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Main points

  • Our focus in this report has been on how to support real and decisive change.
  • The Health and Disability Sector Review has a key part to play in considering broader system and structural issues.
  • Improving New Zealand’s mental health and wellbeing is a long-term challenge. Collective and enduring political commitment is essential. We recommend the establishment of a cross-party working group in the House of Representatives.

At this point, He Ara Oranga passes from our hands to the Government’s.

Others will be tasked with assessing it, weighing options and preparing a response. Like us, they will be acutely aware of the hopes and high expectations of all those who participated in the Inquiry process.

We have set a clear path for the future. In saying this, we are aware that as our report moves out of our control, other issues come into play. They include the decisions the Government takes, any flow-on effects (including to the range of other inquiries and reviews that are under way), the available resources and how quickly changes can be implemented.

These are not things we can predict. In preparing our recommendations, we knew there would be issues around phasing, resourcing and how quickly some decisions could be implemented. Our approach has been to identify how to support real and decisive change, while other processes are under way.

That is why we have given precedence to the service co-design process, but have been silent about whether or when a new mental health and wellbeing strategy should be developed. We see little value in putting effort into a formal strategy at this point. The direction is clear and can guide decision-making from this point. Implementing the Government’s decisions on this inquiry should be the priority, and progress should be monitored by the new Mental Health and Wellbeing Commission. Development of a strategy may be useful in the future. That option should be left open.

We recognise that funding will be required to extend access to, and choice of, mental health and addiction services. We have suggested some areas where decisions around early investment can be made easily, while a full staged funding path is developed and agreed. Additional resources will also be required to implement the other recommendations in this report.

Legislation will be required to establish the new Mental Health and Wellbeing Commission. The legislative process may take some time, but we need a change agent now. We suggest that a ministerial advisory committee be established as an interim body while the Commission is being set up, to lead or participate in urgent tasks.

We have not specified which agency should develop a new suicide prevention strategy and implementation plan. We are aware that the Ministry of Health has already completed significant preparatory work for the strategy. The strategy and implementation plan need to be completed urgently and funded, probably before new organisations can be established. Similarly, we have not specified where our proposed suicide prevention office should reside. This will depend on the wider decisions the Government makes around agency roles and functions.

We emphasise that our recommendations are intended to work together as a cohesive and comprehensive package for change, which builds on the structures and systems in place now.

Over the course of the Inquiry, there were significant structural and system issues we discussed at length. We comment on these issues throughout Part 2 of this report, including concerns about the current district health board model and the transformation required in the primary health care sector (chapter 5). Part way through the Inquiry, the Government established the Health and Disability Sector Review. That review has a wider scope than our Inquiry, and is better placed to consider broader issues such as the future structures, roles and functions in the health and disability system, including the establishment of a Māori health commission or ministry. We refer these important issues to the Health and Disability Sector Review for its consideration.

In closing, we respond to the call we heard from people up and down the country for a collective and enduring political commitment to improved mental health and wellbeing in New Zealand.

Mental health is too important to be a political football. Although different parties have differing priorities, we believe they all share a commitment to improved mental health and wellbeing in New Zealand. We think an opportunity exists for politicians to work together on these important issues. Similar initiatives are in place in the United Kingdom and Canada, and some support exists for a similar concept in New Zealand. We note that a cross-party working group on drug harm reduction already exists.

We recommend the establishment of some form of cross-party working group on mental health and wellbeing, supported by a secretariat. This would provide an opportunity for members of the House of Representatives to collaborate and advocate for education, leadership and legislative progress on mental health and wellbeing. It would also provide a forum for members to collectively connect with New Zealanders about mental health and wellbeing on topical issues of concern.

Recommendations

Wider issues and collective commitment

  1. Ensure the Health and Disability Sector Review:

    • assesses how any of its proposed system, structural or service commissioning changes will improve both mental health and addiction services and mental health and wellbeing
    • considers the possible establishment of a Māori health ministry or commission.
  2. Establish a cross-party working group on mental health and wellbeing in the House of Representatives, supported by a secretariat, as a tangible demonstration of collective and enduring political commitment to improved mental health and wellbeing in New Zealand.

Kua takoto te manuka – the challenge has been laid

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