Editorial: Government's mental heath inquiry brief too broad

Feeling pain and depression. Photo / 123rf

Reading its terms of reference, you might wonder why the Government needs an inquiry into mental health care in this country.

A lengthy preamble outlines the problems identified in numerous previous reports and on our own investigation of youth suicide last year, "Break the Silence", which highlighted many deficiencies in mental health services including the official discouragement of discussions of suicide in schools and the media.

The new Government's directions to its inquiry team list a range of known problems such as limited access to services and long waits, too few treatment options, ineffective responses to people in crisis and underfunding in the face of rising demand.

About 20 per cent of New Zealanders are believed to suffer a diagnosable mental disorder each year and half of them receive no treatment, either because they do not realise their need or the service lacks the capacity to treat them. Mental disorders vary from distress to enduring psychiatric illness and all can involve drug abuse, hence the late addition of addiction to the already wide ambit of the inquiry.

If the exercise is to be worthwhile, and meet its October deadline, the panel, led by a former Health and Disability Commissioner, Ron Paterson, will need to take a great deal of knowledge as read. For example, the Government already knows risk factors for mental health include poverty, inequality, inadequate parenting, lack of affordable housing, low paid work, exposure to abuse, neglect, family violence, social isolation and discrimination. It says so in the terms of reference.

It also says "the inquiry will need to understand and acknowledge the wider social and economic determinants" and adds "commentary on these matters is welcome to help inform the Government's work programmes in these areas". Really? The Paterson panel will have its work cut out reviewing services for the full range of mental illnesses in the time available without producing a treatise on every other social problem.

The country needs a report clearly focused on ways to alleviate and prevent serious mental illness though even there, the Government observes practical steps are already being taken.

Funding has risen for alcohol and drug addiction services and frontline health workers, more nurses are being put into schools, free medical attention is available for children under 14 and free counselling for anyone under 25. The Paterson inquiry needs to tell us whether that money is being well spent, and whether more effective mechanisms exist for early detection of mental illness.

This subject is too important for time and money to be wasted going once more over well-traversed ground. We have the highest youth suicide rate in the world and something is seriously wrong. Our society and economy is not so different from many countries with better rates.

The inquiry needs to compare our approach to the problem with the approaches of others and tell us what is unusual here. Our Break the Silence series raised questions that do not appear to have been referred to the inquiry. It might need to plot its own course.