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Introduction

This part describes the current situation – where we are now – for mental health and addiction in New Zealand.

Chapter 1 describes the context of this Inquiry. In chapter 2 we summarise what we heard from the people who use mental health and addiction services, their families and whānau, and the people at the front line of service delivery. In chapter 3 we outline what we think – our findings about what we’ve seen and heard and the other evidence we gathered during the Inquiry to inform our deliberations. We set out our vision and direction for a transformed mental health and addiction system.

Explanation of important terms

The most important terms used in this report are explained in Table 1.

Table 1: Meaning of important terms

Term

Explanation of term as used in this report

mental health and wellbeing

Mental health and wellbeing form one component of broader wellbeing. Te Whare Tapa Whā is a model that uses the symbol of the wharenui (meeting house) to illustrate the four cornerstones of wellbeing: taha wairua (spiritual health), taha hinengaro (mental health), taha tinana (physical health), and taha whānau (family health).

For Pacific peoples, mental health and wellbeing encompasses a holistic approach of reciprocity, respect, belonging, genealogy, and relationships with all entities – Atua, the land and environment, ancestors, cultures, languages, family and others, collectivism – elements that protect and strengthen family and individual wellbeing.

Mental health is “a state … in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community”. a

addiction

For the purposes of this report, we focus on addiction as it relates to alcohol and other drugs. This includes the full spectrum of severity from mild issues to more serious addiction.

tāngata whaiora

Tāngata whaiora, literally translated, means ‘people seeking wellness’. In this report, it refers to people from all ethnic backgrounds who experience mental health or addiction challenges and who are seeking wellness or recovery of self. It includes mental health and addiction service users and consumers of mental health and addiction services.

person with lived experience, service user or consumer

A person with lived experience, a service user or a consumer is a person who accesses, or has accessed, services for mental health and/or addiction needs.

The Health and Disability Commissioner Act 1994 and the Code of Health and Disability Services Consumers’ Rights uses ‘consumer’ to describe a person who accesses health services or disability services.

family and whānau

Family and whānau are not limited to blood ties, but may include partners, friends and others in a person’s wider support network. It is up to each whānau and each individual to define for themselves who their whānau is.

mental health and addiction services

Mental health and addiction services are primary and secondary services (that is, services delivered for people with mild to moderate, moderate to severe, and severe needs) that are provided through primary care organisations (such as general practices), non-governmental organisations or district health boards (DHBs)) in hospital inpatient, outpatient, forensic or community care settings.

service provider

A service provider is an individual or organisation providing support,care or treatment to people with mental health or addiction challenges.

Kaupapa Māori services

Kaupapa Māori services provide health and social services for Māori within a Māori cultural context across a broad range of conditions and ailments and within a whānau-centred framework.

non-governmental organisation (NGO) sector

The NGO sector comprises independent community, Iwi and Māori organisations operating on a not-for-profit basis.

primary health care

Primary health care comprises generalist health services designed for delivery to the general population. These services are partly funded by Vote Health, and include general practice, school-based services, midwifery, Well Child Tamariki Ora, and NGO primary health support.

mental health and addiction specialist services

Mental health and addiction specialist services are services designed specifically for people with complex and/or enduring mental health and/or addiction needs. These services are publicly funded through Vote Health, and include NGO- and DHB-delivered community and residential services and services delivered in a hospital setting.

postvention

Postvention refers to interventions in the aftermath of a suicide. It has a dual focus on bereavement support and suicide prevention among those who have lost a loved one to suicide.

trauma-informed care

Trauma-informed care uses a strengths-based framework “that is grounded in an understanding of and responsiveness to the impact of trauma, that emphasizes physical, psychological, and emotional safety for both providers and survivors, and that creates opportunities for survivors to rebuild a sense of control and empowerment”. b


a  World Health Organization. 2014. Mental health: A state of well-being (web page) www.who.int/features/factfiles/mental_health/en(external link).

b  E Hopper, E Bassuk, and J Olivet. 2010. Shelter from the Storm: Trauma-informed care in homelessness services settings. The Open Health Services and Policy Journal 3, 80–100, p 82.

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