By Louise Ternouth of RNZ
New figures show the rate of antidepressants being prescribed over the past four years is at an all-time high and there's a huge disparity between ethnic groups.
Data released to RNZ's Checkpoint under the Official Information Act showed the rate of antidepressants prescribed to Māori, and Pasifika was up to 34 times less than other ethnicities.
That was despite Māori and Pasifika having higher rates of mental health difficulties.
The data from the Ministry of Health looked at the number of antidepressants prescribed from 2017-2020.
On average, other ethnicities were given antidepressants at eight times the rate of Māori, 34 times the rate of Pasifika and 16 times the rate of Asians.
That was despite research which showed one in three Māori, and one in four Pacific people experienced mental illness compared to one in five for the total population according to the latest mental health report from 2018.
Auckland University Pacific Health academic Collin Tukuitonga said the disparity was not surprising.
"Cost is often a barrier, just logistics and the reality, you know, not having transport and being able to go."
He said Pasifika were often undiagnosed and undertreated for mental health, because of cultural barriers.
"There's a prevailing view that Pacific people - particularly women - don't suffer depression or anxiety or they're not supposed to suffer depression or anxiety.
"We know from studies that Pacific Island people tend to present with physical symptoms such as a tummy ache and often they'll be treated for the tummy ache but their actual problem is a mental health disorder."
A lack of training for GPs on how to discuss mental health and pick up on the signs in Pasifika meant patients were pushed away, he said.
"They'll come once, they have an unpleasant experience and then they just disappear and don't come back."
University of Auckland Te Wānanga o Waipapa School of Māori and Pacific Studies's co-head of school Jemaima Tiatia-Seath said that pointed to institutional racism.
"There is a lack of cultural competency. New Zealand is diversifying thick and fast and yet the workforce isn't quite keeping up with that."
She wanted primary care workers to receive more support to treat patients for mental health.
New Zealand College of GPs medical director Dr Bryan Betty wanted that too.
"There's a huge amount of work that has to be done here, we've still got a very fragmented system, very difficult and there are large gaps. A lot of GPs, they feel a sense of frustration and isolation in dealing with these issues," Betty said.
GPs are often the first point of call for patients and Betty said they did not have the support they needed from specialists.
The biggest jump was in 2020, when 21,721 more people than the year before were prescribed with antidepressants.
Mental Health Foundation chief executive Shaun Robinson put that down to Covid-19 lockdowns and the pandemic's long-term effects.
On average, women were prescribed antidepressants at nearly twice the rate of men, which Robinson put down to stigma.
"Unfortunately, when it comes to suicide, men are much more likely than women to go to the point of attempting or taking their own life, but our research shows women are almost twice as likely as men to have an unhealthy wellbeing."
The latest Government inquiry into Mental Health from 2018 was released last month, finding some progress but frustration over the pace of change.
A new Independent Mental Health and Wellbeing Commission was established in response to the report, with goals to help improve the mental health system over the next five to 10 years.
Where to get help:
• Lifeline: 0800 543 354 (available 24/7)
• Suicide Crisis Helpline: 0508 828 865 (0508 TAUTOKO) (available 24/7)
• Youth services: (06) 3555 906
• Youthline: 0800 376 633
• Kidsline: 0800 543 754 (available 24/7)
• Whatsup: 0800 942 8787 (1pm to 11pm)
• Depression helpline: 0800 111 757 (available 24/7)
• Rainbow Youth: (09) 376 4155
• CASPER Suicide Prevention
If it is an emergency and you feel like you or someone else is at risk, call 111.