Truly making a difference to New Zealanders’ mental health means addressing factors that go far beyond the health system’s remit. There’s a plan ready to go, writes Shaun Robinson of the Mental Health Foundation, and the next government must put it into action.
“I need help.” That’s how many of the emails, Facebook messages and Instagram DMs to the Mental Health Foundation start. Sometimes there’s a greeting, but usually there isn’t. By the time they get to us, many people have tried other places and haven’t found the answer they need.
“My neighbour can’t afford the maintenance on her home and it’s falling down around her. The house is dangerous for her but every time we try to talk to her about it she says she just wants to die.”
“I’m being bullied at work, I’m so lonely, I don’t have anyone to talk to.”
“He lives at the other end of the country and I can’t get to him. He says his voices are getting louder and crueller, and he’s scared.”
“I lost my daughter to suicide, and I don’t know if I can ever face going back to work. But I can’t afford not to.”
These messages have a common theme: they’re sent to us from people in distress, people who are worried (for themselves, for others), people who are hurting. And their distress isn’t easily solved by the health system alone.
The most common piece of mental health advice is: if you’re struggling, if you need extra help, go to your GP. And this is good advice. GPs are there to help you, and, for many people, the help they get from their GP will be what they need to start feeling better.
But as the messages above show, the health system isn’t the right system to respond to the causes of distress for many people. It can’t fix your home, get involved with workplace or school bullying, help you make friends or address systemic racism. It can’t prevent these things from happening in the first place. And it can’t overcome some of the barriers to accessing health services experienced by some groups, particularly Māori, who often stay away from the GP because of issues with transport, affordability, time off work, cultural barriers and fear of getting bad news from the doctor.
Other systems, other ministries, other agencies need to be involved, but we’re not used to thinking about mental health as anything other than a health issue, and that means we’re not always aware of how the policies and practices of these other ministries and agencies impact mental health.
The MHF answers these emails as best we can. Our role isn’t to save or to counsel, but we do what we can to connect people with support and help people to understand their rights and their responsibilities. Our role is to listen, to truly hear what people are going through, and try to turn what we hear into a call to action.
Our election 2020 call to action to the next government is: implement He Ara Oranga (the recommendations of the Government Inquiry into Mental Health and Addiction, published in November 2018).
The government accepted, accepted in principle or agreed to further consideration of 38 of 40 the recommendations made by the inquiry panel, but we’re still waiting on a plan of implementation for many of the recommendations.
Look, we know that politicians want stats that get headlines. They’re not going to publish flyers saying “we promise to implement the dense recommendations from a 2018 report you might never have heard of”. They want to say how many more beds they will be providing, how many new services they will be funding, the number of people their new programmes will help. We also know these are the figures that will touch most voters.
And those things are important! But the mahi that matters to mental health goes beyond just beds and into transformational change that touches every aspect of our lives. A well-resourced implementation plan will ensure we have better services and that the factors that can cause or contribute to poor mental health – including (but not limited to) poverty, trauma and abuse, racism, and the impacts of criminal justice, housing and employment – can be addressed in a meaningful way.
Done well, an implementation plan should mean that we stop seeing increases in the number of people needing mental health services and start seeing more people enjoying good mental health and wellbeing.
Covid-19 has created and will continue to cause unprecedented strain on our collective mental health, there is no doubt about that. But it also presents us with an opportunity: to reimagine wellbeing together. To be courageous and bold enough to create an Aotearoa where inequities are acknowledged and addressed, health is considered across all policy decisions and the meaning of wellbeing is one we define together. We believe our best chance of doing that is to implement He Ara Oranga in a clear and measurable way. And that’s what we’ll be asking MPs and candidates to commit to in the upcoming election.
Shaun Robinson is the chief executive of the NZ Mental Health Foundation.