What's behind New Zealand's mental health funding crisis?
According to many Kiwis working in mental health, the system in this country is broken, seriously underfunded and in crisis.
They say there is a constant waiting list for beds in all mental health care facilities, and not enough staff.
New Zealand's only 24-hour suicide counselling service Lifeline, which receives 15,000 calls a week, is struggling to find the funds to keep operating and will likely close next year.
Tragically, more Kiwis are taking their own lives more than ever before, and suicide is now our third highest cause of death behind heart disease and lung cancer.
Despite these horrifying statistics, the Ministry of Health (MoH) told Newshub there is more money being pumped into mental health care than ever before.
The MoH say since 2008 mental health expenditure has increased by $202.5 million from $1.1 billion to $1.3 billion, an increase of 18 per cent.
But many working in the mental health sector claim the money isn't getting through to the services that really need it.
Overall health funding is up from $9 billion in 2008 to more than $12 million this year.
It's up to each individual DHB to allocate funding to their separate health departments.
Psychotherapist and mental health blogger Kyle MacDonald says DHB spending on mental health and health services in general is too frugal.
"We are always having to juggle what we spend," says Mr MacDonald "But we've got a government that is talking about DHBs being over-budget. So we're looking at solving problems with accounting rather than looking at what actually does the community need in terms of health spending?"
"The DHBs are not spending money frivolously, if they're over-budget then it's because they don't have enough money to provide the services that they need," he added.
The MoH's Director of Mental Health Dr John Crawshaw told Newshub: "Expenditure for mental health services by DHBs increases year on year as there is a ring-fence in place."
"This means that although a DHB has discretion over where it allocates funding and can increase its allocation to mental health, it cannot spend less than the previous year. The ring-fence was put in place to protect specialist mental health and addiction service investment and development," says Dr Crawshaw.
However, Professor Max Abbott believes half of New Zealand's DHBs are in big trouble financially, and their mental health services are suffering as a result.
"Ten DHBs are in financial strife despite big moves to increase efficiency and extend services the best they can. I think it does suggest that more funding is required to health generally and also mental health," claimed Prof Abbott.
In 2012 the Government disbanded the mental health commission, robbing New Zealand of its only independent body looking into mental health services.
Public Services Association (PSA) organiser Brendon Lane says the Government needs to re-evaluate how mental health services are funded.
"The last time any government acknowledged there was under-funding in the system was back in the mid-2000s with the Labour government."
"They ring-fenced a whole lot of additional money and said DHBs could only spend that money on mental health, and that was a boost. It certainly didn't fix everything but it was a welcome boost. But this government has slowly undermined the ring-fencing, there's no additional money," says Mr Lane.
Andy Colwell has worked in mental health in Auckland for 16 years. He's witnessed first-hand the end results of the funding crisis.
"One of the DHBs in Auckland wasn't able to provide the service they are actually funded for, for a number of weeks on the evening shifts. Part of the mental health crisis team wasn't able to carry out its duties because they didn't have the staff to cover."
It's been 12 years since New Zealand's one and only national survey into mental health, and Prof Abbott believes another one is long overdue.
"You need to do these studies over time to see whether there are increases or decreases in different sorts of mental health disorders, in what parts of the country, what groups and how does this shift over time, what percentage of people are getting help and what sort of help are they getting. We don't know."
While throwing millions of more dollars at mental health services seems an obvious quick-fix, Prof Abbott says the Government needs to take a long term view and approach.
"It's difficult to say if 20 or 30 million a year would make a significant difference," says Prof Abbott.
"We no longer have a mental health commission which used to provide some degree of independence, they were political appointees but they did provide some degree of autonomous assessment of what was happening. But now we don't even know if there's been an increase in the prevalence in the number of mental health disorders."