Mental health expert labels priority of under 24-year-olds 'confusing'

One of the Government's priorities to support mental health with a focus on under 24-year-olds is logical, according to an expert, but also "unclear". 

The Government's increased mental health funding is welcomed by Max Abbott, dean of the Faculty of Health and Environmental Sciences at Auckland University of Technology.

But he also questioned how the Government could prioritise under 24-year-olds for mental wellbeing when it also labelled its new frontline mental health service "universal". 

"It's possibly a bit confusing because the major injection of funding over the next five years for mental health is to establish a new primary mental health service which they refer to as a 'frontline universal mental health service'.

"What I don't know is whether there's an intention to ration that initially for younger people and then expand it out to other age groups. I don't know whether that's planned or not, so it's a little unclear as to what 'priority' means."

The Wellbeing Budget, released last week, allocated $1.9 billion to mental health, including $200 million for new and existing mental health and addiction facilities. 

The funding also covers the establishment of a universal frontline mental health service, expected to help 325,000 people with mild to moderate mental health addiction needs by 2024. 

Prime Minister Jacinda Ardern said in Budget 2019 that early intervention works. She said the Government wants to "provide our young people with support and early intervention as they learn to cope with the pressures that come with becoming a young adult". 

Prime Minister Jacinda Ardern and Health Minister David Clark.
Prime Minister Jacinda Ardern and Health Minister David Clark. Photo credit: Getty

According to Health Minister David Clark, the reason the age group was highlighted as a priority for mental health services was that "three quarters of all lifetime cases of mental illness are developed by 24 years of age". 

Dr Clark announced in February that Porirua would be the first community to benefit from a trial of free mental health support under the Piki pilot, targeted at 18 to 25-year-olds with mild to moderate mental health needs.

"It's not always easy for younger people to navigate the challenges they face, or to know where to turn to for help when they need it," Dr Clark said at the time. 

"Free access to counselling services and other mental health support for 18 to 25-year-olds will make a real difference."

Professor Abbott said it does make sense to target youth. He said approximately 75 percent of people who develop a mental health disorder do so for the first time by the age of 25.

He also pointed to the country's high youth suicide rate. New Zealand's youth-suicide rates are the highest in the OECD and the burden falls heavily on Māori and Pacific people. 

"There is clearly the intention to reach the vast majority of people seeking help who have problems with anxiety, depression and substance use," Prof Abbott said. "But there is a lot going into youth."

Part of the Government's mental health spend on youth was $19.6 million over four years to extend the nurses in schools programme to a further 5600 students by "commencing the rollout to decile five secondary schools". 

Professor Max Abbott.
Professor Max Abbott. Photo credit: Auckland University of Technology

The Prime Minister said evidence showed that when students have more time with on-site professionals there was significantly less depression and suicide. 

But the intention of the new frontline service is to reach an additional 320,000 people a year per annum within five years, and Prof Abbott said "there are just simply not the resources or the staff to be able to achieve that". 

The Budget acknowledged the need for more qualified staff for the service, with a section in brackets that says: "recognising the need to train more qualified mental health workers and build new facilities."

As dean of the Faculty of Health and Environmental Sciences, Prof Abbott said the number of students coming into health programmes has been "significantly increased" to "reach the workforce need". 

"But the problem is, at the moment we're not getting funded for it."

He said he's interested to see how initiatives to support the Government's mental health priority - such as $20.8 million to expand tele-health and digital support for mental wellbeing - will be rolled out. 

Where to find help and support:

  • Need to Talk? - Call or text 1737
  • Lifeline - 0800 543 354 or (09) 5222 999 within Auckland
  • Youthline - 0800 376 633, text 234, email talk@youthline.co.nz or online chat
  • Samaritans - 0800 726 666
  • Depression Helpline - 0800 111 757
  • Suicide Crisis Helpline - 0508 828 865 (0508 TAUTOKO)

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