Analysis by Bryce Edwards
The area of mental health has been a key strength for Jacinda Ardern and her Labour Government over the last few years. They campaigned strongly in 2017 on fixing up the dysfunctional system, and initially they made some vital strides forward in reforming the sector.
An in-depth inquiry was instigated and the Wellbeing Budget of 2019 pledged nearly $2bn. For a while, it looked like the one area in which the Government was achieving true transformation. This has all changed lately. An explosion of bad stories and complaints from the sector suggests that the Government has failed to deliver on this, and that the mental health system is now getting worse under Labour.
Over the last week, in particular, there have been a string of scathing media articles and comments, that together amount to an overwhelming vote of “no confidence” in the Labour Party, the Prime Minister, and the Minister of Health. The latest, published yesterday in the Guardian, is from journalist Oliver Lewis, who has been investigating Labour’s reforms. He argues the Government appears to be more concerned with image management on mental health than making progress to deal with the crisis – see: The gap between NZ Labour’s soaring rhetoric on mental health and the reality is galling.
On the one hand, Lewis says, “the soaring rhetoric and initial investment – which has often been slow rolling out – has failed to translate into substantive change, and people are rightfully frustrated.” But to make matters worse, and what he finds particularly galling, the government is trying to hide the crisis: “in a bid to paper over failings and push a particular narrative – crucial information seems to be being buried or obfuscated.”
Lewis’ concern was prompted by journalist Henry Cooke’s detailing of how the Government has omitted various mental health metrics in the Ministry of Health’s annual monitoring report on mental health released last week. You can see Cooke’s article here: ‘A lot of data and negative statistics’: Inside the battle behind dramatic edits and huge delays to a Government mental health report.
Cooke’s investigation reveals the quite extraordinary story of how Ministry of Health senior officials battled for two years to remove data from this report, seemingly because it made the government look bad. What’s more, the report was released two years late, and “still showed a very distressing picture of New Zealand’s mental health system – with a spike in the use of seclusion, a practice some liken to torture.”
Cooke reports that “Shaun Robinson of the Mental Health Foundation said it was ‘gobsmacking’ and ‘not acceptable’ that so much information had been removed from the ‘scathing’ report.”
And Cooke follows this up, with further political reaction, including the National Party’s mental health spokesman Matt Doocey claiming “there appeared to be some ‘politicisation’ of the ministry”, and Health Minister Andrew Little being “totally comfortable with the process of the report’s release” – see: Judith Collins says heads should roll over ‘sanitised’ Government mental health report.
For more details of the contents of the “scathing” mental health report, it’s worth reading Tess McClure’s Guardian article: New Zealand mental health crisis has worsened under Labour, data shows. Here’s the article’s introduction: “New Zealand’s mental health system is ‘in crisis’ and in worse shape now than four years ago, practitioners say – despite much-heralded government efforts to reform it and prioritise national wellbeing.”
This followed on from another Henry Cooke piece last week, which covered the “huge growth in mental health patients being locked in rooms alone”, otherwise known as “seclusion”, which the Government was supposed to phase out – see: Huge growth in use of ‘last resort’ seclusion indicates mental health system in crisis, and in worse shape than when Labour elected in 2017.
The fact that the Labour Government aren’t delivering, led prominent psychologist Kyle MacDonald to write a condemning opinion piece for the Herald on Sunday, in which he lays the blame at the Prime Minister’s door, recounting when a tearful Jacinda Ardern spoke to a mental health rally during the 2017 election campaign and promised to fix the problems: “Standing there that day, in the sunshine among the crowd, I believed her. I believed she was going to bring transformative change to our crippled and broken services. We all did, because we wanted to believe our work had come to something. We were wrong” – see: Jacinda Ardern has failed us on mental health – and it’s only going to get worse (paywalled).
MacDonald details how the most recent findings on mental health show Ardern’s promises to have been rather hollow, and calls for the government to stop with the endless reviews and consultations and just take action, especially when it comes to funding service delivery: “It would mean providing fully funded training for psychotherapists, psychologists, nurses, social workers, counsellors and peer support workers – and bonding them to work in the mental health system. It would also mean increasing staffing levels in all front line DHB mental health and addiction services by creating new positions and improving pay and conditions.”
A big part of the problem appears to be underfunding from the Government, and in February clinical psychologist Dr Marthinus Bekker spoke out publicly about the “chronically underfunded” public health sector, being reported as believing “Budget 2019’s headline-grabbing $1.9 billion for a Mental Health Package had in reality made no difference for those working on the front line” – see Nick Truebridge’s Ex-DHB psychologist claims chronic failings in mental health services.
According to Bekker, “Getting into public services has gotten to the point where, at times our waitlist has been in excess of four to five months.” He declares: “The situation is absolutely dire and remains in crisis.” The Minister of Health, Andrew Little, is quoted in contrast, saying: “the message I’m getting is actually things are improving”.
According to Victoria University of Wellington’s Dougal Sutherland, who trains psychologists, the Government simply hasn’t been willing to invest in training enough workforce to deal with the size of the problem, and there appear to be no plans for them to do so – see: No time to waste on mental suffering. What reforms that are taking place, he says, are simply “a reshuffling of proverbial deckchairs”.
Further evidence that the promised changes from Government aren’t actually occurring came out in February via the release of interviews that the new Mental Health Commission carried out last year – see Laura Walters’ Mental health: A top priority stalls.
This article also reports that the former Mental Health Commissioner Kevin Allan recently wrote to the Minister of Health “laying out his concerns about the pace of change, and lack of a long-term action plan for the sector’s transformation.” Furthermore, “In July last year, Allan called on former health minister Chris Hipkins to have a plan ready by the end of the year. There is still no plan.”
The Mental Health Foundation is also growing increasingly frustrated with this lack of action, and have started to speak out much more strongly. Two weeks ago, the Chief Executive of the Foundation, Shaun Robinson, asked: Has the Government lost its vision on mental health?. In this, he argues that the Government is missing out on a once in a generation chance to transform mental health.
The Foundation’s main problem is that, although the Government initiated a wide scale inquiry into mental health, it appears to have ignored the need to implement its recommendations, taking a “piecemeal” approach, and just looking for “obvious wins without making a plan”. Robinson points out that the Government’s own Mental Health Commission report on how progress is going on implementing the recommendations says that 23 of the 36 recommendations receive a 1 or 2 out of six – meaning very poor progress.
So, has Labour given up on real mental health reform? According to campaigner and advocate Dave Macpherson, it’s possible that the system has got worse under the current government – see: Is Labour on top of mental health issues?. Not only is Macpherson is disappointed in Andrew Little, but says that new Chair of the Mental Health Commission has “seemed more concerned with patch and boss protection, than in outlining how they would hold the Government to account on behalf of the community.” Overall, Macpherson believes that a lot of Labour’s problems stem from leaving all the same officials in charge of mental health.
The Minister of Health says the Government will “ramp up” progress to reform the sector, saying, “I’ll keep putting the pressure on officials to do that” – see 1News’ Andrew Little says mental health reforms ‘largely on track’, following criticism.
The Government has also been under pressure from advocates this week, who say they have been fobbed off by the various health ministers – see Ireland Hendry-Tennent’s Nicky Stevens’ mother accused Labour MPs Andrew Little, David Clark of fobbing her off.
There are other signs things are getting much worse. In the weekend, Cherie Howie wrote about how “Mental health conditions among Aotearoa youth have already doubled in the past decade, with experts sounding a call to action in September over what they call ‘a silent pandemic of psychological distress’ already escalating among young people” due to Covid – see: The parallel pandemic: Covid-19 and the mental health impacts on New Zealand young people (paywalled).
An example of this is the skyrocketing of eating disorders amongst youth – see Anna Leask’s ‘Tsunami’ of child eating disorders emerging after lockdowns in New Zealand (paywalled). In this, one psychotherapist, Kellie Lavender, complains that her profession is being treated as “an ambulance at the bottom of the cliff”.
And in Christchurch, there are serious problems at the new hospital: “There are growing fears mental health patients in Christchurch are not getting adequate treatment due to an understaffed and underfunded emergency department” – see 1News’ Christchurch Hospital’s new acute unit still without key services, nurses say (https://bit.ly/3uoqsWH).
The same crisis continues at the University, where a six-month waiting list for mental health help has meant the Psychology Centre has had to close their books – see Chris Lynch’s Where has all the mental health funding gone?. And the same article reports the New Zealand Association of Counsellors asking questions about where all the government funding is actually going.
The problem of all psychological services is well surveyed in Helen Harvey’s January article, New Zealand’s psychological crisis putting lives at risk. According to this, “New Zealand is in a psychological crisis. More people than ever are seeking help but a shortage of psychologists is making it harder for them to get it. And in some cases that can be fatal. Access to mental health and addiction services has increased 73 per cent in the past decade, while funding has only gone up by 40 per cent.”
Finally, is the pressure from mental health advocates leading to a crackdown from the Minister of Health? The Mental Health Foundation claim that in February the government tried to gag them for speaking out about the failures to produce their promised reforms – see Jessica McAllen’s Ministry of Health accused of ‘gagging’ Mental Health Foundation.