The Mental Health and Wellbeing Commission Bill: A Step Closer to Equitable Care

By Renee Wells

“One in six New Zealand adults have been diagnosed with a common mental disorder at some point in their lives.” Poor mental health and wellbeing can detrimentally impact the lives of those directly experiencing it, as well as their friends and whānau. The Mental Health and Wellbeing Commission Bill will establish a Commission once it becomes legislation, which will be a significant factor in “transforming New Zealand’s approach to mental health and wellbeing.”

The Bill underwent its second reading on 27 May. The Commission it establishes has similarities to the 1996 Mental Health Commission, which was abrogated in 2012 by John Key’s National-led government. With the establishment of a new body, what is in place to ensure that future governments do not undermine the significant issue of mental health in New Zealand and once again disestablish the Commission? The 2021 Commission is set to become an independent Crown entity, which will “ensure its independence from the Government of the day”.

This new Commission also has different goals from the 1996 Commission, which sought to reduce discrimination and strengthen the medical health force. Conversely, the 2021 Commission’s objectives seek to promote, monitor and provide oversight of mental health and wellbeing in New Zealand, with a specific focus on minority groups.

Schedule 1A of the bill refers to the He Ara Oranga report, which illustrates the various groups that are disproportionately affected by mental health issues and must be targeted in addressing New Zealand’s problem. These groups include but are not limited to: New Zealand’s youth, disabled people, prisoners, Māori/Pacific peoples and rainbow communities.

In the Bill’s second reading, Green MP Chlöe Swarbrick highlighted that in the establishment of this Commission, social issues such as housing, education and employment will be at the forefront of partisan debate, adding that Parliament will need to accept greater accountability in recognising and addressing the problem. This diverges from the 1996 Commission, which seemed to have a more medical stance to approaching mental health.

According to Dr Barbara Disley, the first chair of the 1996 commission, “we don’t need to spend a larger proportion of our mental health budget on more costly hospital-based services that cannot, no matter how good they are, always meet the real needs of people in the community who present with complex mental health, drug and alcohol, trauma, social, employment and housing needs”.

As New Zealand is faces an economic crisis following the COVID-19 lockdown, socio-economic issues such as homelessness and unemployment must be addressed by the Government in relation to mental health. The Ministry of Social Development notes that “the experience of mental illness and housing difficulties are linked..[and] recovery [from mental illness] requires specific housing arrangements that combine support, a quality physical environment and suitable local environment.” Those with a lower socioeconomic status may not have access to such housing arrangements and therefore may be disadvantaged when it comes to recovery.

Furthermore, there is evident disproportionality in access to health services for Māori and Pacific peoples in New Zealand. It has been stated that “even when Māori can access services, the evidence shows inequity in the quality of those health services and treatments”.

Under s 8(2)(a) of the Bill, there is a requirement for the Committee to have experience and knowledge of Māori culture, which could have a significant contribution in improving mental health equity for Māori. Members must collectively have knowledge, understanding and experience of the following:

• te ao Māori (Māori world view), tikanga Māori (Māori protocol and culture), and whānau-centred approaches to wellbeing; and

• the cultural, economic, educational, spiritual, societal, environmental, and other factors that affect people’s mental health and wellbeing; and

• mental health services and addiction services; and

• public health approaches and population health approaches to improving health outcomes; and

  improving overall system performance.

This is in addition to the requirement of members having personal experience of mental distress and addiction, under s 8(2)(b) and (c).

New Zealand’s first Wellbeing Budget was established in 2019, which allocated $1.9 billion to mental health. However, the significant question being raised is: who will staff this service? The Committee must work towards resolving New Zealand’s workforce shortage in the mental health and addiction sector. Addiction is an issue that has been recognised in s 11(1)(e) of the Bill, yet it was stated last year that the wait time for addictions treatment in New Zealand can range from two to six months.

$40 million has been allocated in the Budget to suicide prevention services and extra nurses in schools However there has been no specific reference to New Zealand’s high rate of suicide in the Mental Health and Wellbeing Commission Bill and how it will be addressed once the Commission is established. New Zealand has “the highest youth suicide rate in the OECD”, and in the first six months of 2019 the Māori suicide rate increased from 23 to 28%, while the rate among Pacific Island New Zealanders increased from 7.77 to 11.49. Matthew Tukaki, the executive director of the Māori Council, asserts that New Zealand’s suicide rate "is a complete failure from successive governments”.

Prime Minister Jacinda Ardern expressed her concern about New Zealand’s high suicide rate, and in response to setting a target number for suicides per year responded that “a target implies that we have a tolerance for suicide, and we do not… the goal has to be no one lost to suicide”

The Mental Health and Wellbeing Commission Bill is a valuable step toward addressing the problem of mental health and the high rate of suicide in New Zealand. With the Government investing a significant amount of time and money into the wellbeing of kiwis, we will hopefully see an impact left by the Commission in the years to come.

Where to get help:

Need to Talk? Free call or text 1737 any time to speak to a trained counsellor, for any reason.

Lifeline: 0800 543 354 or text HELP to 4357

Suicide Crisis Helpline: 0508 828 865 / 0508 TAUTOKO (24/7). This is a service for people who may be thinking about suicide, or those who are concerned about family or friends.

Depression Helpline: 0800 111 757 (24/7) or text 4202

Samaritans: 0800 726 666 (24/7)

Youthline: 0800 376 633 (24/7) or free text 234 (8am-12am), or email talk@youthline.co.nz

What's Up: online chat (3pm-10pm) or 0800 WHATSUP / 0800 9428 787 helpline (12pm-10pm weekdays, 3pm-11pm weekends)

Kidsline (ages 5-18): 0800 543 754 (24/7)

Rural Support Trust Helpline: 0800 787 254

Healthline: 0800 611 116

Rainbow Youth: (09) 376 4155

If it is an emergency and you feel like you or someone else is at risk, call 111.

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Featured image source: Wikimedia