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Budget 2019: Mental Health - Expert Reaction

The Government's 'Wellbeing Budget' includes a big boost in funding for mental health.

A $1.9 billion package includes:

• A new frontline mental health service, expected to help 325,000 people by 2023/24;

• $40m over four years for suicide prevention services;

• $200m ring-fenced funding for DHBs' new and existing mental health and addiction facilities.

The SMC gathered expert reaction to the Budget announcement. Please feel free to use these comments in your reporting.

________________________________________

Dr Dougal Sutherland, Clinical Psychologist, Victoria University of Wellington, comments:

"The Government has boldly announced a new 'universal frontline mental health service' that is aiming to reach 325,000 New Zealanders within three to four years. The question is, who will staff this service? Current estimates are that the psychology workforce sees about 200,000 people per year and another 200,000 are being seen by counsellors, social workers etc. In order to meet the Government’s target, this workforce would need to be doubled by 2023. Yet the Budget provides no details on how this will happen. Instead we are told we need to wait till later in the year.

"The Mental Health and Addiction Inquiry report repeatedly called for an increase in talking therapies, of which psychologists are experts in developing and delivering and which are ideal for those with mild-moderate mental health issues. However, current Ministry of Education funding rates for clinical psychology training are so low that courses typically run at a loss. Clinical psychology training is funded at substantially lower rates that all other health disciplines including medicine, dentistry, dietetics, and even acupuncture and osteopathy. The Government cannot claim to take the Mental Health and Addiction Inquiry’s recommendations seriously, nor is it likely to achieve it’s ambitious 2023 goal, without stumping up the cash for training. (See current funding rates.)



"The Government must also think about how to fundamentally reshape the delivery of mental health services. Even if the current psychology workforce is doubled overnight it would still not reach all who need access to services. Innovative initiatives will need to be considered such as e-therapies and prevention programmes targeted at children and teens. In this regard, the expansion of nurses into secondary schools for a further 5,600 students is a good start but unlikely to be enough. It may be that the soon to be re-established Mental Health & Wellbeing Commission will be given the task of considering how to expand services outside the current one-to-one intensive, in-person model.

"The 2019 Budget was labelled the 'Wellbeing Budget'. From a mental health view, this involves thinking more widely than just providing individuals with treatment. It also needs to address societal factors that influence mental health such as poverty and homelessness. The Government seems keen to address these broader issues with plans to reduce child poverty, increase benefit levels, and tackle homelessness. If successful, then today’s Wellbeing Budget may yet live up to its name."

Conflict of interest statement: I am Clinical Practice manager in the Clinical Psychology Training Programme at VUW.

________________________________________

Dr Fiona Hutton, Senior Lecturer in Criminology, Victoria University of Wellington, comments:

"The Government is to be commended for supporting those with mental health and addiction issues and for delivering a Budget that is aimed at supporting the wellbeing of vulnerable New Zealanders.

"Particularly welcome is the recognition that addiction and mental health are often linked and that these issues are intensely complex. Further, the funding that will be released for addiction treatment will be of huge benefit, expanding these services for those who need them, in particular, the extended funding for the Te Ara Oranga programme in Northland to support the positive work that this project does.

"However, the Government could have further supported those who use illicit drugs by funding and expanding its harm reduction remit to make Naloxone (that reverses opioid overdoses) readily available through needle exchanges, prisons and pharmacies. Those who use illicit drugs recreationally also need education and harm-reduction interventions - it would have been excellent to see support and funding for grassroots groups who provide crucial drug-checking services, contributing to the health, mental health and wellbeing of a section of the drug-using population.

"The Government also seems to be stubbornly wedded to the idea of addressing alcohol and other drug use through the criminal justice system with an emphasis in this 'wellbeing' budget on drug testing and detection anklets. Using these methods does not support wellbeing and I urge the Government to reduce its use of drug testing, in particular, which often leads to 'drug switching', and the use of more harmful substances such as synthetic cannabinoids that cannot be detected in drug tests.

"Further consideration of the decriminalisation of personal possession and use of illicit drugs as recommended in the Mental Health and Addiction Inquiry report would support people with mental health and addiction issues, and contribute to their wellbeing, by not criminalising them and removing crucial barriers to treatment such as stigma, and fear of a criminal conviction."

No conflict of interest.


ends

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