by Christopher Ruthe
This Government allocated an extra $1.9 billion on mental health in 2019. At the time the Government was warned that this could be a giant misallocation. Not a cent was going to increasing the number of psychologists, and very little on upskilling psychiatric nurses. Not a cent on training more doctors in neuroscience so people that were unwell could see a medical specialist. It was principally lavished on ‘feel good sessions for those who felt a ‘little down’.
Dougal Sutherland clinical psychologist at Te Herenga Waka a.k.a. Victoria University of Wellington reviewed the achievements of this spend and was interviewed by Radio NZ on 22 June 2023. He said ” In 2019 the New Zealand government committed an unprecedented NZ$1.9 billion to improving mental health services. But four years later, it is clear these high hopes have not been realised.”
What has happened to the billions set aside to improve mental health services? He reported Almost a quarter of the funding has gone to health improvement practitioners (HIPs) and health coaches based within general medical practices. Considerable investment has also gone into making mental health apps widely available to the public.”
The rest appears to have gone down the bureaucratic plug hole.
The ‘feel good sessions’
As for the ‘feel good sessions’ for those who are feeling a little blue? Sutherland says: “These initiatives focus mainly on providing proactive support to people with mild symptoms and/or upskilling the general population to help prevent psychological distress occurring”. And “it allows a quick and ‘warm’ handover from GP to mental health clinician”.
Upskilling psychiatric nurses and mental health professionals
And the very little on upskilling psychiatric nurses and mental health professionals? Sutherland finds “it has done little to increase the pool of mental health professionals”.
Are New Zealanders happy about this way of spending tax dollars? It would appear so if the current polls are to be believed. Dr Sutherland confirmed the total failure to increase quality services. “The [Health Improvement] Practitioner are drawn from the existing health workforce.” He goes on to describe how “we have robbed Peter to pay Paul as clinicians move from one area of the mental health sector to another.“
Mental health apps
Research to date shows that Mental health apps, while they may include good psychological tools and techniques that can enhance wellbeing, are of no proven use. The reasons include low uptake. Even if there is uptake, people may link on to them once or twice, but not meet the course of the treatment sessions. On top of that not everyone has an iPhone to download the app so it is inaccessible to the most disadvantaged in our society. This form of “treatment’ totally fails to and fail to meet the need for human interaction when treating mental disorder.
Did the large expenditure on Mental Health improve mental health?
The state of mental health in New Zealand has plummeted since the 2019 reforms and the $1.9 billion spend-up The figures from the Mental Health Foundation state that in 2020 11% of young people aged 15–24 years experienced high or very high levels of psychological distress. Just 2 years later In 2021/22 it was almost 24% nearly one in four (23.6%). This graph shows where it is currently at: women with high levels of psychological distress have gone from 5% to nearly 20% by 2020/21, according to the Ministry of Health.
Currently it is extremely difficult for any ordinary New Zealander to access adequate mental health services. If you want to see a psychiatrist in Wellington, for instance, you have to wait 7 to 9 months and pay $900 per hour. Access to public services is limited to those who are so seriously ill they pose a serious danger to themselves or others. If the $1.9 billion had been properly spent we could have expected significantly improved outcomes instead of a deplorable decline in the services available.
Christopher Ruthe is the former Convenor of The Mental Health Tribunal.