By Elisha Foon for RNZ
There is growing frustration over the government's work to match its promise to tackle New Zealand's suicide rates and improve well being.
While a Mental Health Commission report has described frustration over the pace of change, mental health advocates have also criticised the lack of progress in helping people in Canterbury, where many are still severely affected by ongoing trauma.
For those needing mental health support - gaining access is still one of the biggest hurdles.
Cantabrian Holly Kerr-Logan, 21, has struggled through the mental health system.
"It's really difficult to get into services and when you finally do you are so limited to what is actually available to you. I've had more bad experiences then good ones when I'm unwell and have had some very awful times.
"When you are doing well or better, they seem to be a lot more friendly and nice but as soon as you are struggling they all just leave you to your own really."
The government promised $455 million for front-line mental health services over five years, with the cash being scattered across the country.
Canterbury has received $8m for mental health services over the next three years.
That's on top of $8.5m in response to the 15 March mosque shootings and another $10m to Christchurch's Odyssey House over four years. It provides youth mental health and well-being services and the money was expected to help 1000 rangatahi.
The Canterbury District Health Board's annual mental health expenditure increases year on year, and there have been further investments outside of this process. There has been an increase in funding for new initiatives in youth mental health and Pacific wellbeing.
The mental health funding ring fenced for the CDHB for 2017-2018 was $163 million and that jumped to $184 million in 2020-2021.
But mental health advocate Dame Sue Bagshaw said 20 percent of young people in the region were still struggling and needed better access to wrap-around support.
"I do think Canterbury people have had to endure way more than anywhere else in the country and that's got to take its toll. We need extra funding and support. It's all very distressing and makes a difference to how we function."
A similar picture across the country
The Association of Salaried Medical Specialists (ASMS) raised concerns about frontline mental health workers overwhelmed by skyrocketing demand and had seen no meaningful progress despite the promises of the 2018 mental health inquiry.
ASMS Executive Director Sarah Dalton said while the commission's report was welcome, it did not reflect the dire situation facing patients and those trying to provide services on the ground.
"I think staff would argue that there has been no meaningful change to the system at all, with acute and community psychiatric services completely overwhelmed and in crisis," she said.
ASMS recently asked psychiatrist members to detail their experiences. Below are a few of their comments.
"Increasingly we are seeing people turning up later into the course of their illness, or patients who were already on the waiting list turning up at the emergency department, because the wait list is months long. We are seeing things reaching a crisis point for people more often. Usually, we'd be able to intervene earlier and stop someone from getting to crisis point, but we can't do that if we don't have enough staff".
"We haven't increased inpatient beds in 20 years and the population has increased, so there needs to be more sub-acute beds. A lot of our beds are blocked by people because there is no accommodation and then we can't get crisis patients in or they come in later and so they're sicker".
Dalton said: "We know we're well short of psychiatrists but there's been no assessment of how many we actually need to provide a quality service and what is urgently needed is a kind of national 'job sizing' of the psychiatrist workforce".
Jazz Thornton from Voices of Hope, a non-profit group working in mental health, agreed.
Very little had happened - far too many people were still on waitlists - some for eight months -to get help and it was not good enough, she said.
"It's actually really dangerous to be saying we are going to be doing all these things and prioritise mental health. People are getting their hopes up and when that doesn't happen it creates false hope. We've seen that time and time again."
Mental Health Foundation chief executive Shaun Robinson said the government has little to show for the funding so far.
"There is no plan. The Ministry of Health has started the process just last week to develop the path way. It's been a long time coming. Despite COVID-19 in 2020, this work really should have started immediately after the Well-being budget in 2019."
He believed those with lived experiences and Māori and front-line workers held the keys to fixing the broken mental health system.
"We will fail in our transformation of mental health if we don't now use this as a watershed moment. We really need to understand what's not been working and adjust and make change."
He called for greater collaboration to provide wrap-around support that would boost the well-being of the nation long-term.
Josiah Tuamanali'i was one of six authors of the He Ara Oranga Mental Health inquiry.
He said the government must not lose sight of what truly mattered - listening and including tangata - the people.
"Communities want to be part of the transformation. Whether we are whānau, hapū and iwi, Pacific, Asian, Rainbow. The people have the solutions and that's what we say in He Ara Oranga."
Overall, it would take the effort of all of Aotearoa - not just government - to change our mental health landscape, he said.