Seventy-two people are waiting for mental health support at the Lakes District Health Board, prompting fears some could "lose their lives".
The Mental Health Foundation said some who were "significantly distressed" could die if they did not get the support they needed.
But a Rotorua mental health service manager said the number of people waiting for a face-to-face appointment was "not unreasonable" and challenges posed by Covid-19 had impacted the amount of face-to-face contact that could occur.
The Lakes District Health Board said although wait times had increased "somewhat," the 72 people waiting for first face-to-face contact were still within Ministry of Health timeframes.
The board said 95 per cent of people received their first face-to-face contact within eight weeks of referral and 85 per cent of people within three weeks of referral.
Data obtained from the Lakes District Health Board under the Official Information Act showed as of May 2, 36 people were waiting for adult mental health treatment and 36 for infant, child and adolescent mental health treatment.
Data also showed two patients from the Mental Health and Addiction Service for Older People had died after they were triaged, or sorted by priority, but before receiving mental health treatment in the past six years.
The average wait time for a first specialist appointment last year was 21 days and there were 296 admissions to the board's adult mental health inpatient unit, Te Whare Oranga Tangata o Whakaue, last year.
Mental Health Foundation chief executive Shaun Robinson said one was "one too many" for those waiting for face-to-face appointments.
When people were "significantly distressed" and did not get support, in some cases, people could lose their lives.
"It's just not good enough."
He said district health board services were "pretty much slammed" with demand, which made him "very frustrated and angry" for people who needed support and their families.
Robinson said there had been "decades and decades" of neglect of mental health in New Zealand.
He acknowledged the Government's investment in providing mental health services "earlier" - before people became extremely distressed.
"However, it's not enough, it's not comprehensive and it's not well planned. And it's not funded enough."
He said there needed to be an "integrated" implementation plan and an investment strategy to go alongside it, as mental health was the biggest health issue in New Zealand next to Covid.
"Every indication is that the Covid-19 pandemic is actually exacerbating mental health demand."
A Lakes District Health Board spokesperson said the longest average wait time for a face-to-face appointment in 2020 was 24 days, which was "very likely" impacted by sudden service changes when Covid restrictions were introduced.
During the triage process, treatment options were discussed, including e-mental health resources which could form part of treatment prior to first face-to-face contact.
"The district health board always aims to see people within the shortest available timeframes and this includes streamlining processes such as triage, caseload management and care planning."
Piringa Mental Health Support in Rotorua provides rehabilitation and accommodation for people recovering from mental illness.
Manager Joyce Fowler said the number of people waiting for a face-to-face appointment was "not unreasonable" in light of health expectations today.
She said the figures seemed to be "trending down", which was a testament to the Lakes District Health Board.
Challenges throughout the pandemic had impacted the amount of face-to-face contact that could occur, she said.
In the neighbouring Bay of Plenty District Health Board, data obtained under the Official Information Act showed as of April 29, 488 people referred to mental health and addiction services in the Bay of Plenty had been triaged but not yet seen face-to-face.
A caveat to this data was that non-face-to-face contact may have occurred after triage to support their needs and some referrals may not have been closed.
Ministry of Health deputy director-general of mental health and addiction, Philip Grady, said it was working to improve and transform the mental health and addiction system.
"I don't think you'd find anyone working in the sector right now would say things are where they need to be."
Grady said an important part of improving the system was ensuring people had a wide range of support, including face-to-face as well as telephone services, apps and online support, or through community groups.
"There is definitely pressure on specialist services, and our work to ease this pressure includes investing in growing the mental health and addiction workforce and working with DHBs to address areas that contribute to demand on specialist beds."
DHBs in Canterbury, Waitematā and Counties Manukau were providing community-based "acute alternatives" to inpatient services and a community-based crisis service had been established in Hawke's Bay.
Waikato and Auckland DHBs were running a pilot plan to support homeless people to be supported into community-based alternatives, Grady said.
A total of $472.3 million had also been invested into projects through the Government's Mental Health Infrastructure Programme. The Ministry's Access and Choice programme, which focuses on primary mental health and addiction services, was free and did not require a referral.
"We know there is more work to do, and part of this work is ensuring people get access to support early, before their needs and mental distress becomes acute."
Health Minister Andrew Little said the Government was "building a whole new mental health system because we take the mental wellbeing of New Zealanders seriously".
"Many parts of the health system have been underfunded for so long there is a lot of catch up to do. We have prioritised mental health but know there is still more to do in this area.
He said the 2018 He Ara Oranga report found the largest gaps in mental health services were in the primary and community sector, so that was where the Government made "the biggest investment in mental health in New Zealand's history" in Budget 2019.
He said it was still too difficult for some families to get help, in part due to too little support to stop problems escalating.
There were now real services to help stop more people from falling through the cracks, he said.
"We've put mental health help at local doctors and schools around the country, as well as universities, online, on the phone and through smart apps. This means more people are being seen and referred to the help they need.
"The latest data I've seen shows 80 per cent of people had their first face-to-face contact with mental health services in the first three weeks, and 94 per cent of people were seen within eight weeks."
He said there was still a lot to do for people with the highest needs.
"Fixing these services is the next step."
Where to get help
If it is an emergency and you feel like you or someone else is at risk, call 111.
For counselling and support
Lifeline: Call 0800 543 354 or text 4357 (HELP)
Suicide Crisis Helpline: Call 0508 828 865 (0508 TAUTOKO)
Need to talk? Call or text 1737
Depression helpline: Call 0800 111 757 or text 4202
For children and young people
Youthline: Call 0800 376 633 or text 234
What's Up: Call 0800 942 8787 (11am to 11pm) or webchat (11am to 10.30pm)
The Lowdown: Text 5626 or webchat
For help with specific issues
Alcohol and Drug Helpline: Call 0800 787 797
Anxiety Helpline: Call 0800 269 4389 (0800 ANXIETY)
OutLine: Call 0800 688 5463 (0800 OUTLINE) (6pm-9pm)
Safe to talk (sexual harm): Call 0800 044 334 or text 4334
All services are free and available 24/7 unless otherwise specified.
For more information and support, talk to your local doctor, hauora, community mental health team, or counselling service.
A disregard for authority could be why those attending court are thumbing their noses.