The review of mental health services in New Zealand about to be undertaken by the Government is likely to come up with findings so many know already - they are in crisis.
Have been for a long time according to those who would know - users of the services.
What I find so hard to stomach is the underspend by some DHBs of their mental health services budget. That shouldn't be happening. It's not as if the need isn't there.
I know some people working in the sector get impatient when mental health advocate Mike King is on the attack, but he is right when he says mental health services have already been reviewed, locally and nationally. Numerous reports written. He questions why change takes so long to implement when it is clear "the system is broken". Nothing will change if nothing changes.
The extent of unmet needs and barriers to care have been well documented. People falling through the cracks, lives lost to suicide and recovery treatment patchy at best. The system for both adults and children is at fault.
We deserve a health care system that treats mental illness with the same urgency as it treats other medical illnesses. Ideally everyone who needs care would receive prompt, quality, effective care with the same priority.
Well we know that's not going to happen. Our health system doesn't have the dollars to cover all the costs of those who need health care.
But mental health care should never have been put in the too hard basket. While many people do receive effective treatment and services, many others do not.
Mike King says the system is fragmented and in disarray, not from lack of commitment and skill of those who deliver care, but from the underlying structural, funding and organisational problems.
Programmes, well intentioned maybe, lack overall direction, co-ordination and consistency.
He continues to question the delay in making the necessary changes. And it is this that puts him off side with health policy makers.
But his knowledge of service gaps and inability to access services comes directly from consumers of the services. They bombard him with real life experiences of the system. Too many to be ignored.
He continues to stress when systems fail this can lead to unnecessary and costly disability, homelessness, school failure, and incarceration. And tragedy when all hope appears lost.
I think part of the answer lies in community-based models of care. Time and again we have seen success through the co-ordinating of services at local level.
Rotorua may be ahead of the game when looking at more effective mental health outcomes.
Last week local Maori health provider Te Utuhina Manaakitanga opened Te Whaare Oranga Ngakau, a residential facility for individuals with longer histories of complex drug and alcohol misuse, related health and social and/or offending problems.
The recovery process of the programme encourages a lifelong commitment to personal development and knowledge of cultural background.
It is a Maori values based therapeutic community. In a safe, supportive environment people experience and respond to emotions and gain understanding of issues relating to their drug and alcohol use.
It is merely one model of care for addressing and producing desired mental health outcomes.
There are many pathways for help for anyone with mental illness if they can gain access to services.
These vary from medication, psychotherapy, substance abuse treatment, or counselling. Or offering rehabilitation support. The system is supposed to function in a co-ordinated manner. It doesn't. Services are getting harder to access.
Te Whare Oranga Ngakau believes in, and provides, culturally appropriate mental health care. They demonstrate Maori beliefs, values and practices.
Residents and team members, combined with the experience of living in a caring whanau community, work to support change and personal development. It was heart-warming to hear a young mother declare "if it wasn't for the recovery programme provided by Te Whare Oranga Ngakau, I would be dead by now."
We have experienced those deaths in Rotorua and in other communities throughout New Zealand. These are our people.
As taxpayers we pay for the health services provided. High time they were fit for purpose and able to be accessed by all when needed. The stakes are high enough when we continue to get it wrong.
Merepeka Raukawa-Tait is a Rotorua district councillor, Lakes District Health Board member and chairs the North Island Whanau Ora Commissioning Agency. She writes, speaks and broadcasts to thwart political correctness.