There’s no simple solution to the problems besieging New Zealand’s mental health sector, but our politicians are pledging to give it a go. With just over 50 days to go until the election, Haimona Gray assesses the major parties’ policies.

If our mental health services were a person, they would be a latchkey kid of too-busy parents (politicians) who abandon them for two out of every three years, showing up to promise attention and gifts only to then ignore them for another two years.

They would have significant abandonment issues requiring their own services to come to terms with. They might even drink a bit too much for someone in their 30s, or worse, they might become a political commentator just to vent about their lousy childhood. 

Mental health is an easy thing to give lip service to. You can put a target on reducing unmet need but you can’t ensure it will achieve a permanent solution. Likely it won’t. Not immediately.

This difficulty in clearly articulating its successes is in stark contrast with the public’s high valuation of mental health as a vital asset in desperately short supply. 

How bad of a hole are we in? According to data from the Ministry of Health’s most recent Health of New Zealanders report, 8.8% of adults reported an unmet need for professional help for their emotions, stress, mental health or substance use in 2021/22, compared to 4.9% in 2016/17. Young adults reported the highest rates of unmet need for this professional help (16.2% for 15-24 years and 15.6% for 25-34 years). 

The situation has also worsened for children 14 years and under, with 6.2% of children having an unmet need for professional help for their emotions, behaviour, stress, mental health or substance use in the year before being surveyed, up from 4.5% in 2016/17.

Why does the year 2017 play such an important role in understanding our current political reality? In 2017 the Labour Party ran on a promise of radical caring, and bringing “kindness” back to politics. 

In 2019, following its self-initiated Mental Health Inquiry in 2018, the Labour majority government allocated $1.9 billion in the budget to dramatically improve the delivery of mental health services. This year’s Mental Health and Wellness Commission Te Huringa Tuarua report showed their almost $2 billion investment for the Potemkin village it was. 

It found that while taxpayer funding for the sector had increased by 33% since 2017/18, wait times for people trying to access mental health services had consistently increased, particularly among young people. 

These appalling wait times are largely due to workforce shortages. Vacancies across publicly funded mental health services had already been trending upwards for years, and they somehow doubled in 2022. 

Prime minister Chris Hipkins and his health minister Ayesha Verrall know this; they might not have been prime minister or health minister at the time, but it is their role now to spin objective failure into something more opaque.  

Labour has used cherry-picked data and underplayed a workforce collapse in the media to muddy the waters, but Labour’s mental health policy is handcuffed to the weight of a dismal present and attached to the cement shoes of heightened expectations they created. 

Facing an opponent drowning under its own hubris, National has taken a “less is more” approach. 

National’s mental health spokesperson Matt Doocey has promised a National government would establish a minister of mental health, and importantly “ensure we have the front-line staff and services to support some of our most vulnerable New Zealanders”.

While small in budget when compared with the billions being thrown around by the current government, National’s mental health innovation fund would initially see up to $20 million in matching funds distributed to community mental health organisations that are delivering strong results to “scale up their already successful operations”.

This is a small fund, but one that would encourage growth among quality pre-existing community health NGOs. These organisations are the heart and soul of our mental health services and deserve funding to grow. 

More impactful would be anything they can do to recruit more front-line staff. If National succeed, they will be celebrated, if not they will be in a less expensive version of where Labour is right now. 

National’s likely coalition partner hasn’t traditionally been the party associated with “mental health”, but that has changed this election. Act deputy leader and health spokesperson Brooke van Velden has been more vocal on mental health than any of her predecessors on social policy. 

Their mental health policy is still pure Act – finding a way to get non-government entities to provide what would traditionally be the responsibility of a ministry – but it could also prove a significant win for NGOs, even kaupapa Māori health providers like the John Tamihere-led Te Whānau o Waipareira. 

“Act will establish Mental Health and Addiction New Zealand (MHANZ), a standalone agency on a national scale, empowering patients to choose between a range of providers, rather than simply accepting what their DHB offers.” 

MHANZ would take the idea behind National’s mental health innovation fund and elevate it by allowing individuals to pick a health service provider they feel would best support their needs. 

They haven’t outlined a workforce strategy to make sure NGOs would be able to step up to added demand, and likely wouldn’t be in a position to enact one as the smaller party in a coalition anyway. 

While they have the most inspired solution out of the current parties, it is inherently undermined by their own position as a minor party.

This also applies to the Greens, a party with another young and vocal advocate, spokesperson for mental health and Auckland Central MP Chlöe Swarbrick. 

Like National, the Greens have committed to introducing a minister for mental health. Like both National and Act, they have proposed funding “innovative initiatives that effectively facilitate mental health promotion and suicide prevention or that indicate high recovery rates”.

They have chosen the Mental Health and Wellbeing Commission to “transform mental health, monitor services, and lead a whole government approach that holds it to account”. 

While you could accuse both Act and the Greens of proffering policies they made trade later, Te Pāti Māori has chosen to adopt a single-minded one-issue approach that will be divisive. 

Te Pāti Maori has exactly one mental health policy, a promise to establish a comprehensive kaupapa Māori mental health service first pitched to voters in 2020. The service itself would likely do a great deal to address the shockingly poor mental health outcomes for Māori. It would be funded by transferring funds from the existing mental health service funds to the order of $500 million per annum. 

It’s easy to dismiss Te Pāti Maori as a party only interested in the wellbeing of Maori and actively disinterested in the other communities that inhabit Aotearoa. When it comes to mental health policy, it would also be correct to do so. 

It’s interesting that all current parliamentary parties have acknowledged that NGOs and charitable community health services do a lot of the hard mahi in mental health and should be bigger contributors and better supported. 

Going back to our kid under the stairs metaphor, this is an acknowledgment that it will take a village to raise our collective mental health.