Major mental health, addiction treatment shift proposals would extend 'young adult' treatments to age 25

A focus on the first thousand days of life and extending young adult treatment options until people turn 25 are among proposed mental health and addiction service reforms.

And people with personal experience of mental health distress could help lead, deliver and partner with colleagues to transform the system.

Ministry of Health officials predicted how mental health and addiction services would look in ten years' time, and made the suggestions in a new discussion paper.

The mental health and addiction system and service framework (SSF) draft identified ways to potentially improve addiction and mental health services.

One proposed shift involved focusing on the first thousand days of life, with specialist infant and perinatal mental health services.

These services could possibly stand alone, or have specialist expertise integrated into other areas such as specialist child and youth mental health services.

The paper said services for young adults should be developed in line with recent evidence on human development which recognised that adulthood did not begin until the late 20s.

It proposed youth not have to transition to adult services until turning 25.

Another shift involved building peer-led transformation.

That meant people with experience of mental health distress would help lead, deliver and partner with colleagues to transform the system.

"People with lived experience of distress will form the heart of the future system of services," the paper added.

University of Auckland Psychology Professor Ian Lambie said extending youth adult treatments to 25 and focusing on the first thousand days of life were both good ideas.

"As an overarching thing, it's very good to hear they're using what the evidence suggests to guide policy."

He said the frontal lobe of the brain wasn't fully developed until the mid-20s.

"It largely focuses on impulse control, executive function...being able to be more considered and think through the consequences of your actions."

Lambie said policies which prioritised early intervention were also laudable.

Green Party mental health spokeswoman Chlöe Swarbrick welcomed the draft paper but said some big gaps remained around approaches to addiction. Photo / Dean Purcell

"It's really clear that we need to have more investment at the early stages of everyone's life," Green Party mental health spokeswoman Chlöe Swarbrick said.

"Obviously it is really good to see on paper what the pathway looks like," she said of the SSF.

"But there are still some really glaring gaps, particularly around addiction."

Swarbrick said the paper should also have addressed foetal alcohol syndrome.

"That has been languishing with successive Governments."

And she said it was important drug abuse was treated as a health issue.

National's mental health and suicide prevention spokesman Matt Doocey also welcomed the proposed focus on early childhood.

"We do know there's a real window of opportunity around the first thousand days," he said.

"Unfortunately for mental health, we invest more money later in life."

Doocey supported suggestions young adult services continue to age 25.

"For young people, going into adult services too early is actually detrimental. Quite often they drop out of adult services."

Doocey said it was important to view promoting mental well-being as a parallel workstream to addressing mental illness.

Ree George, a health coach specialising in mental fitness and addiction, lost her older brother to suicide in 2008 when he was 32 years old.

She previously experienced depression herself and said it was sensible for people with lived experiences of distress to play a central role in mental health services.

She is studying for an advanced certificate in mental health through PreKure, and believed mental health and addictions coaches were an emerging solution to some treatment gaps.

"We have the time, the knowledge and the skill set to help people early on, rather than waiting till their problems are firmly established."

She said even for people older than 25, there was also hope for mental health improvements through behavioural changes and better lifestyle choices.

This hope was partly due to neuroplasticity - the brain's ability to change and adapt.

The draft Ministry of Health paper also highlighted how factors including income, housing, employment and education influenced wellbeing.

It called for all people in New Zealand to have access to resources and live in healthy environments conducive to mental wellbeing.

"Substance-related harm, mental health issues and distress occur within a cultural, social, spiritual, environmental and economic context," the SSF added.

The system should provide pathways for people to get holistic support, acknowledging most people would be able to cope without formal mental health and addiction services.

The draft is intended to prompt discussion and be refined after feedback from the mental health sector.