This is the sixth general inquiry into mental health policy and services in New Zealand since 1858. Historian Warwick Brunton notes that setting up an inquiry is a generational phenomenon in this country, 4 yet several features of this Inquiry mark it out as different from its predecessors.
This Inquiry is significantly different because it is not incident driven, although it was prompted by widespread concern about the toll of suicide on New Zealand families and communities and reports of difficulty accessing help for mental health and addiction challenges. 5 It has a wide scope. It is not just about services for people with acute and semi-acute mental disorders, which was the focus of the 1996 Mason Inquiry report 6 but includes mental health problems across the full spectrum from mental distress to enduring psychiatric illness, and looks beyond the health sector to other sectors (including education, justice and social policy) that influence mental health outcomes. In addition, it covers addictions and harmful use of alcohol and other drugs, which past reviews generally treated as a separate policy area.
The Inquiry encompasses the broader social determinants of mental health and wellbeing, including how mental illness and addiction might be prevented or treated from outside as well as inside the health sector. It has a specific focus on Māori, the obligations of the Crown under Te Tiriti o Waitangi (the Treaty of Waitangi) and poorer mental health outcomes for Māori, and an explicit focus on other groups with special needs, including Pacific peoples, young people, disabled people, Rainbow communities, 7 the prison population and refugees.
The Inquiry panel is diverse and multicultural and brings a wide variety of life and work experiences, including lived experience of mental health challenges. The Inquiry process was broad and far reaching, with panel members meeting with thousands of people from Kaitaia to Invercargill, in urban and rural settings, on marae, in churches and in community halls. We met people with lived experience of mental health and addiction challenges, younger and older people, Māori, Pacific peoples, families, service providers, community and government organisations, members of Rainbow communities, refugees and others. We received submissions (written, online, by video and artwork) from thousands of individuals and organisations.
For all these reasons, many people, including the panel, see this Inquiry as a ‘once in a generation’ opportunity. Our report reflects the momentum for real change and makes recommendations for a new approach to achieve enduring improvements in an area that touches all our lives.
4 W Brunton. 2005. The place of public inquiries in shaping New Zealand’s national mental health policy 1858–1996. Australia and New Zealand Health Policy 2(24). www.ncbi.nlm.nih.gov/pmc/articles/PMC1351184/(external link).
5 A number of groups and petitions explicitly called on the Government to initiate an Inquiry.
6 Committee of Inquiry into Mental Health Services (K Mason, Chair). 1996. Inquiry under Section 47 of the Health and Disability Services Act 1993 in Respect of Certain Mental Health Services: Report of the Ministerial Inquiry to the Minister of Health Hon Jenny Shipley. Wellington: Ministry of Health. https://tinyurl.com/y6w4nqr5(external link).
7 In this report we use the term ‘Rainbow’ as an umbrella term for people who are lesbian, gay, bisexual, trans, intersex, queer, asexual, and other diverse sexual orientations and gender identities. The term ‘LGBTIQA+’ is another term often used in this context.