Hon Pete Hodgson
Minister of Health

09 March 2007 Speech
Mental health: the work continues

“Te Haererenga mo te Whakaoranga 1996 – 2006: The Journey of Recovery for the New Zealand Mental Health Sector” is a challenging publication.

It challenges our idea of what a record of developments in mental health services over the decade since publication of the Mason report should look like. It will also challenge some of us with its analysis and about the path forwards for development of mental health services over the next decade.

None-the-less, as the sector moves into a second decade of the development through Te Tāhuhu and Te Kōkiri (the second national mental health plan and its accompanying implementation plan) it is timely that we take stock and assess the challenges ahead of us.

Te Haererenga tells the story of the development of mental health services in New Zealand from the launch of the National Mental Health Strategy in 1994 through to the launch of Te Tāhuhu – Improving Mental Health 2005-15: The Second Mental Health and Addiction Plan, launched in June 2005.

Te Haererenga highlights key elements of the development of services over the last decade, some of it through data, but much of it through the voices of those have been involved. This includes the voices of those who use services, and their families and whānau, alongside the voices of service providers and policy makers. The inclusion of these voices brings the document to life.

Te Haererenga is not a straightforward record of developments over the last decade. Such a record would have been useful, as a reminder of where we have come from, and what path we took, and what false steps we took also. Such a record could well sit on shelves in libraries and be soon forgotten.

Te Haererenga is more than this; it gives us a good sense of the path we have taken but, importantly, it also identifies a range of issues we will have to address as we take the development of mental health services forwards over the next decade, and it sets out a number of challenges that will need wide discussion within the sector over the next few years.

The report recognises and celebrates the significant achievements in the mental health sector over the past decade. In particular, it:

- notes that mental health services became more responsive to service user needs during the decade

- notes that the past decade has been a time of increased quality service development

- celebrates the progress towards achieving the vision of recovery, and Whānau ora

- notes New Zealand has become a more socially inclusive society for people with experience of mental illness

- pays tribute to the role of the mental health workforce, families and Whānau and service users in supporting the vision of recovery, whānau ora and social during the past decade

- notes this major transformation for the mental health sector could not have happened without the vision and support from successive Ministers of Health, and significant investment to fund the expansion of services by their governments.

Access to services is examined in some detail. The Commission notes that:

- while access figures have not reached targets, a better range of quality services have been developed during the decade

- once individuals access services they are being referred to a wider range of services

- there is evidence that the number of contacts that individuals accessing mental health services receive has increased.

More and better was the goal of the first NMHS, published in 1994, and we appear to have managed that and it is reasonable that we argue the merits or better versus more, and vice versa. Indeed, we need to be able to form a clear picture of how much of “more” and of “better” we have got. The variation in findings between Te Haererenga and my December 2006 report on implementation of the New Zealand Health Strategy illustrate that we have some way to go in forming such a clear picture.

As the sector moves forwards we will collectively need to take considerable care to ensure we are consistent in the way we define performance expectations and measure performance against those expectations.

I want to acknowledge those who make up the mental health workforce, and those who support development of the workforce. The last decade has been a time of rapid development which has placed extra pressure on the workforce. There have been major initiatives launched to support development a more skilled, qualified and competent workforce; the workforce is to be commended for their role in the development of the sector.

I also want to acknowledge the achievements or the many non-governmental providers of mental health services. Without the efforts and enthusiasm of providers we would not have seen such a growth in diversity of mental health service settings as have emerged in recent times.

Te Haerenga that raises some challenges around the rights of those with mental illness, and the operation of the statutory framework for protecting their rights. These are issues that need to be debated.

In conclusion, there will be much in Te Haerenga that most readers will agree with; there will be some findings that some will take heart from and that others will take issue with. There will be ideas for the future that some will embrace but that others will reject.

The challenge for the Commission and for the sector will be to ensure the debate Te Haerenga generates takes us forwards on a path consistent with the goals established in Te Tāhuhu, the second national mental health plan.

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Draft Foreword: “Te Haerenga mo te Whakaoranga 1996 – 2006: The Journey of Recovery for the New Zealand Mental Health Sector”

“Te Haerenga mo te Whakaoranga 1996 – 2006: The Journey of Recovery for the New Zealand Mental Health Sector” is both an interesting and an important publication.

Te Haerenga tells the story of the development of mental health services in New Zealand from the launch of the Looking Forward: the National Mental Health Strategy in 1994 through to the launch of Te Tāhuhu – Improving Mental Health 2005-15: The Second Mental Health and Addiction Plan in June 2005. Te Haerenga highlights key elements of the development of services over the last decade, some of it through bald data, but much of it through the voices of those have been involved, including the voices of those who use services alongside the voices of policy makers. This brings the document to life.

Te Haerenga is not a straightforward record of developments over the last decade. Such a record would have been useful, as a reminder of where we have come from, and what path we took, and what false steps we took also. It is more than this; it gives us a good sense of the path we have taken, but more importantly it identifies a range of issues we will have to confront as we take the development of mental health services forwards over the next decade.

There will be much in Te Haerenga that most readers will agree with; there will be some findings that some will take heart from and that others will take issue with. There will be ideas for the future that some will find difficult to accept but that others will endorse.

The challenge is to debate the lessons of the past and the ideas presented in Te Haerenga as we move forwards with implementation of Te Tāhuhu – Improving Mental Health 2005-15: The Second Mental Health and Addiction Plan.

Te Haerenga tells a good story and raises a number of issues that will be debated for some time. But the truth is, although we can and no doubt will argue about how much progress has been made, we now have substantially more and better mental health services than was the case a decade ago.

Looking further forward, the question we must ask is how do the findings set out in Te Haerenga, and the challenges it raises, inform our path into the future as mapped out in Te Kōkiri: The Mental Health and Addiction Action Plan 2006-2015?

Thank you.

ENDS

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