Transforming the mental health and addiction system must remain a priority as Aotearoa New Zealand continues to deal with the fallout from the pandemic, writes Karen Orsborn.

Covid-19 is one of the most significant societal events many of us will experience in our lives. It is not over yet, and people will continue to be affected for some time to come.

Aotearoa New Zealand's responses to it will continue to evolve. An essential part of the early response was to isolate people and family units. This is the prudent action when dealing with an infectious disease and kept many people in Aotearoa safe during the worst of the Covid-19 outbreak.

For some people the responses that have kept them safe have also contributed to loneliness and isolation, disconnecting them from family, whānau and friends. For some, it has meant a reduction in the support and services needed to live safely, with dignity and to flourish, or a reduced ability to take part in their community for fear of becoming seriously ill.

It hasn't stopped there. For others the pandemic has changed their lives completely, perhaps through leaving education, becoming unemployed, or contracting long Covid. For those people, their future wellbeing, and hopes for a better life, have been severely curtailed.

The ongoing wellbeing impacts of Covid-19 are yet to be seen. For many, longstanding inequalities were exacerbated. Households with incomes of less than $30,000 have been most likely to lose jobs and income, with higher rates of job loss for Pacific and Asian people. Experience from past downturns shows us that more economically vulnerable populations, including people with a health condition, disability or mental health diagnosis, tend to recover more slowly from employment shocks.

The response to Covid-19 had a significant impact on women and wāhine in Aotearoa. Rates of gender-based discrimination against women increased, largely owing to job losses and the unequal sharing of parenting and childcare.

Māori and Pacific peoples overall bore the early brunt of Covid-19. Many people in these communities worked in essential and frontline roles, resulting in high Covid-19 case numbers. They also experienced high levels of racism and discrimination on social media during lockdowns, which intensified existing social and economic disparities for those communities.

Lockdowns hit some groups particularly hard. LGBTQI+, Māori, Pacific peoples, and people with disabilities reported feeling unsafe within their bubbles over these periods.

Young people reported much higher levels of psychological distress than in previous years, and have been particularly affected by job loss, anxiety, and stress about education.

We also know that service providers for whānau and for sexual violence reported increases in demands for support, and that there were significant unreported experiences of violence during lockdowns. Many of these impacts, while fundamental to people's lives, have not always been as visible as the immediate health impacts of contracting Covid and getting well again, but they are just as real.

Mental health services and addiction services have continued performing at pre-Covid-19 levels, which is a substantial achievement. Non-government organisations (NGOs), particularly kaupapa Māori and peer-support services, stepped up and provided increased support and outreach during lockdowns. These organisations were supported by the Government through faster access to funding and allowing services to act outside the confines of their contracts. This has created an opportunity to provide support to people who may not have received it otherwise.

However, while access to specialist services has not changed since the beginning of the Covid-19 pandemic, the Ministry of Health has reported people experiencing increased levels of distress during the pandemic.

The Comission believes that having better access and options for support is more important now than ever, because of the increased pressure Covid-19 has placed on people and communities and the health workforce that supports them.

We welcome recent funding in Budget 2022 to support people in need, and want to see continuing investment in youth services, as well as in kaupapa Māori services, peer services, and other community-based specialist services. Alongside this, we would like to see the Government engage more in high-trust and collaborative community approaches, giving NGOs, iwi, and other organisations the freedom to support their communities in the way that works best for them. Having access to the right kinds of support that work for different populations will be important to maintaining and improving wellbeing.

Beyond improving access to services, we need to adapt Aotearoa's ongoing Covid-19 response to support wellbeing. Wellbeing means much more than having access to services in times of distress – it means having connections to our families, whānau and communities, as well as having the environment and resources we need to thrive. It also means having hope and trust, and the freedom to flourish.

The Commission will focus on understanding the impacts of Covid-19 so that the response and recovery supports mental health and wellbeing. Over the coming year we will closely monitor emerging information, to understand what has happened, and how we can improve and transform the systems that support wellbeing in Aotearoa.

In the meantime, we urge the Government, particularly at this time of transition in the health system, to make sure transforming the mental health and addiction system remains a priority. We know how important mental health and wellbeing is to people and echo their calls for a continued focus on delivering tangible improvements and continued investment to lift the wellbeing of our communities, particularly those who have borne the brunt of the Covid-19 pandemic.

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