back to work was the key. "Keeping a routine and keeping in life is the most important thing." Linfoot said more needed to be done to help sufferers when they were ready to re-enter the workforce. "There needs to be help and coaching with CV and interview preparation but with a mental health focus. At the moment, there is no help like that available."