Review finds no change in access to specialist mental health services in 5 years despite $1.9 billion funding boost

A review has found no change in access to specialist mental health services in five years despite the Government's $1.9 billion cash injection in 2019. 

The review has also found that one-in-five people in New Zealand are not followed up after discharge from acute inpatient mental health units.

The Mental Health and Wellbeing Commission on Tuesday released its new report for 2022 which assessed what is working well, and what is not, in the mental health and addiction sector.

The Government allocated $1.9 billion to mental health as part of Budget 2019 in response to the Inquiry into Mental Health and Addiction (He Ara Oranga), which estimated the annual cost of serious mental illness, including addiction, at $12 billion

But Newshub revealed in June that just five new places for acute mental health patients had been added since 2019, while a Newshub-Reid Research poll found 70 percent of voters did not think enough was being done in mental health.

The Government commissioned a review in July to assess progress made on the $1.9 billion investment. It found that initiatives funded in the package were on track to deliver what was expected by at least 2024.

But it also highlighted a lack of accountability over the package, with different agencies focussing on their area, without a cohesive overarching plan to work together.

Health Minister Andrew Little admitted the Ministry of Health had "struggled to achieve as much as we would have liked them to" on mental health.

The latest report from the Mental Health and Wellbeing Commission found that while the mental health and addiction sector is continuing to provide services at pre-pandemic levels, access to specialist mental health services and addiction services has not changed over the past five years.​

The review also found:

  • one-in-five people are not followed up after discharge from acute inpatient mental health units
  • one-in-six are re-admitted to hospital within 28 days of discharge
  • there is a lack of data on mental health and addiction needs
  • wait times for young people to access specialist mental health services continue to be high
  • Māori continue to disproportionately experience higher rates of community treatment orders and solitary confinement
  • the number of community treatment orders has increased at the same rate as specialist mental health service use over the past five years​
  • there has been an overall increase in the use of solitary confinement from 2016 to 2020

Mental Health and Wellbeing Commission Board chair Hayden Wano says despite significant investment in mental health and addiction services in 2019, "improvements in services have not materialised as we had hoped for over this time". 

"We commend the investment in additional, and much needed, primary and community services, but more is needed to address pressures on specialist services, particularly for young people."

The report says the Government has "made a promising start to addressing the recommendations made in He Ara Oranga" but "there is an understandable lag between the new services being commissioned and getting up and running, and challenges in recruiting and retaining the workforce required impacts this". 

There were some positive conclusions in the report, including that use of telehealth and digital supports is increasing as they become more available, and access to primary mental health services has increased over the past year. 

But there is clearly more work to do. Wait times for mental health services have not decreased over the past five years, and wait times for addiction services have become longer, the review found. 

"Despite the prioritisation of youth in Government policy - including the Child and Youth Wellbeing Strategy, and the focus on increasing access to support for young people - these wait times have gotten worse for young people since 2017 / 18."

Review finds no change in access to specialist mental health services in 5 years despite $1.9 billion funding boost
Photo credit: Mental Health and Wellbeing Commission

In 2020 and 2021, only 65 percent of young people aged 19 and under were seen in the first three weeks of their referral, and 87 percent within eight weeks. 

The review also noted a 15 percent increase in the total population of young people aged under 20 accessing  primary mental health services to 18 percent, up from 12 percent in 2016 and 2017. 

Young people are also accessing more antidepressant drugs. The review found a 21 percent increase for initial dispensings of antidepressants for young people compared to an 8 percent increase for the total population. 

"Antipsychotic and antidepressant medicines can be prescribed for several reasons outside of mental health, for example, pain management, sleep, and smoking cessation," the report says. 

"However, we don't believe this would explain the recent increases in prescriptions for young people. It's more likely these increases have resulted from increased stress from COVID-19 and a lack of non-medical treatment alternatives."

The report includes a sobering statistic that 515,036 people in New Zealand - one-in-10 -  visited in 2021. 

Hayden Wano  sees potential in the Government's half-a-billion-dollars health restructure, with the 20 District Health Boards (DHBs) to be replaced with the new centralised Health NZ that will work in partnership with a Māori Health Authority. 

Wano said it will "provide opportunities to embed strong leadership in their operating models and enhance the focus on mental health and wellbeing" and also creates "an opportunity to hear the voices of Māori and people with lived experience and provide a greater choice of support". 

The Health Minister last year established an external oversight group for mental health. The Government launched a new long-term plan to support people who experience mental distress.

In addition, the Government on Monday launched a new two-year recruitment campaign to bring on more mental health nurses. 

This year the Government has funded 234 new-entry places for registered nurses to specialise in mental health from the $77 million workforce development fund, part of Budget 2019, and it's hoped the campaign could help double that number.

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 or online chat
  • Samaritans - 0800 726 666
  • Depression Helpline - 0800 111 757
  • Suicide Crisis Helpline - 0508 828 865 (0508 TAUTOKO)