Te Tāhuhu: Improving Mental Health 2005

Te Tāhuhu: Improving Mental Health 2005–2015

HP 4129
Date of publication: June 2005

page 1 of 6

Contents
Foreword
Introduction
This Plan
Government Outcomes for Mental Health and Addiction
Ten Leading Challenges
Promotion and Prevention
Building Mental Health Services
Responsiveness
Workforce and Culture for Recovery
Māori Mental Health
Primary Health Care
Addiction
Funding Mechanisms for Recovery
Transparency and Trust
Working Together
From Challenges to Action
Conclusion
References

This is the full text online version of this document.

It is also available as a PDF file to download or print: Te Tāhuhu: Improving Mental Health 2005–2015

Foreword

Our mental health is important. It enables us to seize new opportunities, overcome challenges and reach our potential. It also helps us to make the most of our families, our friendships, our jobs, our communities and live our lives to the full.

However, none of us can afford to take our mental health for granted. One in five New Zealanders experiences a mental illness or an addiction, and this takes a huge toll on individuals and their families, on society and on the economy.

People with mental illness and addiction can also experience severe discrimination, and this undermines their recovery.

Hon Annette King

We have come a long way since the current Mental Health Strategy was first released in 1994, and this plan mirrors the change in attitudes that has occurred since the time when mental illness was poorly understood and rarely spoken about. It also reflects an increased understanding amongst more and more New Zealanders that mental illness can affect any one of us, and builds on a number of encouraging developments.

Specialist services have expanded to meet the growing needs of people, the quality of services has improved and we have a skilled, capable, committed workforce. People who have spent much of their lives in institutional care are now living in communities and are better able to enjoy the same opportunities and privileges as any other New Zealanders. The development of the Primary Health Care Strategy has also provided new opportunities for primary health care services to respond to the mental health needs of their populations.

Compared with a decade ago, more people can have a say about the delivery of mental health and addiction services, and the creation of District Health Boards has given local communities a real stake in determining how their needs are met. Non-governmental organisations, Māori and Pacific mental health providers, service users and families also now play a crucial part in delivering services, and people with a mental illness or addiction are taking lead roles in the sector.

While much has been accomplished, much is still to be achieved. The Blueprint is not yet fully implemented and service gaps remain in some areas. The Government remains committed to implementing the Blueprint and this is a priority woven into this Second New Zealand Mental Health and Addiction Plan.

When the draft plan was released for comment last year, the overwhelming message I received was that it should be more strategic and overarching. I am proud of the strides New Zealand has made to support people with a mental illness and addiction and I am pleased to present this document which:

builds on the current mental health strategies and draws together Government interests in mental health and addiction
broadens the Government’s interest in mental health from people who are severely affected by mental illness to all New Zealanders – while continuing to place an emphasis on ensuring that people with the highest needs can access specialist services
sets out government outcomes for mental health and addiction
clarifies priorities for action to 2015
builds on past successes, establishes a platform to maintain momentum and provides a mandate for leadership.

Hon Annette King
Minister of Health

Introduction

First steps to a mental health policy

New Zealand first developed a co-ordinated mental health policy in 1994, with the Mental Health Strategy, Looking Forward (Ministry of Health 1994). The document made mental health a priority for the Government and emphasised the need for more services for people. It also signaled the Government’s commitment to developing community-based services.

Three years later, Moving Forward, the first Mental Health Plan (Ministry of Health 1997), emphasised the need for better services. The first plan was followed in 1998 by the Mental Health Commission’s Blueprint (Mental Health Commission 1998), which detailed the service developments needed to put Moving Forward into action.

Looking Forward, Moving Forward and the Blueprint have resulted in a number of significant achievements, including:

a steady growth in access to specialist services and a growth in clinical capacities
continued progress in helping people move from institutional care into the community
a rapid growth in the non-government sector and in the number of Māori mental health providers.

These achievements have been made possible by government commitment to a number of funding packages that have led to substantial increases in funding for the sector – from $465 million (GST excl) in 1997/98 to $863 million (GST excl) in 2004/05.

Recent developments

Times have changed since Looking Forward, Moving Forward and the Blueprint were written, and in the past decade, a number of important developments have impacted on the way mental health services are delivered.

These include:

the establishment of 21 District Health Boards (DHBs), which are responsible for determining the mental health needs of their communities and planning and delivering services
the development of Primary Health Organisations (PHOs), funded through DHBs with the aim of providing primary health care services to their enrolled populations
the integration of mental health into the broader health system and the development of four key health strategies to give the health and disability sector an overall focus: the New Zealand Health Strategy in 2000 (Minister of Health 2000), the New Zealand Disability Strategy (Minister for Disability Issues 2001) and the Primary Health Care Strategy (Minister of Health 2001) in 2001 and He Korowai Oranga: the Māori Health Strategy in 2002 (Minister of Health and Associate Minister of Health 2002)
the continuing growth of a clinical workforce committed to evidence-based practice, and the recognition that service delivery must be both needs and evidence based
the growth of a strong consumer voice and a recognition that services must be built around the needs of the people who use them
the development of a recovery philosophy that underpins services for people and recognises that service users must lead their own recovery, have personal power and a valued place in their whänau and communities
an increasing recognition that family and whänau must be involved in service delivery and treatment
government reforms that have placed an emphasis on improving the performance of State services
recognition that social and economic factors such as employment, housing and poverty all impact on mental health, wellbeing and recovery – and an understanding of how essential it is that all parts of the State sector, and wider community services, work together to provide services.

These health sector changes sit alongside other social trends, including:

New Zealand’s growing ethnic diversity. Māori make up nearly 15 percent of the population, Pacific peoples nearly 7 percent, and Asian peoples 6.4 percent. Ethnic communities include people who identify with ethnic groups originating from across the world as well as people who may also identify as migrants and refugees. Mental health services must be able to respond to the unique needs of all New Zealanders.
Ongoing developments in technology, from changes in pharmolocogy to new ways of gathering, managing and sharing information. The development of telepsychiatry for people in remote areas and the increasing use of the Internet for self-management are becoming a reality for many people.
A global workforce. New Zealand’s mental health services have had to work hard to recruit and retain staff. The increasing number of health professionals from overseas has implications for service delivery, local knowledge and cultural understanding.
Changing professional roles. Roles for the next generation of mental health workers will evolve to meet the changing environment. New disciplines may emerge, and established jobs may change.
Changing attitudes. Sound progress has been made over the last eight years in tackling stigma and discrimination, and general public surveys show significant improvements in attitudes and support for people with mental illness.

It is within the dynamic and evolving health environment and against these wider societal trends that the mental health sector faces an important challenge to make a difference for all New Zealanders.

This Plan

Building on past success

This plan draws together the Government’s priorities for mental health and addiction services and builds on previous successes.

Unlike previous strategies, this plan sets out the outcomes that the Government expects State services (which comprise all departments and Crown entities), and other agencies to pursue. These outcomes are clear, unambiguous and aimed at letting people know what they can expect from mental health and addiction services.

The plan also sets out:

priorities that must be tackled collectively if the outcomes are to be achieved
how this plan will be implemented through the development of a detailed action plan.

The approach

This new approach reflects a wider move across the State services to ensure that Government and New Zealanders feel able to trust the services they fund and use.

This plan is for all New Zealanders and will:

provide a uniform set of directions to govern mental health and addiction services, no matter which agency provides them or how they are funded
give mental health workers an overall sense of how their work fits into the total picture of mental health and mental health services
support the Government’s ongoing investment in funding and services needed to advance the outcomes and priorities in this statement support the Government’s commitment to developing a more innovative and accountable funding environment.

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Related Information

Mental Health