While the I Am Hope foundation accepts $24m in government funding, the Counselling Centre in Marton has some tough decisions to make about its future. Centre manager Anna Sophia shares her experience and views on life in rural mental health.

On a side street lined with abandoned historical buildings in the central North Island town of Marton, is a narrow green building. This is the whare of the Counselling Centre, a non-profit community organisation that has for 24 years provided a “no-cost” counselling and family therapy service to children, teenagers, adults and families living within the wider Rangitīkei district. 

Spanning a geographical area of around 4,500 square kilometres, Rangitīkei has only one counselling service available.  People travel to the Centre from the surrounding Rangitīkei towns of Bulls, Turakina, Koitiata, Ratana, Hunterville, Mangaweka, Taihape and other isolated rural locations. From a population pool of 16,000 people, over 6,000 people have received help since we opened our doors.

The building is welcoming and warm. There is local art on the walls, and an espresso machine. If you are seeking help, you will likely see someone within a week of making contact, often the same day. Within these walls, confidentiality rules.

The Counselling Centre is an outlier.  Off the radar and independent, it has developed a practical model of care for people with mild to moderate mental health concerns based on Sir Mason Durie’s concept of Te Whare Tapa Wha. 

A simple evaluation process at each appointment allows clients to record how it was for them.   A recent client said: “The counsellor helped me more than any ‘child specialist’ agency that I had been referred to in the past. She gave me the tools to get through what I felt was an impossible time.”

As I write this, the future of the Counselling Centre is in doubt. 

While Mike King’s Gumboot Friday, through his I Am Hope foundation, was recently handed $24 million by the government to provide counselling for young people, the Counselling Centre has had its annual funding to provide counselling to children and young people slashed by recent Oranga Tamariki funding cuts.

Auditor-general John Ryan recently outlined concerns with how King’s contract was awarded, and that the charity was selected “without an open and transparent process to assess which type of service would best meet the policy objective, which providers might be able to deliver that service, and the appropriate amount to pay.”

The role of counselling in contemporary Aotearoa, its effectiveness in practice, how it should be funded and who should be paying for it requires an in-depth consultation, that includes grassroots community networks like the Counselling Centre and not just a knee jerk reaction to paper over societal mental health unease with a $24m backroom handover to a self-created celebrity with very little experience in the field.

The notorious Lake Alice Hospital casts a shadow over the Rangitīkei district.  For decades it played a dominant role in the region. For better or worse, conversations about mental health have always flowed easily in this part of the country.

I spent my teenage years rampaging through the district. My adolescent ghost still lurks in the shadows, reminding me what it’s like to feel trapped without an obvious route to freedom. I know the Rangitīkei district intimately from its darkest underbelly to its wealthy land owners and the strata in between. It’s a microcosm of New Zealand society. Our clients come from all these layers with a multitude of different life experiences to talk about. 

The NZDep2018 index of deprivation showed that Rangitīkei District residents are among the most deprived economically and socially in our country. The residents hold fewer qualifications and have a much lower personal income than other areas of Aotearoa. Many of our clients do not have cars or adequate income to travel outside of the region for help. 

I have been the manager and a counsellor at the Centre for 24 years, since it opened. When I returned to Marton to work in 2000, the Counselling Centre was teetering on self-destruction. Originally established in 1994 as a sexual abuse counselling centre, it was a radical organisation for a conservative rural town. However, its original formation had exhausted its funding options, its management committee had disbanded, and in response to the  local communities request for a generic counselling service, the Counselling Centre Marton (Incorporated) tentatively came into existence. 

In my first decade at the Centre, if I hadn’t been driven by idealism and ex- catholic “payback penance” for my wild adolescence, I would have walked away. At the time, I had the right mix of youthful energy and naivety to believe I could change the world or at least a small part of it by creating a “no cost” and accessible community counselling service.   

During the years that Mike King was appearing in TV adverts convincing us to eat pork and then a couple of years later to “not eat” pork, I was campaigning on the benefits of free counselling for our local communities and trying to raise funding to do this. My voice at that time was a lone one. It feels like that again as the $24m National-Act-NZ First coalition deal with Mike King effectively took away the money from established organisations like ours with decades of service and a proven track record and left us powerless. 

It reeks of a wealthy city old boys celebrity club and cronyism handshake deals sealed inside dark locked rooms. While King has used celebrity power to champion a cause and was subsequently handed money on a silver platter, organisations like the Counselling Centre must continually jump through tiresome hoops to provide not only the same service Gumboot Friday provides but a more robust and sustainable service than Gumboot infrastructure is capable of offering. Young people wanting help through the Gumboot charity can only receive two free sessions of counselling which I believe is not helpful in its brevity. At the Counselling Centre, young people can see a counsellor for as long as they want and need to.

In 2024, 40% of our clients are referred to us from their GP, 51% self-refer and the rest come from other community networks. With a nudge from their doctor, more men are requesting counselling (still only 35% of our client numbers but up from 14% 10 years ago). While gumboots line up outside our entranceway, Gumboot funding does not.

Funding required at the Counselling Centre is $250,000 per annum and it comes from a variety of different grants and donations.  Strategic use of financial and human resources allows the Centre to be open five days per week while employing four part-time Counsellors. All the Counsellors are very experienced and are registered members with the New Zealand Association of Counsellors.

Every year I write funding applications and file accountability reports. I am a busker with my hat out, singing the same old song. 

Over half of the funding comes via a contract with Oranga Tamariki (Ministry for Children) specifically to provide counselling to children and young people and their whānau. A four-year contract with them ended in June this year and we had no idea until late August whether it would be renewed at all. Eventually we were offered a new three-year contract but the amount offered to us has been significantly reduced.

This year there have been massive funding cuts and job losses throughout government departments so when $24m is signed off by the Ministry of Health without any consultation with proven organisations already doing that exact counselling mahi then this entire contract process seems grossly unfair.

Not only does it lack transparency but also shows up fundamental inconsistencies between government ministries (Health vs Oranga Tamariki) about who is already providing free counselling for youth across Aotearoa and  which government departments are contracting it.

In December 2019, counsellors (despite having the exact skills required) were informed by the Health Ministry that were not eligible to apply for the new HIP Health Improvement Practitioner positions at medical centres because the counsellors registration system is self-regulated and not part of the Health Practitioners Competence Assurance Act 2003. HIPs are mental health clinicians who are based on site at a GP or medical centre and in theory can see patients with mental health distress quickly. 

A grand idea that may work in cities but unfortunately the Rangītikei region hasn’t been able to employ or retain any HIPs. One of the medical practices has had one intermittently for a few months at a time while the other has never been able to fill the position. Every so often I approach the local Whanganui Regional Health Network for updates and I am told how difficult it is to employ and retain health practitioners in isolated rural regions. For eight years prior to 2019 and before the advent of HIPs, the Counselling Centre sent one of its counsellors to the Bulls Medical Centre to see GP-referred clients onsite for one day per week. By all accounts we did a great job and at a local level it was very much appreciated. 

Last year an “accreditation” opt in was developed that to qualify for Health Ministry funded HIP jobs, an applicant must have a degree in counselling.  

I have a university degree but it’s not in counselling so would not be eligible to apply. Despite having a  diploma in counselling and 30 years of practice as a counsellor, I would be excluded from a position that a recently graduated colleague with a counselling degree and very little experience is eligible to get.

Many of the counsellors who receive payment from Gumboot Friday (via a Health Ministry contract) do not have counselling degrees. 

These are all inconsistencies that need to be addressed at all ministry levels about counsellors’ role as health professionals in contemporary Aotearoa and the I Am Hope foundation should not have received any funding at all until these were discussed through an open and transparent process.

My view of what makes counselling effective based on 30 years of community-based practice takes a much wider perspective than just a couple of sessions of talk therapy. Effective counselling cannot be delivered in a vacuum from the rest of the person’s life. The premise that we exist as individuals isolated from each other is a western individualist viewpoint. 

In our rural community we provide a wraparound service for our people. Clients are more than individuals who call in once a fortnight for an hour with a counsellor. 

Whānau can be invited in (with permission) to help mend fractured relationships. The GPs and other health providers are a couple of minutes’ walk away from our premises. We have regular community health networking meetings, so all local services can know each other. We maintain positive community relationships with our local schools and iwi providers Te Kōtuku Hauora, the primary health and social service provider under Te Rūnanga o Ngā Wairiki Ngāti Apa. 

We reach out to wider support networks for people who feel isolated, contact the local food banks/community welfare for kai or to pay bills. We strive to help heal the individual but also our service helps to strengthen, heal and educate whānau and ultimately our local communities become a more positive place to live. 

This wraparound service will not happen when a young person contacts Gumboot Friday online to see a random private practice counsellor for their two free sessions of counselling. I wonder how we can know whether these sessions are helpful to the young person? Will there be follow-up care and if so, who will pay for this? 

The accountability checks and balances in place for our small amount of government funding (currently $90,000 per annum) are extreme. It feels like my whole job is providing endless layers of proof of our competence. I am required to file a three-page report every three months to prove that we are seeing the contracted number of clients. 

For 23 years an annual report was deemed sufficient until someone in the echelons of Wellington decided it wasn’t. My reports first go to a contracts manager, then get signed off by another manager before we can receive our $24,000 quarterly payment. 

All of the employees in the Oranga Tamariki hierarchy who manage our paltry contract have full-time employment positions compared to our community nonprofit part-time work force with limited resources working on the front line.

Every six months an Oranga Tamariki funding advisor drops by for a monitoring visit to once again check we are fulfilling our contractual obligations. 

Every two years we suffer through the “accreditation” process performed by Te Kahui Kahu, an independent government business unit whose role is to assess organisations against the Social Services Accreditation Standards (SSAS) and make sure they meet these standards.

All of our current policies, procedures, audited financial accounts, staff files, annual reports, meeting minutes and reports, occupational health and safety records including incident and accident reports must be uploaded and then a full day is scheduled for an in-house visit. 

Client paperwork is examined in detail (without identifying details) to prove that counselling is actually helping the person. 

Staff files are scrutinised to check that counsellors have current employment agreements, have done enough training, had enough supervision and practice in an ethical manner. Two years ago the assessor discovered there was no proof in my staff file that I am who I say I am. I had to put authorised copies of my licence and passport into my own staff file to prove to myself as manager that I am me.  

Any counsellor who has changed their name must provide a complex paper trail of authorised certificates from birth certificates, marriage certificates, divorce papers and other documents to prove their existence.  

While the Te Kahui Kahu assessors also have full-time well paid government service jobs, I juggle a part-time role at the Centre accumulating piles of paper to be stamped as authentic while side-stepping clients who are asking for help.

I don’t believe the counsellors on Gumboot Friday contracts have to face the wrath and scrutiny of Te Kahui Kahu or monitoring visits or provide a mountain of verification checks. These counsellors just send an invoice to the fund for payment once they have seen the client for their allotted sessions.

Over my 30-year practice as a counsellor I have had long periods of doing private practice work and there isn’t much accountability at all. You see a client and give them or a third party an invoice for your time and renew your NZAC registration once a year. 

The Counselling Centre always passes the Te Kahui Kahu’s accreditation process with flying colours, always sees up to 50% more clients than the Oranga Tamariki contract demands and has glowing feedback from clients and the wider community so the subsequent loss in funding this year is a mystery. 

When Oranga Tamariki publicly announced mid-year they were cutting the contracts of underperforming services, we knew this didn’t apply to us. However, six weeks after our contract expired we were advised that there wasn’t sufficient funding available in our rural district to fund our service to its required standard.

It is unfair that there are different societal and governmental rules at play here. The I Am Hope Foundation has received a sizeable amount of funding as an unproven entity while lacking an in-depth analysis of what is required for lasting  societal mental health healing to take place.  

With its meagre financial and human resources, the Counselling Centre, backed by 24 years of statistical data, knows that it is making a difference, and is still expected to jump through always-moving hoops.  

Every day at the Centre we hear devastating stories of loss, grief, sadness, despair, betrayal, family and relationship problems, abuse, trauma, loss of hope and uncertainty about life direction. It’s tough work. It’s satisfying work. Knowing that you have helped to guide someone to make fundamental changes to their outlook on life is uplifting. Listening to the stories of how violent humans can be to one another and themselves can be soul destroying.

My energy is restored by the maunga that dominate my central North Island landscape. I see Ruapehu and Taranaki on my drive to work. 

On the way home I let the client stories flow down the Rangitīkei River to the sea and focus my energy on the changing light over the Tararua and Ruahine Ranges and make plans for my next hike across them. 

Early next year, radical decisions will be made about the future of the Marton Counselling Centre. Without a top up of $60,000 per annum it cannot continue in its current form. The five-days-a-week service will be severely scaled back and specialist child counsellor positions will be lost. This will be a huge loss for the district with far-reaching effects on mental health and wellbeing in the local Rangitīkei communities.

It is incredibly difficult to employ good counsellors for  work in community organisations, especially in rural locations, because private practice counselling is far more lucrative financially, and perhaps not so challenging. The Counselling Centre is fortunate to have a dedicated team of the best counsellors in Aotearoa in terms of experience and skill base. 

Everyone who works here is committed to the mahi and magic of working at a unique service that is revolutionising grassroots mental health care in Aotearoa. 

We don’t want our Rangitīkei communities to lose this service but we are tired of being unsupported, unseen and unheard by successive government ministries who have been fully aware of our work for decades. Instead, our funding is reduced (and ultimately our service) while at the same time Mike King just keeps being Mike King.