New primary mental health and addiction support provides a welcome expansion, but gaps remain – new report

There have been significant changes in access to mental health and addiction over the past five years a monitoring report released today by Te Hiringa Mahara - Mental Health and Wellbeing Commission shows. The new report, Kua Tīmata Te Haerenga | The Journey Has Begun, provides the most up-to-date picture of the system available.

More New Zealanders are accessing mental health or addiction support from a GP or other primary health provider. The Access and Choice programme, newly established in 2019/20, provided support to around 186,000 people in 2022/23.

However, the number of people accessing specialist mental health and addiction services has decreased over a five-year time frame. In 2022/23, 3.4% of the population accessed a specialist service, a decrease from 3.8% in 2018/19. This is a drop of 9,000 people using these services. Of those seeking specialist support the decrease for addiction services is higher than mental health services.

“There is now an expanded range of services for people seeking initial help with their mental health or addiction through GPs and other primary services and this is a real positive. There remains much more to do to ensure that those needing a higher level of care get the support they need,” says Karen Orsborn, chief executive of Te Hiringa Mahara.

“It is a real step forward that a significant number of people are getting early access to help. At the same time, we continue to hear that demand is increasing and people are reporting difficulties getting access to higher levels of care such as specialist services when needed.

“If you can’t get help in one part of the system you’ll invariably turn elsewhere. For instance, emergency responses continue to see increasing mental health related calls.”

“We have got to do more to ensure everyone requiring a higher level of care gets the support they need. Focused attention is now required on addressing this problem.”

The report shows mounting pressure on specialist services. This is primarily related to acute workforce shortages in specialist services and is compounded by having more complex cases. For example, vacancies rates sit at 22% for psychologists and 19% for psychiatrists.

“What we’re seeing is that under-pressure services have constraints on how many people they can see, with some people not meeting the threshold to access specialist services. Some people can get continued care with primary services but this isn’t available or appropriate for all. When people finally do see a service, often their level of need has become higher. It’s a vicious circle that we need to break,” Orsborn says.

For Māori, we heard high levels of frustration and disappointment after many failed attempts to access services, and failure to get the care they need has resulted in a loss of trust. This has been reported by the Commission previously and we again call on services to meet the needs of Māori.

The report shows rangatahi and young people face significant barriers to access appropriate support. They have the longest wait times for getting access to specialist services of any age group.

Across the whole population, there is a continued increase in psychological distress experienced by New Zealanders.

“The challenges we face as a society show no sign of abating and we need to be able to respond,” Orsborn says.

“Based on this new report, we now better understand what is happening across the system. Our report offers five recommendations that put the spotlight on where we can improve access and options available for people seeking support.”


Kua Tīmata He Haerenga | The Journey Has Begun report June 2024

Voices report: Accompanying report to Kua Tīmata Te Haerenga June 2024 

Update monitoring dashboard