Five years after the Mental Health Commission closed shop, New Zealand First has secured plans for its reestablishment. Alongside that, the Greens have also committed to a Government that acknowledges and treats drug-use as a genuine health issue. Teuila Fuatai reports.
More than 20 years after a galvanising series of inquiries into New Zealand’s mental health practises, which culminated in the legislation-defining Mason Report of 1996, we seem to have reached another pivotal point in our mental health landscape.
AUT professor of psychology and public health, Max Abbott – who lists founding director of the Mental Health Foundation as part of his extensive CV – said that particular point, and the current state of affairs, was indicative of the real need for a “stocktake” of mental health systems.
The re-establishment of the Mental Health Commission – announced yesterday as part of the Labour and New Zealand First coalition agreement – was an important step towards this, Abbott told Newsroom.
“I was actually in support of it [the Commission] being closed down [in 2012]…because I thought mental health was sufficiently established and strong enough that it would no longer be marginalised and sidelined as part of the Ministry of Health,” he said.
And while vast improvements in systems and treatments have occurred in the last two to three decades, it has become obvious in more recent years funding and development of mental health services have failed to keep up with demand.
That failure to keep up had resulted in unacceptable, and dangerous consequences such as “inordinate” waiting times for things like talking therapies and counselling for those requiring immediate help, as well as problems with poor access to services, Abbott said.
“While there’s a lot of good work being done, it’s not sufficient and there are definitely gaps and cracks appearing.”
When the Mental Health Commission was established in 1996, it operated as a watchdog for mental health services, independent from Government. Its job was to ensure that funding for mental health services remained in that sphere – rather being used and filtered through to other health areas, he said.
Under the current system, too many people were being failed either during, or even prior, to interaction with the mental health system. Addressing problems around access to care, in addition to the quality of care, must include an independent assessment of what is and isn’t currently working, and where the major shortfalls are, Abbott said.
An independent inquiry, which carried out that assessment, could be undertaken by the Mental Health Commission once it was reestablished. Alternatively, a Royal Commission of Inquiry, or even a Ministerial Inquiry, could be triggered, he said.
Ross Bell, executive director of the New Zealand Drug Foundation, agreed reestablishment of the Mental Health Commission was needed, and also emphasised the need for broader interaction between alcohol and drug addiction services, and drug policy.
As part of the Greens confidence and supply agreement with Labour, also released yesterday afternoon, the development of legislation which directed drug-use be treated as a health problem has been prioritised in the incoming Government’s agenda.
And while Labour had already promised to address current rules which restricted access to the cannabis, and associated products for medicinal purposes, the Greens have further advanced this area of drug reform by planning a referendum on “legalising the personal use” of the drug before the next election.
“What New Zealand would need is a significant investment in drug treatment to eliminate treatment waiting lists, and give people help when they need it.”
Ross Bell, NZ Drug Foundation
Bell, whose organisation has spent a decade advocating for a shift away from drug policy rooted in a criminal-justice model, to one that was “health-focused”, said while a public referendum wasn’t ideal, it may just be what is needed to achieve long-overdue changes to New Zealand’s drug policy.
“In terms of a referendum – it’s not perfect law-making, but it could provide the kind of cover that politicians want when it comes to drug-law reform,” he said.
“However, 2020 is a long way away for there to be referendum, and any lawmaking will occur on top of that [time period]. We want to see drug reforms happen much more quickly – and probably in areas less controversial than legalising cannabis.”
Bell pointed to a “Portugal model” of drug reform for New Zealand to explore. In 2001, the European nation decriminalised all drugs. Significant to that decriminalisation process was the simultaneous reallocation of Government resources and funding into drug and addiction prevention and treatment.
“They [Portugal] saw drug use go down, particularly drug use amongst young people – which is a good example of how you can combine investment in health services, like drug treatment, with drug law reform,” Bell said.
“What New Zealand would need is a significant investment in drug treatment to eliminate treatment waiting lists, and give people help when they need it, as well as providing more help in the community [setting]. That needs to be combined with a Portugal model of decriminalisation and health-referral, and then ultimately putting in strict regulations…around public health over things like cannabis.”
According to the Drug Foundation, 80 per cent of the what the New Zealand Government spent on dealing with drugs was dedicated to law enforcement, with the remaining 20 per cent going towards addiction treatment.
Bell said in addition to increasing support for drug-treatment, lawmakers needed to signal to police that referring people for help around drug and substance problems was preferable, and more effective, than arrest and conviction.
“Re-instating the Mental Health Commission will help in this, and shape the way we deal with mental health and addiction problems.”
Concerns raised by communities desperate for help around drug dependency and harm also needed to be properly acknowledged and addressed in any drug policy reform process, he said.
“There are some communities that don’t even have waiting lists [for drug addiction services] because they don’t have any of those services available. We’ve already been talking to the Government about this issue – how do you get more resources out to those communities now to deal with the concerns they have around methamphetamine, but also long-term cannabis dependency?” Bell said.
Feedback from school principals, parents, and mental health workers in those communities outlining the harm cannabis caused, as well as the link between the drug and mental health, had to be put in context if a genuine, national discussion around drug reform was to take place, he said.
“[We have to remember] that those real harms from cannabis exist right now, under the current approach.They are a result of successive Government’s failure to deal with the drug problem properly. Since 1975, we have been trying to fix that problem from a criminal justice approach with the Misuse of Drugs Act, and it just hasn’t worked,” he said.
“Quite often though, the harms that communities would attribute to ‘the drug’ are often the result of our failed prohibition approach. When you scratch the surface, those communities [dealing with drug harm] are actually talking about the drivers of drug problems, which is poverty, social exclusion, inequality, lack of education, lack of jobs.
“Hopefully, this Government will situate the drug problem within that larger social and economic context,” Bell said.