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This photograph of a bulldog attempting to squeeze through a cat door has been chosen in preference to yet another generic therapy stock image
This photograph of a bulldog attempting to squeeze through a cat door has been chosen in preference to yet another generic therapy stock image

SocietyMay 16, 2018

Chemo works, so we fund it properly. Why not do the same for counselling?

This photograph of a bulldog attempting to squeeze through a cat door has been chosen in preference to yet another generic therapy stock image
This photograph of a bulldog attempting to squeeze through a cat door has been chosen in preference to yet another generic therapy stock image

‘Mental disorders’ rank as the third-leading cause of health loss for New Zealanders. Kyle MacDonald makes the case for universal, free counselling for all.

What if I told you that one of the biggest and most expensive health problems in New Zealand was not only being ignored, but although we had the technology to treat it, we as a country weren’t funding the treatment? What if I told you that people were languishing in ill health because they couldn’t afford to get the treatment that we know would help them out of their illness?

What if I told you, as a nation, we were actively encouraging people to talk about their health difficulties, seek treatment, get help, and when they reached out there was no help available?

And what if I also told you that this epidemic was only going to get worse, predicted by the World Health Organisation to be the second most prevalent health condition in the world by 2020, and it was already killing over 600 people a year in New Zealand?

I am of course, talking about mental health, and more specifically depression and anxiety.

Just imagine for a moment if we didn’t fund chemotherapy for cancer patients, and if you needed to access chemotherapy you had to pay to access it privately, or risk waiting on the limited and patchy treatment available via the public health system.

It might sound far-fetched, but that is the reality for thousands of New Zealanders who are forced to go without counselling and talk therapy – which would help them overcome their depression and anxiety – simply because they can’t afford it.

And these are not small problems. The most recent data we have is from the 2012/13 New Zealand Health Survey. It showed that so-called “mental disorders” as a group are the third-leading cause of health loss for New Zealanders (11.1% of all health loss), behind only cancers (17.5%) and vascular and blood disorders (17.5%). And that one in six New Zealand adults (16%, or an estimated 582,000 adults) had been diagnosed with a mental health disorder at some time in their lives

Despite all the work we’ve done on anti-stigma campaigns, on changing people’s attitudes, this is one of the remaining vestiges of the deeply ingrained stigma and discrimination against those who struggle with their psychological health: we continue to deny people treatment – that we know works – based on ignorance, mis-information, and the idea that it is somehow a luxury.

However in New Zealand we do have a tradition of recognising our mistakes, and rectifying them. We sold our rail network and realised that privatising it didn’t work, so we swallowed our pride, bought it back and we dubbed it “KiwiRail”. We also recognised that after having sold all our banks (to Australians no less) we needed a locally owned bank. And so, “KiwiBank” was born.

More recently, staring down the barrel of a massive housing shortage in Auckland, we are embarking on “KiwiBuild”.

It is time we also recognised that the refusal to publicly fund counselling and talk therapy needs to be fixed. We need to build a national counselling and therapy service – free to all – and do everything we can to make sure those who need treatment in their darkest hours can access it.

It needs to be a service that is world leading, and that we as Kiwis can feel deeply proud of.

We need “KiwiTalk”: its time has come. That’s why I’ve started a campaign, via an Open Submission to the Government Inquiry into Mental Health and Addiction, calling on the review to recommend universal free counselling for all Kiwis.

To support my call for Free Counselling for all New Zealanders, go to www.freecounselling.nz

Kyle MacDonald is an Auckland-based psychotherapist.

Keep going!
Empty Wheelchair On Road With Arrow Symbol

SocietyMay 15, 2018

The daily commute: a disability perspective

Empty Wheelchair On Road With Arrow Symbol

Able-bodied commuters who think they’re up against it would do well to take a moment to consider the challenges faced by disabled people on the same journey. Robyn Hunt writes.

My daily commute these days is a few steps to my home office in my PJs and barefoot if I want. But I’ve done the bus, train and walking commute. Getting to work is relatively straightforward for non-disabled people, compared to the complexities for many disabled people.

Before the subsidised door-to-door accessible transport Total Mobility scheme was developed in the 1980s, many disabled people had difficulty getting to work at all, unless they travelled in their own car, or worked at sheltered workshops, which often provided their own transport.

Many drive their own, sometimes modified, vehicles. But the cost of buying, owning and driving a car can be prohibitive unless you are eligible for assistance through ACC or Health funding, or earn a lot, which most disabled people don’t. Once in town a disability park may be necessary. These can be usurped by an occasionally truculent non-disabled driver. Parking is even more of a vexed issue for disabled drivers than for the typical motorist.

Some brave souls, who live close enough, wheel themselves to work because it’s the easiest option once an accessible route has been charted. They run the gauntlet of Wellington’s notorious weather and disruptive road works.

For those of us who want or need to use public transport there’s some history.

Back in 1994 a group of Wellington disabled people and supporters took a complaint to the Human Rights Commission about the lack of accessible public transport.

In response the then transport manager for the Wellington Regional Council, the subject of the complaint, observed that he “was concerned about costs being imposed on ratepayers to benefit a group of people of unknown size” (ODT August 9, 1994). He seems not to have considered that many disabled people are ratepayers, or pay rates indirectly through their rent, and have the same rights of access as other citizens.

At that time Statistics NZ did have an estimate of the number of disabled people. We now know that 24% of New Zealanders are disabled, and this is increasing with an ageing population, many of whom continue to work, and therefore travel to work, past the age of 65.

Comprehensive recommendations in The Accessible Journey, 2005, resulted from the Human Rights Commission national inquiry into accessible land transport.  (The ferries in Wellington remain inaccessible, so if you need wheelchair access and you live in Eastbourne there’s only a land option.) Even after Statistics New Zealand started collecting disability data in 1996 the inquiry discovered only one local authority was using the data in transport planning.

The commute as an accessible journey is a useful way to see accessibility as necessary from door to door. That includes footpaths, signage, pedestrian crossings and so on. Catching the bus means being able to access the timetable, a kerb for boarding and disembarking at the appropriate height, a safe journey and knowing when you’ve reached your destination.  Only 71% of Wellington buses are accessible.  Only a few routes run all accessible buses.

All Wellington commuter trains are accessible. They have announcements as well as visual notices, and spaces for wheelchairs, even if it can be difficult reaching them if the train is crowded.

Wheelchair users also encounter problems with crowded peak-time buses. Manual chair users can take regular taxis, but if a power chair is the only option there’s a long-standing problem of not enough mobility taxis for the morning commute because of school runs. Leaving for work at 7am is too early for many disabled people.

All wheelchair users face Wellington’s narrow and steep streets, not helped by vehicles parking over footpaths blocking access. There are still not enough kerb cuts.

I’m vision impaired, so of necessity I walk around Wellington, the city that boasts its compact size and walkability. I regularly find problems for pedestrians. There are loose or slippery pavers, obstructions such as signs, poorly marked and lit steps, necessary, potentially tricky elements of a hilly city. As winter draws in, good lighting is critical, especially on the steps.

Street accessibility fluctuates. There is never a point when Wellington is finally accessible. It’s now a city of bikes and scooters, their soundless presence on footpaths hazardous for blind people, vision-impaired people or those using sticks or crutches.

Road works, temporary bus stops and other street disruption without adequate signage or ramps is frustrating, occasionally unsafe. I’ve noticed recently that the universal design of some pedestrian crossings has been undermined by lowering the volume of the audible signal, possibly because it annoys people in nearby businesses, but that’s unhelpful and potentially dangerous for those who rely on it to cross safely.

Right now Wellington buses are changing their liveries. They are various colours and the signage is unreadable for me on many.

The decision to allow caged animals on buses has made some guide and service dog owners uneasy about how the distracting presence of other animals might affect their own mobility.

There’s currently a national campaign, Access Matters, for a much needed comprehensive accessibility law. Meanwhile the accessibility of the Wellington commute is a work in progress.