The number of New Zealanders struggling with poor mental wellbeing has risen sharply during the Covid-19 outbreak, according to research obtained exclusively by the Herald, prompting calls from leading health figures for an urgent national recovery plan.
Polling for the Mental Health Foundation found that 36 per cent of people surveyed were experiencing poor emotional wellbeing, up from 27 per cent a year ago, an increase that the foundation says is significant and concerning.
The research adds to a body of evidence indicating that two years of unprecedented stress and disruption brought on by the coronavirus pandemic has had an enormous psychological toll on Kiwis - and that the burden is growing.
Today the Herald and NZME launch a major editorial project, Great Minds, to examine the state of our mental health - and solutions for improving wellbeing as the country recovers from the pandemic.
Health professionals warn the constant threat of illness, social isolation, economic worries, grief from family separation and other pressures imposed by Covid-19 have both compounded the distress of those who were already vulnerable to mental health problems, and caused people to experience symptoms of conditions such as anxiety and depression for the first time.
Prominent health figures including the leaders of the Mental Health Foundation, the Royal Australian and New Zealand College of Psychiatrists, and the Association of Salaried Medical Specialists warn that New Zealand was already struggling to cope with a profusion of mental health challenges before Covid.
A wave of new problems is overwhelming public mental health services that have been depleted by years of underinvestment, experts say.
"What we have is a crisis on top of a crisis, because mental health was already in a crisis," says Shaun Robinson, chief executive of the Mental Health Foundation.
"This is adding significant additional pressure. And it needs an additional response."
The full extent of the psychological impact of the pandemic has yet to emerge, experts say, and could last long after the virus itself has receded from public concern - particularly if the soaring cost of living pushes more people into hardship in the months ahead.
They urged the Government to put mental health at the centre of its post-pandemic plans, including a commitment to provide substantial new funding in next month's Budget.
Speaking to the Herald, Health Minister Andrew Little acknowledged the impact that Covid has had on people's wellbeing.
"We are aware of that and know we need to have support and services in place to be able to respond effectively to it."
Little said the Government remained committed to the transformation of mental health it promised in the 2019 Wellbeing Budget.
"We are still not there yet. We still have plenty to do."
The Ministry of Health would now focus on boosting specialist services for people with serious mental health problems, where there was "major unmet need", after putting much of its investments so far into early intervention for people with milder conditions.
"We need to do more," Little acknowledged, but would not provide details of his plans.
The health leaders' concerns are borne out by an extensive review by the Herald of government and district health board documents and data, along with interviews with numerous people in the sector, which portrays a stark picture of the growing psychological impact.
Among the findings:
• Health officials told Little that Covid's impact on the public may be delayed but wide-reaching and could last for years. The consequences for young people are a particular concern. "The impacts of Covid-19 on youth mental wellbeing is likely to be extensive and enduring," officials said in a briefing to the minister in September.
• DHBs say their specialist mental health services have experienced a surge in referrals during the pandemic. More people coming to them for help are in acute psychological distress and have complex conditions that are difficult to treat. It has pushed the DHBs' already-stretched workforces to the brink. "We are beyond crisis point," said one psychiatrist on the front lines.
• Schools, GPs and hospital emergency departments are also being overwhelmed by the surge in distress. The Royal College of GPs says about a third of doctors' visits are now related to mental health, while the number of calls to police for mental health problems, attempted suicides and suicides has risen - to an average of more than 200 recorded nationally every day in the past three months.
In February, the Herald revealed that children and young people were hospitalised more than 5600 times after self-harming last year, a rate that has increased by 10 per cent since the start of the pandemic and nearly a third in five years.
Since then, the Herald has spoken to numerous people with experience of mental health problems and their carers who said the Covid outbreak has affected their state of mind.
One businessman in Tauranga who lost his teenage son to suicide in 2020 says he believes the pandemic contributed to the sense of hopelessness his son felt before he took his life.
"It wasn't Covid that caused what happened with my son," he says.
"But it might've been the straw that broke the camel's back."
The Mental Health Foundation began monitoring the public's mental wellbeing in December 2020, using a questionnaire devised by the World Health Organisation. The polling was conducted by IPSOS and has been repeated several times since then.
In the latest round, the average wellbeing score of those surveyed slipped to 14, down from 15.9 in December 2020.
The foundation says the percentage of people in a poor emotional state has increased steadily, rising from 25 per cent in December 2020 to 36 per cent now. The rates are particularly concerning among women, with 42 per cent showing poor emotional wellbeing in the latest survey.
"What it's showing is a dramatically deteriorating situation and it's very obvious that it's related to the impacts of Covid-19," Robinson says.
Not everyone with a poor emotional state would develop a life-altering mental condition that requires professional intervention, Robinson said, but more people were at risk of doing so, at a time when the system's capacity to help them was severely limited.
It comes after the World Health Organisation published a report saying the pandemic has resulted in a marked increase globally in mental health problems, including a 25 per cent increase in depression and anxiety.
WHO director-general Tedros Adhanom Ghebreyesus said this was the "tip of the iceberg" and "a wake-up call to all countries to pay more attention to mental health".
Health experts say the scale of the mental health burden in the coming months depends partly on unpredictable economic and social factors but that the long-term consequences could be mitigated by bold policy actions now.
Three years ago, Labour made mental health a focus of its "Wellbeing Budget", promising more investment and several new initiatives, including a counselling service aimed at people with mild and moderate problems. However, critics say these measures were insufficient to meet the need even before Covid.
With a Budget next month and a major reform of the health sector taking effect in July, health experts are calling on the Government to come up with a clear, far-reaching mental health recovery plan that includes a substantial funding increase for specialist services and tangible action on the social "determinants" of emotional wellbeing, such as housing.
"If we want to get in front of the wave, we have to grit our teeth and chuck some serious resource into the mix, in a planned and organised way," says Sarah Dalton, executive director of the Association of Salaried Medical Specialists.
"This is a watershed moment for health services in New Zealand," says Paul Skirrow, executive adviser at the College of Clinical Psychologists. "We absolutely cannot continue with the same models of care and training that we have been relying on up until now."
"There has to be a very clear and transparent plan, and ideally something that all political parties sign up to," says Robinson, of the Mental Health Foundation.
The Ministry of Health, in addition to the work already being done as part of Labour's Wellbeing Budget commitments, says it invested $15 million in a psychosocial response package in 2020 and another $5.6 million last year when the Delta outbreak began.
According to a ministry spokesperson, the support provided included a campaign and website, All Sorts, aimed at helping people cope with difficult emotions, in conjunction with the Mental Health Foundation. It has also boosted funding for digital and telehealth services.
The Herald will continue reporting on the nation's mental health and the way that services help people who experience difficulties. And we need your help.
We want to hear from as many people as possible who have experienced mental health problems, those who care for them, and people who work in the mental health system. The more people we can speak to, the more thorough and accurate our reporting will be. We will not publish your name or identify you as a source unless you want us to.
• Please share your experience by contacting Investigations Editor Alex Spence: alex.spence@nzme.co.nz
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.
They allege the Crown ignored Treaty obligations by not engaging with them.