The He Ara Oranga Report: What’s wrong with ‘Big Psychiatry’ in New Zealand?

Stephen Allison, Tarun Bastiampillai, David Castle, Roger Mulder, Ben Beaglehole

Research output: Contribution to journalEditorial

6 Citations (Scopus)


The portrayal of psychiatry in the recent He Ara Oranga (HAO) Report into New Zealand’s mental health and addiction services raises significant concerns for the profession as a whole. This once-in-a-generation report recommends a decisive shift away from what is termed ‘Big Psychiatry’ towards a new sector called ‘Big Community’ (New Zealand Government, 2018: 97). Big Psychiatry is characterised as a medically led system where ‘most resources are used for psychiatric treatments, clinics and hospitals’ (p. 36). Big Psychiatry is criticised as having a colonising worldview, together with a legacy of paternalism and human rights breaches. In response to this depiction of psychiatry, the HAO Report recommends creating Big Community where ‘resources are used for a broad menu of comprehensive community-based responses’ (p. 36) that embrace multiple worldviews, and respond to people at risk with compassion and support. Big Community is praised as having a strong commitment to partnership, recovery, spirituality and human rights
Original languageEnglish
Pages (from-to)724-726
Number of pages3
JournalAustralian and New Zealand Journal of Psychiatry
Issue number8
Publication statusPublished - 1 Aug 2019


  • New Zealand
  • He Ara Oranga Report
  • mental health
  • community


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