COMMENT:

Hey kids, drugs are bad. But apparently not when they're handed out by the government. Then fill ya boots.

When I was down in the dark lonely pit of depression, I gobbled my antidepressants, sure. But I also started talk therapy.

I believe the pills may have helped me get on the bottom rung of the ladder, but it was therapy that helped me on the long, slow climb out of that hole.

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And now I worry we are not giving people the best advice for how to treat depression.

I'm not anti-medication. I just wish that talk therapy was as readily available as pills are.

For people like Evie Aitcheson, for example. This newspaper reported how Ms Aitcheson, who was suffering after being on the frontline of the 2011 Japan tsunami, was put on antidepressants which led to "seven years of medicated hell". Was Evie Aitcheson offered subsidised talk therapy instead?

It is clear there are many other people in similar situations who are suffering.

New statistics, from a University of Otago study, show almost one in eight New Zealanders over the age of 15 are on antidepressants, despite little evidence the drugs are helping curb the country's alarming suicide rates.

Why is it so easy to get a prescription for an SSRI, yet it is so hard to get subsidised, long-term, talk therapy? Yeah I know. Stupid question. Moola.

It is encouraging that Deputy Prime Minister Grant Robertson has announced next year's budget will have a special emphasis on mental health.

Will there be more subsidised talk therapy? I hope so, although even if the government decides to do so, it might not be easy to implement right away.

There were only 13 graduates from AUT's masters of psychotherapy programme in 2018, and 14 in each of the previous two years.

Disclosure: I am studying psychotherapy at AUT, so I hope one day to be one of them, but this is not special pleading because I want a job. There is a sound economic case for training more.

A major study cited in Scientific American Mind found an 'effect size' - a measure of treatment benefit - of 0.97 for psychodynamic psychotherapy, for CBT (cognitive behavioural therapy) 0.68 was a typical effect size. For antidepressant medication the average effect size was 0.31. But guess which is most expensive, and which is cheapest?

In the most recent figures I could find, New Zealand's district health boards (DHBs) employ 587 clinical psychologists, compared to just 84 counsellors, 54 psychotherapists, and 6 counselling psychologists.

AUT Professor Keith Tudor, who is head of the university's faculty of public health and psychosocial studies, says the employment of more psychotherapists to provide an alternative, talking treatment is not based on professional status; it is a political decision.

When I asked the Auckland DHB about how it funds talking therapy a spokeswoman for the DHB sent me a statement saying: "We believe talking therapy is a very important part of the treatment process and is one of the different tools that is considered for a person's individual treatment plan."

That sounds great. She added the DHB employs 22 psychotherapists.

To put that number in context, the most recent figures show one in six New Zealand adults have been diagnosed with a common mental disorder at some time in their lives. Nearly 8 per cent of adults had experienced psychological distress in the past four weeks.

There are two other health boards in Auckland, but even so 22 psychotherapists to serve something like 129,000 people with mental health disorders doesn't sound like a lot.

As a culture we have become more enlightened on many other issues: drink-driving, smoking, racism, the environment, how we react to sexual harassment. I believe it's time our policymakers caught up with current thinking on mental health.

It's been 23 years since neuroscientist Antonio Damasio published his revolutionary book Descartes' Error, which argued persuasively there is no tidy distinction between the mind and the body.

Yet the "chemical imbalance" theory of mental health has just been accepted as a given because it's cheap. It may be easier to see distress as a disease and sorrow treated as garbage to be got rid of by way of a happiness pill. But this doesn't make it right.

Some of the information being given to young people about mental health is simplistic and unhelpful, if not dangerous.

The government's own health promotion agency, The Lowdown tells teens: "Your body has chemicals in it that control your mood. Sometimes these chemicals get out of balance."

There are many in the medical profession who would challenge this statement and say we simply don't know.

And what is very important is that we may be making things worse by treating this chemical imbalance theory as fact.

University of Auckland sociologist Bruce Cohen points out those who believe their depression is caused by a chemical imbalance have a poorer prognosis than those offered other explanations.

Studies show they suffer more stigma and self-blame, have a greater sense of helplessness and hopelessness and are less likely to engage in talking therapies.

Dr Cohen asks whether it is possible that there is a causal link between New Zealand's high rate of antidepressant prescribing and our position as world leaders in youth suicide?

Sadly, talk isn't cheap. But with our youth suicide statistics, look at the cost of the alternative.

WHERE TO GET HELP:

If you are worried about your or someone else's mental health, the best place to get help is your GP or local mental health provider. However, if you or someone else is in danger or endangering others, call police immediately on 111.

OR IF YOU NEED TO TALK TO SOMEONE ELSE:

• DEPRESSION HELPLINE: 0800 111 757
KIDSLINE: 0800 543 754 (available 24/7)
LIFELINE: 0800 543 354 or 09 5222 999 within Auckland (24/7)
NEED TO TALK? Free call or text 1737 (24/7)
SAMARITANS – 0800 726 666
• SUICIDE CRISIS HELPLINE: 0508 828 865 (24/7)
WHATSUP: 0800 942 8787 (1pm to 11pm)
YOUTHLINE: 0800 376 633, free text 234 or email talk@youthline.co.nz

There are lots of places to get support. For others, click here.