A landmark inquiry has found New Zealand’s mental health services are overwhelmed and geared towards crisis care rather than the wider population who are experiencing increasing rates of depression, trauma and substance abuse.

It has urged the government to widen the provision of mental health care from 3% of the population in critical need to “the missing middle” – the 20% of the population who struggle with “common, disabling problems” such as anxiety.

The 10-month inquiry travelled the country, consulting the public, specialists and community experts as part of a deep-dive into what is commonly described as a ‘crisis’ in New Zealand’s mental health system.

According to the report, 50-80% of New Zealanders experience ‘mental distress or addiction challenges’ at some point in their lives, while each year one in five people experience ‘mental illness or significant mental distress’, at a cost of NZ$12bn – or 5% of GDP a year.

Children and young people are also increasingly showing signs of mental distress, the report found, including rising rates of intentional self-harm. New Zealand has one of the highest rates of suicide in the OECD, especially among young people. In 2017, 20,000 people tried to take their own life.

The 200-page report entitled He Ara Oranga (Pathways to Wellness) – found New Zealand’s mental health system was unsustainable and skewed towards those with the most serious problems.

We can’t medicate or treat our way out of the epidemic of mental distress.

He Ara Oranga mental health report

“New Zealand has deliberately focused on services for people with the most serious needs, but this has resulted in an incomplete system with very few services for those with less severe needs, even when they are highly distressed,” the report said.

The mental health system needed to be broadened within five years to treat 20% of the population experiencing mental distress at any one time, the report urged, and move away from medicalised treatment options to more holistic, societal wellbeing focused care.

Investment in community care and talk therapies that address people’s “wider social needs” was essential, including tackling social isolation and loneliness, addiction, and drug and alcohol abuse. “We can’t medicate or treat our way out of the epidemic of mental distress and addiction affecting all layers of our society,” the report said.

“Wellbeing has been a theme during this inquiry and in national conversation in recent years … Sleep, nutrition, exercise and time outdoors help recovery. So too does strengthening one’s cultural identity and helping others.”

A national suicide prevention strategy needed to be “urgently” adopted, the report found, with a target of reducing the suicide rate by 20% by 2030. Compulsory or coercive treatment should be minimised.

All up the report listed 40 recommendations, and health minister Dr David Clarke said the government would respond in full by March 2019.

Clarke said: “The inquiry panel has delivered a set of strong and coherent recommendations covering everything from the social determinants of health and wellbeing, to expanding access to treatment services and taking strong action on alcohol and drugs.

“The report charts a new direction for mental health and addiction in New Zealand, one that puts people at the centre of our approach.”

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