Te Huringa: Change and Transformation. Mental Health Service and Addiction Service Monitoring Report 2022

Key information 

Te Huringa is our first mental health services and addiction services monitoring report, following transfer of the service monitoring function from the previous Mental Health Commissioner to Te Hiringa Mahara. It shows the performance of mental health services and addiction services between 2016 / 17 and 2020 / 21.

The report covers mental health services and addiction services funded by the public health system, including the following: 

Primary mental health services and addiction services that are provided within a general practice – this includes extended general practitioner (GP) or nurse consultations, brief psychological interventions, individually tailored packages of care (which cover a variety of services, such as cognitive behavioural therapy, medication reviews, counselling, and other psychosocial interventions), and group therapy.

Specialist mental health services and addiction services funded by DHBs or the Ministry of Health – these services are provided by DHBs or NGOs. Specialist services include a range of services for people experiencing moderate to severe mental illness or psychological distress. They include acute inpatient services, community-based services, talking therapies, and forensic services. Most specialist services are delivered in community settings rather than inpatient or forensic settings.

The report shows that there has been little evidence of improvement in services over the past five years and little change in wait times for specialist mental health services. Wait times for young people to access specialist mental health services continue to be well below target.  Furthermore, the wait times for addiction services have increased over the past five years. 

Despite calls in 2018 from He Ara Oranga(external link) to minimise coercive treatment, our measures show an overall increase in the use of solitary confinement (seclusion) and no decrease in the use of community treatment orders.

The findings and a list of changes we want to see can be found in the report's overall summary.

Access and Choice programme providing additional services for tāngata whaiora  

The access and activity measures in Te Huringa related to the existing DHB funded primary mental health services, and did not include access to the new services that are part of the Access and Choice programme. This is because there is no accurate data for the total number of people using the Access and Choice services for the period covered in this report. The percentage of the total population accessing DHB funded primary mental health services is between 2.7 – 3.0 % over the last five years reported. 

Our recent report(external link) into the Access and Choice programme found that the programme has put much-needed investment into primary and community care. The programme intends to provide 325,000 people (6.5 % of the total population) with mild to moderate mental health and addiction needs with free and immediate support.

Background

We released Te Huringa: Change and Transformation. Mental Health Service and Addiction Service Monitoring Report 2022 [PDF, 888 KB](external link) on 22 March 2022. Te Huringa monitors the performance of mental health services and addictions services between 2016 / 17 and 2020 / 21. Te Huringa describes what is working well, what is not, and how this has changed over time.

Te Huringa found that:

  • The mental health and addiction sector is continuing to provide services at pre-pandemic levels. Access to specialist mental health services and addiction services has not changed over the past five years.​ Use of telehealth and digital supports is increasing as they become more available, and access to primary mental health services has increased over the past year (in addition to Access and Choice programme).
  • There is a lack of current prevalence data on mental health needs and addiction needs​
  • Wait times for young people to access specialist mental health services continue to be high
  • Māori continue to disproportionately experience higher rates of community treatment orders and solitary confinement (seclusion)
  • The number of community treatment orders has increased proportionately with specialist mental health service use over the past five years​
  • There has been an overall increase in the use of solitary confinement from 2016 to 2020. Progress toward zero seclusion differs between DHBs ​
  • 1 in 5 people are not followed up after discharge from acute inpatient mental health units, with 1 in 6 re-admitted to hospital within 28 days of discharge

You can read the news story that accompanies our report on our website news page(external link)(external link)

Te Huringa is a transitional report that monitors services using an adapted version of the former Mental Health Commissioner’s framework, while we develop our monitoring framework He Ara Āwhina (Pathways to Support). 

Our He Ara Āwhina framework was released on 30 June 2022.

Te Rau Tira Wellbeing Outcomes Report 2021

We released Te Rau Tira Wellbeing Outcomes Report 2021 [PDF, 9 MB] on 8 December 2021. Te Rau Tira introduces our vision to improve wellbeing for communities in Aotearoa New Zealand.

Our report measures wellbeing through our He Ara Oranga Wellbeing Outcomes Framework(external link), which was developed alongside communities and created with people with lived experience of poor wellbeing. It reflects what people say matters to them.

Our report found that:

  • most communities in Aotearoa New Zealand tend to experience good wellbeing, most of the time
  • a concerningly large minority of people and communities experience persistently poor wellbeing
  • most marginalised groups looked at, such as young people, veterans, rainbow communities, Māori, Pacific peoples, former refugees and migrants, children in state care, older people, rural communities, disabled people, prisoners, and children experiencing adverse childhood events, felt life is less worthwhile, and reported less security, poorer mental and overall health, and greater discrimination and barriers to wellbeing
  • there is a positive story of the growth of Māori collective strength, and oranga / wellbeing
  • at the same time, there continues to be a disproportionate number of Māori individuals and whānau who are not doing well and are experiencing poor wellbeing across multiple dimensions.

We will use our He Ara Oranga wellbeing outcomes framework to continue to monitor, report on, and advocate for improved wellbeing for the whole community, particularly for people with highest need and those who are disproportionately experiencing inequity.

You can read the news story(external link) that accompanies our report on our website news page(external link).

Acknowledgements

We wish to thank and acknowledge everyone who has contributed to this work, without which this report would not have been possible.

We are grateful to all those who participated in the definition phase of the He Ara Oranga Wellbeing Outcomes Framework that guides this report, including the Initial Commission(external link), the Expert Advisory Group(external link), and the many organisations that provided input and feedback.

Access and Choice Programme progress report 

Our independent report on the Access and Choice Programme(external link) highlights the importance of improving access and choice for mental health and addiction services in New Zealand. Access to these services when they are needed, and giving people a diverse choice of services, are vitally important for the successful long-term transformation of mental health, addiction, and wellbeing systems in Aotearoa.

The Access and Choice programme has a particular focus on people with mild-to-moderate mental health and addiction needs. It aims to improve access to primary mental health, wellbeing, and addiction services, including in Kaupapa Māori, Pacific, youth, general practice, and community settings.

The report has found that the programme has put much-needed investment into primary and community care in line with many of the recommendations in He Ara Oranga: Report of the Government Inquiry into Mental Health and Addiction(external link)(external link), enabling important services to be provided.

The overall programme is on schedule, with the rollout of integrated primary mental health and addiction services proceeding as planned. However, we would like to see the rollout of services for Māori, Pacific peoples, and youth accelerated. We also want outh services prioritised and delivered in ways and settings that are acceptable and accessible to young people.

Our key findings show that as of 30 June 2021, there are:

  • Integrated Primary Mental Health and Addiction services available in 237 general practices, across 16 district health boards (DHBs)
  • 12 Kaupapa Māori services across 11 DHBs
  • Nine Pacific services across seven DHBs
  • 18 Youth services across 15 DHBs, including the expansion of Youthline nationally.

For the news story that accompanies this report, click here(external link).

Acknowledgements

We would like to thank our external peer reviewers for their guidance and advice, and the time they gave to strengthen our report.

We gratefully acknowledge the efforts of our peer reviewers:

  • Dr Julie Wharewera-Mika
  • Dr Sarah Appleton-Dyer

We are also extremely thankful to the people with lived experience of mental distress or addiction (or both), and service providers who have shared their perspectives and experiences of the Access and Choice programme. 

 

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