Mental health boost aims to cut welfare rolls

Health Workforce NZ chairman Professor Des Gorman. Photo / Greg Bowker

Health training funds are being redirected into mental health and rehabilitation in one of the first concrete steps towards a radical reform of New Zealand's welfare state.

The reforms, recommended by a working group on the day of February's Christchurch earthquake, aim to cut 100,000 people off the welfare rolls in the next decade above those who will get jobs anyway as the economy recovers.

The first step of boosting the mental health and addiction workforce is targeting the half of the 145,000 people on sickness and invalid benefits who have "unmet mental health needs".

Health Workforce NZ chairman Professor Des Gorman, a member of the working group, said mental health services were "in poor repair" and New Zealand did not have a coherent rehabilitation system except for accident victims.

"Certainly there is going to be funding shifted into mental health and rehabilitation," he said.

"Recruiting people into mental health is exceedingly difficult, yet Treasury, when it looked at what underpins the welfare budget, found that more than half of it is unmet mental health need."

The welfare reforms, which the working group said should lift the proportion of beneficiaries required to look for work from 37 per cent at present to 77 per cent, will take several years to implement.

A spokeswoman for Social Development Minister Paula Bennett said the decisions would be part of the National Party's manifesto for the election.

The working group proposed appointing a ministerial committee and an advisory group this month, preparing legislation by September and introducing a new single-rate benefit called Jobseeker Support and a new body to replace Work and Income, Employment and Support NZ, in July next year.

"We have a year or so to sort out how this is going to work," Professor Gorman said.

"But we can't wait a year to start ... so we are getting on with training people. Those people will be essential."

As well as more mental health nurses, he wants to train more general practitioners to take "a special interest" in mental health.

A discussion paper says mental health and addictions will be the first module developed in a new GP education programme.

The recent Australian Budget provided A$2.2 billion ($3 billion) extra for mental health over the next five years, partly to help people back to work.

Mental Health Commissioner Dr Lynne Lane said there was no more money available for mental health in New Zealand but the Health Ministry was due to publish a service development plan by November to spend the $1.3 billion a year now "ringfenced" for the service more effectively.

She said the plan could mean more flexible funding, with some money from Social Development as well as Health. Under current rules, early intervention by counselling agencies is outside the "ringfence" and is provided mainly on a user-pays basis.

National Committee for Addiction Treatment co-chairman Robert Steenhuisen said alcohol and drug agencies were already funded by the Corrections Department to treat offenders. In Auckland 50 per cent of people on probation were referred for alcohol or drug treatment.

He said group sessions would probably work best for beneficiaries who often had multiple problems besides addictions.

"People have to reach a certain level of awareness that this is how their life is and that no one is going to make it better for them except themselves," he said.

Working with people in groups helped them realise they were not the only ones with difficulties.

REFORM TIMELINE

May 2011: Appoint ministerial committee and advisory board.

To Sept 2011: Technical work; prepare legislation.

July 2012: Establish Employment & Support NZ; new beneficiaries go on to single-rate Jobseeker Support.

Jan 2013 to Dec 2014: Implement jobseeking support and obligations.

Source: Welfare Working Groupby Simon Collinssocial issues reporter