It's worse than we thought - but there is hope.
New Zealand was already struggling to cope with a profusion of mental health challenges before Covid. Now we have cries to police from the overwhelmed for emergency help at an average of more than 200 a day.
Five years ago, we launched a project to confront one of the most tragic outcomes of our struggles with the mind. New Zealand had the worst teen (15-19) suicide rate in the world, a statistic largely unchanged for around two decades.
The Break the Silence series concluded with a story of hope, accounts of two teenagers who wrestled with personal anguish and together fought back from the precipice. Today, we again bring dire reportage from investigations into the state of the nation's minds, but we also offer this sombre diagnosis with ways through.
Two years of unprecedented stress and disruption forced on us by the coronavirus pandemic has now wrought an enormous further psychological toll on New Zealanders - and the fallout is spreading.
Polling by Ipsos for the Mental Health Foundation found 36 per cent of people surveyed in its latest national wellbeing tracker were experiencing poor emotional wellbeing, up from 27 per cent a year earlier. The foundation says this is significant and concerning.
Police attended 21 per cent more callouts for mental health issues, attempted suicides and suicides in December than they did in the same month two years ago - an average of 210 callouts every day across the nation.
We are not alone. A World Health Organisation report says the pandemic has caused a marked increase globally in mental health problems, including a 25 per cent increase in depression and anxiety.
Three years ago, Labour made mental health a focus of its "Wellbeing Budget", promising more investment and several new initiatives, including a counselling service for people with mild and moderate problems. Critics pointed out these measures were insufficient to meet the need even before Covid.
With a Budget next month and a major reform of the health sector to be bedded in this July, health advocates want the Government to have a clear, far-reaching mental health recovery plan that includes more specialist services and tangible action on the social "determinants" of emotional wellbeing, such as housing.
After grappling through the pandemic and lockdowns, financial stress is the latest ogre to throw shade on the room. The Government is aware of this and has recognised it with some measures.
Cutting tax of 25 cents per litre on fuel and halving public transport costs for an initial three months are intended to help ease financial pressure on families.
"We did that because we recognised there was an immediate spike in the cost of living that was causing significant household stress," Finance Minister Grant Robertson said.
Increases to the benefit, minimum wage, and Family Tax Credits in April, and the Winter Energy Payment in May, are also expected to assist low-income households.
Similarly, we say targeted assistance needs to be directed into the nexus where mental unwellness meets the first ports of call. Addressing distress at the earliest opportunity provides the best outcomes.
Getting help to those who need it doesn't have to bankrupt the country. As the WHO points out, many mental health conditions can be effectively treated at a relatively low cost.
The issue is the substantial gap between people needing care and those with access to care.
The WHO says the priorities should be increased investment on all fronts: for awareness to increase understanding and reduce stigma; for efforts to increase access to quality mental health care and effective treatments; and for research to identify new treatments and improve existing treatments for all mental disorders.
The stigma is real and, according to a recent report from Consumer NZ, systemic.
Consumer NZ checked with 14 insurance companies and found customers who sought advice or help with their mental health could be regarded as "high-risk" claimants. This could cause exclusion clauses to be added to their policies that Consumer considered unfair in denying customers cover when they needed it most.
Covid-19 not only added to the delays in providing mental health services, but it has also likely heaped more cases onto the wait list. Many people who have caught Covid-19 feel they did not get the healthcare needed to cope, according to a recent report called the "Impacts of Covid-19 in Aotearoa - Ngā Kawekawe o Mate Korona" by Te Herenga Waka - Victoria University of Wellington.
Twenty-nine per cent of nearly 900 infected people surveyed said they did not get mental health support but would have found this useful. Women were twice as likely as men to say this would have helped.
Over the coming weeks, the Herald will be joined with sister publications across the NZME whānau to explore the issues around the state of our mental wellbeing in the Great Minds project. A big part of our efforts will be seeking out and sharing the solutions. We have appointed broadcaster, stoicist and regular columnist Matt Heath as Happiness Editor.
We can all join this recovery. The rudimentary tools are effective and are already at our disposal - a hug, a reassuring word, being there, listening, and a reminder that this will pass and they will be okay.
If you are struggling, ask for help and accept it when it is offered.
Hold on to hope.
WHERE TO GET HELP
If it is an emergency and you or someone else is at risk, call 111.
For counselling and support
Lifeline: Call 0800 543 354 or text 4357 (HELP)
Suicide Crisis Helpline: Call 0508 828 865 (0508 TAUTOKO)
Need to talk? Call or text 1737
Depression helpline: Call 0800 111 757 or text 4202
For children and young people
Youthline: Call 0800 376 633 or text 234
What's Up: Call 0800 942 8787 (11am to 11pm) or webchat (11am to 10.30pm)
The Lowdown: Text 5626 or webchat
For help with specific issues
Alcohol and Drug Helpline: Call 0800 787 797
Anxiety Helpline: Call 0800 269 4389 (0800 ANXIETY)
OutLine: Call 0800 688 5463 (0800 OUTLINE) (6pm-9pm)
Safe to talk (sexual harm): Call 0800 044 334 or text 4334
All services are free and available 24/7 unless otherwise specified.
For more information and support, talk to your local doctor, hauora, community mental health team, or counselling service. The Mental Health Foundation has more helplines and service contacts on its website.