Te Huringa: Mental Health and Addiction Service Monitoring Reports

Te Huringa Tuarua: Mental Health and Addiction Service Monitoring Reports 2023

Key information 

Te Hiringa Mahara is producing a series of four monitoring reports Te Huringa Tuarua in 2023.

The reports are the mental health and addiction service monitoring report, accompanied by three focus reports on:

• compulsory community treatment orders
• kaupapa Māori services
• youth services.

Lived experiences of compulsory community treatment orders report | Ngā mātau ā-wheako o te whakahau maimoatanga hapori e whakaturehia ana - 12 July 2023

This report looks at compulsory community treatment orders (CCTOs) made under section 29 of the Mental Health Act 1992. The focus is on amplifying voices of tāngata whaiora, whānau, and family.  

We heard that the clinical review and the court hearing processes involved in CCTOs can silence or override tāngata whaiora and whānau perspectives. The report also documents how clinical reviews and court hearings marginalise Te Ao Māori and lived experience perspectives. 

The number of people subjected to a Compulsory Community Treatment Order under the Mental Health Act increased by 8% between 2017 and 2021.   

In the 2020/21 year, almost 7,000 people were under compulsory treatment in our communities. We also report that Māori are more likely to be subject to CCTOs than other populations in Aotearoa. 

Te Hiringa Mahara is calling for:

1/ Replacement of the law

• We want to see the new mental health law based on supported decision making, and embedding Te Tiriti o Waitangi and a Te Ao Māori worldview.

2/ Practices that need to change now under the current Mental Health Act 1992

• We want to see a reduction in the number of applications and outcomes granted for CCTOs, and a reduction in the rate of CCTO use.
• We want to see a reduction in the inequitable use of CCTOs for Māori and Pacific.

• We want to see services and courts implementing cultural and other practices that ensure tāngata whaiora as well as whānau and family perspectives are heard, and tāngata whaiora make the decisions about their care. 

Read the report [DOCX, 1.4 MB]

Kaupapa Māori services report | Te pūrongo ratonga kaupapa Māori  - 27 June 2023

The report provides an overview of investment into kaupapa Māori mental health and addiction services, sheds light on the significant disparities faced by Māori in mental health outcomes, and calls for the need for change to address these inequities. 

Despite increased investment in kaupapa Māori mental health and addiction services over the last five years, the level of investment into kaupapa Māori services remains at less than 11 per cent of the total mental health and addiction expenditure.

In addition:

• Māori, who make up 17 per cent of the population and have higher rates of mental distress than other populations groups, have been advocating for equitable funding for kaupapa Māori services for decades.
• The proportion of tāngata whaiora Māori accessing Māori specialist mental health and addiction services has decreased over the last five-year period from 30 per cent in 2017/18 to 26 per cent in the last financial year (2021/22).

To ensure a more balanced allocation of resources, we call for an increase in funding for kaupapa Māori services to address inequities in the funding model. This includes an allocation of any new mental health and addictions investment allocated to kaupapa Māori services.

We also advocate for a comprehensive mental health and addiction prevalence survey to strengthen evidence-based decision-making. Our He Ara Āwhina pathways to support framework will support this.

Read the report [PDF, 12 MB]

Mental health and addiction service monitoring report | Te Pūrongo Aroturuki i te Ratonga Hauora Hinengaro me te Waranga - 31 May 2023

This mental health and addiction service monitoring report is the main report that monitors across the breadth of national-level data. It aims to show what is working well and what isn’t in mental health and addiction services, how this has changed over time, and advocate for improvements.

This report uses a wide range of data to monitor service performance, along with other published information, and case-studies from exemplar organisations.

Overall there has been good progress with investment and increased access to primary services, although there has been a reduction in access to specialist services, increased prescribing and little or no change on many other measures

In addition:

• Fewer people used specialist services, primary mental health initiatives, telehealth and online services than the previous year, but many people are accessing new services being rolled out under the Access and Choice programme.
• Workforce vacancies in specialist adult mental health and addiction services have doubled between 2018 and 2022, and we want to see a clear strategy and roadmap to address growing workforce shortages.
• Coercive practices continue to be widely used, particularly for Māori and Pacific peoples. All services need to urgently address these inequities, and we want to see more by Māori, for Māori approaches, such as kaupapa Māori services
• There have been substantial increases in medication dispensing, particularly for young people, and this warrants investigation whether young people have a full range of treatment options available.

This report is accompanied by supplementary data tables including a subset of measures, and soon we will release our online dashboard with the full measure set. The subset of measures included in the supplementary data tables were chosen to support the report’s key findings.

Read the report [PDF, 18 MB]

Youth services focus report - Admission of young people to adult inpatient mental health services | Pūrongo arotahi ratonga taiohi - Te whakauru i ngā taiohi ki ngā ratonga hauora hinengaro pakeke ā-hōhipera - 17 May 2023

This report is the first of a series of monitoring reports that Te Hiringa Mahara is publishing in 2023.

This report examines the trends in admitting young people (aged 12 to 17 years) to adult inpatient mental health services in New Zealand and reflects on perspectives gained from discussions with young people, whānau and family.

We want to see zero admissions of young people to adult inpatient mental health services.

Achieving zero admissions of young people into adult inpatient services will not be easy. We need genuine commitment, leadership, and a comprehensive plan to make this happen. It is not too late to start, but we certainly cannot afford to wait.

At the heart of this report are young people and whānau who shared their experiences of adult inpatient mental health services. It is for them and future generations that we stand up for a better future of mental health support.

There must be investment in youth-specific acute alternatives, including kaupapa Māori services - residential alternatives to hospital based inpatient mental health care and short-term respite care. These services can provide appropriate treatment, and a supportive culture, where young people are safe and have hope for the future.

Read the report. [PDF, 6.4 MB]

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