Kerre Woodham: Are our mental health services working?

The Access and Choice Programme, biggest investment in mental health in a generation, has now been in place for five years. The Mental Health and Wellbeing Commission released its final report on the programme rollout yesterday. The programme was funded from the 2019 wellbeing budget. You'll remember that, where more than a billion dollars, nearer to $2 billion, was committed to mental health support, to provide support for ‘mild to moderate’ needs relating to mental health and problematic substance use or gambling in primary care and community settings. That’s the official name for it. So you turn up to your GP, the GP says your corporeal self is not the issue, you need to shore up your mental wellbeing and instead of sending you away and then you have to make an appointment and wait, they can just hand you over to a mental health worker who's parked up right next door. It’s is a really sound idea in principle.  

Did it work? Is it working? The answer appears to be, looking at the report, up to a point, yes, it is. The number of people seen per year by services has increased steadily over the last five years to more than 207,000 for the 23/24 financial year, but it does fall short of the programs target of 325,000. CEO of the Mental Health and Wellbeing Commission, Karen Orsborn defended the program on the Mike Hosking breakfast yesterday and says the program is achieving what it's set out to do.  

“It does work. And we've heard some really, really positive feedback from the people who use these services. And so it is working for many people, it's just not getting to the number of people that it really needs to. And some of this is the way the service was designed – so having people in individual practices and people being able to access on the day and that's, there's not a steady flow of people always needing those services. So what we also need to use is some of the digital virtual tools to make sure that people are being fully utilised across the country. So there are some strengths in the model, but there's also some areas that need to improve.” 

And that's pretty much what the Minister for Mental Health Matt Doocey said when he spoke to Early Edition yesterday. He said that when he was in opposition, he was broadly supportive of the Access and Choice Programme, but since becoming Minister, he's seen ways to improve it and to broaden its reach.  

“Looking forward, I think part of the solution is going to be digitising the Access and Choice Programme, shifting it online so that will enable the staff to have higher utilisation rates and see more people. What I want to see is that programme rolled out further. We want to hit its target of seeing 325,000 people. Not only that, one of my first targets, I've set five targets for mental health —first time in New Zealand would have mental health targets— is for people to be seen within one week of the service, so I want more people to be seen and seen quicker.” 

I guess the questions I have are, given the conversations we've had around the lack of support for parents looking for help for their children, for people looking for help and dealing with their mental wellbeing is, is it fit for purpose? Are you able to access the help when you need it?  

When it comes to the substance abuse, that's one aspect of mental health and wellbeing. When it comes to the problem gambling, it's another, when you've got children who are in pain that's a whole other area. When you've got people who are just struggling with the day-to-day life, that's a whole other area as well. There are so many different ways, just as there is with physical ill health, that you can be mentally unwell. Are the services there for those who need it across the broad spectrum? 

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Episode Transcript

Speaker 1 (00:06):
You're listening to the Carrywood and Morning's podcast from news
Talks hed.

Speaker 2 (00:10):
Be Now the story got surpassed by events yesterday. She
was a busy old day yesterday, what with the tariffs
and Chris Hipkins, the letter of the Opposition and for
an hour. But this story is well worth revisiting. The
Access and Choice program, the biggest investment into mental health

(00:30):
in a generation, has now been in place for five years.
The Mental Health and Well Being Commission released its final
report on the program roll out, and that was released yesterday.
The program was funded from the twenty nineteen well Being budget.
You remember that where more than a billion dollars, like
nearer to two billion dollars was committed to mental health

(00:53):
support to provide support for mild to moderate needs relating
to mental health and problematic substance use or gambling in
primary care and community settings. It's the official name for it. Obviously,
the gambling wasn't in primary care and community settings. The
support was. So you turn up to your GP, the

(01:16):
GP says, your corporial self is not the issue. You
need to shore up your mental well being and instead
of sending you away and then you having to make
an appointment in waiting, they can just hand you over
to a mental health worker who's parked up right next door,
which is a really sound idea and principle. Did it work?

(01:36):
Is it working? The answer appears to be looking at
the report up to a point, yes, it is. The
number of people seen per year by services has increased
steadily over the last five years to more than two
hundred and seven thousand for the twenty three to twenty
four financial year, but it does fall short of the
program's target of three hundred and twenty five thousand. CEO

(02:01):
of the Mental Health and Wellbeing Commission Karen Osborne. Osborne
defended the pro on the mic Hosking Breakfast yesterday and
says the program is achieving what it's set out to do.

Speaker 3 (02:11):
It does work, and we've heard some really really positive
feedback from the people who use their services, and so
it is working for many people. It's just not getting
to the number of people that it really needs to.
And some of this is the way this service was designed,
so having people in individual practices and having people being
able to access on the day, and that there's not

(02:33):
a steady flow of people always needing those services. So
what we also need to use is some of the
digital virtual tools to make sure that people are being
fully utilized across the country. So there are some strengths
in the model, but there's also some areas that need
to improve.

Speaker 2 (02:48):
And that's pretty much what the Minister for Mental Health,
Matt Doosey said when he spoke to earlier edition yesterday.
He said that when he was in opposition, he was
broadly supportive of the Access and Choice program, but since
becoming minister he's seen ways to improve it and to
broaden its reach.

Speaker 4 (03:04):
Looking forward, I think part of the solution is going
to be digitizing the Access and Choice program, shifting it
online so that will able the staff to have high
utilization rates and see more people. What I want to
see is that program rolled out further. We want to
hit its target. I've seeing three hundred and twenty five
thousand people. Not only that, one of my first targets

(03:26):
I've set five targets for mental health, first time in
New Zealand would have mental health targets is for people
to be seen within one week of the service. So
I want more people to be seen and seen quicker.

Speaker 2 (03:38):
So I guess the questions I have are given the
conversations we've had around the lack of support for parents
looking for help for their children, for people looking for
help and dealing with their mental wellbeing. Is it is
it fit for purpose? Are you able to access the

(04:00):
help when you need it? This is for mild to
moderate mental healthcare. So you can be at the beginning
of the spiral, and that's the best time to get help,
before you write down at the bottom, or when you
think you're drinking, or you're gambling, or your drug use
is starting to get a little bit out of control.

(04:24):
How do I pull back from the brink? How do
I pull back from the edge? So it's for mild
to moderate. The people we've talked to in the past
when it comes to the parents who are looking for
help for their children, they've got children in crisis. They've
got kids who really are on the edge, who've been
brought back by police officers to the home. And then

(04:45):
all of a sudden, you are confronted with the horror
that your child has unraveled, has been unraveling for a while,
and you haven't been aware of it. They've been able
to hide it from you, and you need help, and
you need it urgently. You need it quickly? Is that
help there? That sort of help. You are someone who

(05:07):
has perhaps seen your business collapse, or has had a
marriage breakup, or for whatever reason, you're starting to find
it heavy going just getting out of bed, finding the
joy in life. You're feeling like everything is gray, nothing

(05:28):
is bringing you joy. Everything seems hopeless, and you think,
this isn't normal, this isn't how I normally feel. I
want to feel better. Is that the sort of help
you're looking for? This sort of access and choice service
that allows you to speak your mind to a practitioner.

(05:50):
Your GP says, yes, I can see what's going on here.
It's not your blood pressure and there's nothing wrong with
you physically. You need to see the mental health practitioner
next door and they'll give you some easy steps to
help get you back on track. The sort of thing
that they're doing. We also heard from people who wanted
to see a counselor or a psychologist, but the counselors

(06:15):
and psychologists told us that they had to give preferential
treatment to young Mary Young Pacifica. If you were a
thirty two year old Barkier mail, you are fresh out
of luck. You had to pay for it the others
did not. Are we stillium? I don't think mental health

(06:39):
discriminates in any way, shape or form. It is extremely egalitarian,
very broad church. And who it reaches is there's still
the preferential treatment of psychologists, counselors still having to turn
people away and say, look, I'm sorry, I know you
can't afford it, and I know that free counseling is
available for some people but not for you. Are we

(07:01):
seeing these sorts of demarcations. Have they been removed now
or I'm only going on what you have told me.
Over the past few years, we've had a change of government,
We've had a change of focus, We've had programs that
have become embedded. Are they actually helping? There are a

(07:23):
lot of people who are in a lot of mental distress,
of varying degrees. There are a lot of people who
are struggling with substance abuse. Do the online counselors help?
I mean, I look at my instapage and it's full
of all of these services that you can sign up
for that will help improve your mental wellbeing and help

(07:46):
you stop drinking and help you with your drug abuse.
You don't have to check yourself into a really expensive
rehab clinic. Do they actually work? You know, when it
comes to the substance abuse, that's one aspect of mental
health and wellbeing. When it comes to the problem gambling,

(08:07):
it's another. When you've got children who are in pain,
that's a whole other area. When you've got people who
are just struggling with the day to day life, that's
a whole other area as well. So there are so
many different ways, just as there is with physical ill health,
that you can be mentally unwell. Are the services there

(08:30):
for those who need it across the broad spectrum? Be
really interested to know.

Speaker 1 (08:35):
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