“One of the election promises being kept by the incoming government is to bring back an independent mental health commission. This policy was supported by all three of Labour, the Greens and NZ First in the lead up to the election, and includes both the re-establishment of an independent Mental Health Commission and a review of mental health services.
The increased media attention this year surrounding mental health has painted the sector in a grim light, one befallen by lack of funding, lack of access and out of touch with how to help the people who are requesting it.
An overhaul of primary care is needed to address people’s access to health services. Overwhelmingly people want to be able to go to their primary health care provider to access mental health support (in multiple different forms) and because of the way funding is allocated to geographic areas rather than the people who need it, this support simply isn’t available. This should be a key priority for any Mental Health Commission.
The Health and Disability Commission currently has an appointed Mental Health Commissioner. They have set out a monitoring and advocacy framework that was circulated in July this year that sets out key priorities for a public mental health sector, which includes:
- Can I get help for my needs?
- Am I helped to stay well and get well?
- Am I a partner in my care?
- Do services support me to be safe?
- Do services work well together for me?
- Do services work well for everyone?
- Is the workforce healthy?
These priorities also have markers, indicators and supporting documents and contexts attached to them that bring together different projects, organisations and frameworks to assist in measuring and evaluating on an annual basis ways and recommendations for improving mental health and addiction services. The first report is scheduled to be released in Feb 2018.
An independent mental health commission is well placed to pick up this work and its mandate would be to bring together disparate initiatives, frameworks, documents and recommendations for improving mental health for all of Aotearoa.” Kieran Moorhead, Changing Minds
“While on holiday, upon running out of medication and experiencing an acceleration of symptoms, I called the Crisis team to ask for support. After expressing my need for medication, I was told that “I should have thought of that before I went on holiday” and dismissed. I ended up being taken to hospital by police after assaulting a family member. In an earlier hospitalisation for psychosis I was sexually assaulted by another patient. The staff had noticed that I was receiving unwanted attention but failed to act upon this. Something needs to change.” Anonymous
“It’s great to see the new government is reinstating the Mental Health Commission. But the Commission will only be as strong as its powers, its scope and the people who lead it.
Mental Health Commissions around the world either have a funding, monitoring or complaints focus.
It would be a bad idea to set up a complaints focused Commission because its focus would be too narrow and negative.
A funding Commission would need to have the power to allocate intersectoral funds and not just Vote Health funds.
I suspect the government will go again with a monitoring Commission. If this is the case the Commission needs to monitor the whole system of services and supports for people with mental distress, not just the health system. It may be possible for the Commission to report to more than one Minister – Social Development and Health?
The new Commission must have people with lived experience in the leadership. Otherwise it will have no credibility with the people it is supposed to be there for.
Finally the Commission needs real teeth. Its powers were gradually eroded over the 2000s. This shouldn’t happen again.” Mary O’Hagan (Mental Health Commissioner 2000-2007)
“I would like to see a new mental health commission that:
- addresses the social issues that lead to mental distress, taking a preventative approach across communities to reduce the need for crisis services
- reviews what needs improving and what initiatives are working well, with a view to how successful initiatives could be replicated throughout the country.
- re-educates the public, especially the media to see that mental distress, such as hearing voices is a human experience, shifting the public view from the ‘us’ and ‘them’ that exists when psychiatric labels are placed on people
- works alongside suicide prevention programmes to eliminate our appalling suicide statistics
- keeps the increasing numbers of people being prescribed antidepressants and antipsychotic medication in check
- ensures that people have access to a range of supports quickly, THAT THEY CHOOSE THEMSELVES, especially talking therapies.
- ensures immediate access to high quality crisis mental health services where everyone who accesses them has their human rights met, and services are held accountable for meeting these requirements” Sarah O’Connor
“While I was under the care of the New Zealand mental health system in January and February of 2017 it became clear to me very quickly that I was dealing with a system that was in crisis. The most insulting part was booking appointments in the clinic, where a massive poster listing patients rights was prominently displayed, knowing full well that these rights were not being respected, and there wasn’t a damn thing anyone could do about it. I welcome an external review of the service. ” LaQuisha St Redfern, BSc
“I am heartened that the new government has acknowledged the distress registered by many over the current state of mental health services for New Zealanders. I hope the appointing of this commission will be the first step in a series of many positive and forward moving changes.
If a review is to be held I would like to emphasise that it must include the views of those who use the services, or have used them, from resources and reports outside of medical services.
The current type of compulsory treatments and orders in the system have created a false sense of accomplishment where compliance is often interchanged, or applauded, as an achieved outcome of wellness.
Just recently the Hearing Voices Network Aotearoa lodged a submission regarding the Mental Health Act. We have had no feedback of any results or actions taken from this by the previous government. Any review must result in change.
I am excited by the action promised by the new government. I hope they can be bold enough to do what needs doing.” Adrienne Giacon, Hearing Voices Network Aotearoa NZ
“It’s exciting news. I’m banking on strong Commission leadership of people with lived experience holding equal status with other Commissioner’s who have had roles that intersect with our community. This Commission could be a creator of perpetual and future focused innovation that, of course, includes all understandings of people’s lived experiences. It would work closely with the Ministry of Health and every other Ministry to implement it’s cross-society vision and planning. Good thing we have so many talented, positive and humble people in our country who might apply for all these roles!” Andrea Bates
“A new Mental Health Commission:
- We seem to have a Drug First, check them out after policy (like USA army – shoot first, ask questions later…)
- Trouble is, once drugged you are no longer looking at the original problem or even cause. It has been modified.
- Check out Open Dialogue and Narrative Therapies.
- No real alternatives such as Nutrition and Nutrient treatments – see work in Dunedin, see Orthomolecular in USA and Canada.
- The are many other helpful ways too – including herbs, homeopathy, acupuncture, EFT and much more.
- Person must lead their own recovery for it to be meaningful, and may use a mix of modalities.
- Presently DHB psychiatrists are GODs in the system and have ultimate power. This is both a human rights issue and a recovery issue.
- I have been to the precipice but managed not to fall into the system’s mouth. I know many who have and as a result have lost their lives to lives of dependence.” Richard Gray
“Many of us were excited when the mental health commission was established 1996. It had vision. New Zealand was truly looked to as leading the way. It had a role in getting recovery more on the map in New Zealand.
I remember in early 2000s I was in the US running some workshops at a conference in Atlanta and I had Recovery Competencies for New Zealand Mental Health Workers (2001)(a great publication then) on the table for my workshop. I was swamped by people wanting them. I also remember having those competencies incorporated into the staff competencies for the organisation I worked for. They made a difference.
There were many other aspects to the commission then. I can still remember looking up and toward the commission in those days. I thought it could be the catalyst for a way forward. It was looking out to us in communities, and I am sure having its tussles in the corridors of government. Over time though I felt its focus was diverted more and more to looking inside the corridors toward the government ministers and using more and more of its time and resources mitigating government minister’s risks.
So how do I think about reestablishment of a Mental Health Commission? If it starts off with the same passion as in 1996, if it truly looks out toward us I think it will be of value. It needs teeth though in a time when the Ministry appears to have little teeth as far as DHBs are concerned. What we don’t need is a mental health commission that has relatively no power in regard to the Ministry of Health and the DHBs.” Gary Platz