New Zealand’s mental health crisis, He Ara Oranga and the future

The term “mental health crisis” was originally defined as an emergency that poses a direct and immediate threat to an individual’s emotional wellbeing. The definition has been expanded to refer to problems in community mental health and in mental health services (MHS)as a whole. A mental health crisis has been widely used to describe the state of New Zealand’s mental health. For example, recent headlines include “New Zealand mental health crisis as Covid stretches a strugglingsystem”1 and “New Zealand mental health crisis has worsened under Labour, datashows,”2 suggesting deteriorating mental health in the population and an overwhelmed health system. This paper sets out to test the veracity of these headlines. First, we will present data on whether rates of mental distress and the use of services are increasing in New Zealand. Second, we will consider the mental health system’s response to evaluate whether it has been effective. Third, we will consider where the limited available resources could most effectively be used. We conclude that New Zealand’s mental health planning is heading in the wrong direction by directing resources and thus services away from people with serious mental illness who are often affected by social exclusion and deprivation. The current government’s plans, yet to be implemented, will expand psychotherapy to the “middle class,” an approach labelled as the “Big Community.”3 Evidence from both the UK and Australia indicates that such initiatives might not reduce population distress in New Zealand, as intended. Instead of spending on programmes for moderate psychological distress, we suggest that the limited resources available for mental health should be carefully targeted towards those with serious mental illness, using integrated services located in areas with the highest levels of deprivation, which is often determined by ethnic, cultural and historical factors.