A revamped mental health and wellbeing commission is expected to be the centrepiece of the Government's response to the mental health crisis, which is due any day. Lucy Bennett reports.
Prime Minister Jacinda Ardern and senior ministers have said mental health and wellbeing will be a priority for Budget spending this year, and with six months already gone since the inquiry into mental health and addiction reported back, hopes are high that it will be substantial.
Ardern further delayed the Government's response to the report last month, saying it would be announced closer to the Budget so the public could see not only the plan for transforming the entire approach to mental health and addiction but also how it will be resourced and delivered.
The long-awaited Report of the Government Inquiry to Mental Health and Addiction, the most comprehensive report into the area since the 1996 Mason report, warned of a "rising tide of mental distress and addiction" in New Zealand.
It made 40 recommendations that would create the kind of transformation Ardern has promised.
The re-establishment of a mental health commission, renamed as the Mental Health and Wellbeing Commission, is a key plank of any reform.
It is also a condition contained within the Labour-New Zealand First coalition agreement and was part of Ardern's 2017 Speech from the Throne.
There has been no standalone mental health agency since the time-limited Mental Health Commission was disestablished three years early by the former National government in 2012 and its functions subsumed into the Office of the Health and Disability Commissioner.
What had been an organisation with three commissioners, 15 to 20 support staff, an advisory board of about 10 and an annual budget of up to $3 million was reduced to one commissioner, three staff and a $1m annual budget.
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Mental Health Commissioner Kevin Allan is hoping for a commitment to establishing a new mental health commission soon.
"We certainly want decisions and we want a clear investment from the Government from this Budget.
"We're at a point where we need decisions made, a clear plan of action to get on and deliver them so I'm certainly hopeful that the Government will make a commitment to establish a standalone mental health and wellbeing commission," said Allan, who works within the Office of the Health and Disability Commissioner.
Allan, who is involved in discussions with the Ministry of Health about the changes required for a smooth transition to a new Mental Health and Wellbeing Commission, said it would take some time to roll out so transparent timeframes would be crucial.
He also called for a commitment to providing more money and resources to improve mental health and addiction services and broader support for people in areas that contribute to poorer mental health such as poverty and homelessness.
"We do see the commission as having a broad view on mental wellbeing, addressing issues about attitudes to mental health and looking at what's being done to help improve attitudes about mental health and wellbeing and also addressing wider wellbeing factors," he said.
Allan saw the commission as an independent watchdog, responsible for monitoring and advocacy.
"We would be concerned if it sets a strategy, implements it and then decides whether it did a good or not. I think it needs to be an independent watchdog, making sure that there is a good strategy, that it's delivered as intended and also has a critical view of where that's succeeding and where it needs to improve."
He was also keen to see a legislative change to implement a permanent mental health and wellbeing strategy.
"At the moment, under the New Zealand Public Health Act, there has to be a health strategy, there has to be a disability strategy. Both of those things have had an impact over time. But there's no statutory requirement for the Government to have a mental wellbeing strategy. We think that's overdue."
Allan said the commission had to have the confidence of the entire country and the experience and expertise of people with lived experience and their whānau, and Māori.
Allan said while the idea of a 20 per cent suicide reduction target - another of the inquiry's recommendations - was controversial, "what is not controversial is that we have to do more to address the level of suicide in New Zealand".
Shaun Robinson, Mental Health Foundation chief executive, said an impending announcement on a mental health commission was a "no-brainer".
"But if that's all that is all that came out, that would be pretty pathetic. I'm taking Prime Minister Jacinda Ardern's word at face value that basically people need to get clarity from the Government about what the direction and vision is for mental health, and that's the response to the mental health inquiry," Robinson said.
"Then they need to see how that's going to be resourced, and that starts with the Budget."
He warned mental health was not a one-Budget fix.
"It is very much a long-term, probably 10-year programme of action that is going to need long-term investment.
"Unless we have that clear direction and sense of commitment from Government that they're going to keep going on the path of that direction then it will be very hard to interpret the Budget. It'll turn into a lolly scramble where people try to grab what they can."
Robinson also expected to see Government support for Māori-led responses to mental health in the Budget.
"Māori are so significantly overrepresented in poor mental health outcomes. There is a really strong aspiration within the Māori community and the overall sector that things be done differently because for many Māori existing services simply don't work."
Dave Macpherson, whose son Nicky died in the care of Waikato DHB's mental health unit, said he and his wife Jane Stevens would like to see more support for family and whānau with a loved one in care or following a suicide.
READ THEIR STORY HERE: Nicky Stevens' whānau to meet Jacinda Ardern over Waikato DHB battle for new inquest
"We're talking about some place you can go to for advice and support and advocacy. The places like Victim Support, they know nothing about this area to be frank, and there's no training for dealing with it. We've learned on the job.
Macpherson approached the Health and Disability Commission about three weeks after Nicky's death in 2015 but said he it was not able to act until after a coroner's inquest. That matter has yet to be resolved.
The couple strongly backed the creation of a new Mental Health and Wellbeing Commission.
"We said it's a no-brainer that a mental health commission should be re-established," he said.
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)
• The Word
• 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.