The future of primary mental health care
A think tank convened by Te Hiringa Mahara created space for ‘blue sky’ thinking about the future role primary and community care can play in supporting people with mental health and substance use needs. To share the outcome of the think tank workshop held in August 2025, we have published a short paper.
The paper documents the discussion which answered two provocative questions:
- What does the primary care landscape need to look like?
- How do we get there?
This discussion followed the release in April 2025 of our final monitoring report on the Access and Choice programme. During development of the report we heard extensive feedback from people with lived experience, whānau and the broader sector about the wider primary care landscape.
Participants expressed strong support for the need for continued Access and Choice programme funding and approach as part of this future system. Other components of an effective landscape noted down include:
- Community oriented, locally-led and flexible
- Integrated across key boundaries – both horizontally with community services and vertically with specialist services
- Access to primary care needs to be fast and accessible
- Mental health and physical health needs are intertwined, and responses need to be holistic with a wellbeing focus
- Support empowers people and their whānau
- A greater focus on social determinants could reduce demand for primary and community health services.
Further work to achieve this vision needs to include:
- Funding and commissioning approaches that support change
- Evaluating impact of existing and new services
- Recruit and upskill a broad workforce
- Prioritise the enabling systems
- Build from existing strengths and innovation, including refinement of Access and Choice.
We will build on these insights to inform future development of primary responses to mental health and substance use needs.
Think tank participants were: Kevin Hague, Hayden Wano, Karen Orsborn, Sonya Russell (Te Hiringa Mahara), Bryan Betty (General Practice NZ), Darryl Bishop (Ember Korowai Takatini), David Codyre (Tamaki Health), Glynis Sandland (Whakarongorau), Helmut Modlik (Te Rūnanga o Toa Rangatira), Kevin Harper (Changing Minds), Luke Bradford (Royal New Zealand College of GPs), Phil Grady (HealthNZ), Shelley Campbell (Wise Group), and Professor Tony Dowell (University of Otago).