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The MHS - Annette King Speech

Hon Annette King Speech Notes

The MHS --- The Mental Health Services Inc. of Australia and New Zealand

For a number of reasons I feel privileged to be part of your conference this morning.

The first reason is that I am a Wellington MP as well as being Minister of Health, and it is a great pleasure to welcome so many distinguished visitors to our beautiful harbour capital city.

The second reason is that in a week in which we have sent some of our most talented young New Zealanders to Australia to bring home the Tri-Nations trophy, it is good to see so many talented Australians, of various ages, crossing the Tasman in the opposite direction.

The third and most important reason I am pleased to be here is that I believe New Zealand has an increasingly positive story to tell in terms of mental health services, and I believe it is entirely appropriate such an important conference is being held in our country.

Last year New Zealand was invited, as the only non-European invitee, to attend a European Union conference on mental health, and was able to say that we appeared to be one of a few countries putting significantly more money into mental health services.

That has to be said with provisos, of course, because mental health services can only develop as quickly as we can develop trained staff.

But we have gone from expenditure of just under NZ$500 million in 1996/97 to a budget commitment of just under NZ$800 million for 2003/2004 to support implementation of our national blueprint for mental health services. That represents 68% growth in seven years, a rate unheard of in other sectors of New Zealand government.

The importance of what we are doing cannot be overstated. There are few areas of the health sector more subject to misunderstanding, fear, and bigotry than mental illness.

In May this year I had the privilege of chairing a ministerial round table in Geneva at the World Health Assembly on mental health, and of speaking at a plenary session. The Assembly was both comforting and daunting, comforting in the sense of realising that New Zealand is in the forefront of improving mental health services, but daunting from the aspect of realising just how much there is to do.

Ministers taking part in the round table debated how they could make a difference for those who suffer from mental illness. I was impressed by the willingness with which they confronted the increasing burden mental illness poses in both social and economic terms, including reduced productivity and unemployment, financial and emotional burdens on families and caregivers, and premature deaths.

It was accepted that mentally ill people have suffered all around the world through marginalisation of mental illness from physical illness. Entrenched social attitudes, fear and suspicion of mental illness have led to discrimination and stigmatisation of sick people.

The WHO has warned that many member states are ill equipped to cope with the predicted worldwide rise in mental and neurological disorders, currently forming 11 percent of the worldwide disease burden. By 2020 this burden is expected to rise to 14.6 percent.

The picture painted is a sorry one of neglect and a severe lack of resources, but countries have had to address hard health issues before. Tackling mental health requires the same determination and commitment given to other serious health problems.

In New Zealand we have been forced to acknowledge our failures, and to accept the need to do things differently. Containment of large numbers of mentally ill people behind locked doors and barred windows is not a replacement for a mental health policy. Mental illness, like physical illness, exists within the community. The way ahead is to integrate mental health with other illnesses. To do otherwise is a violation of the basic human rights of patients.

I only have a brief period to speak to you today before I present some special awards, and I want to use that time to make some important general points, particularly concerning the media's role in developing increasing understanding of mental health issues.

Mental illness scares many of us, usually needlessly. When media coverage of mental illness is often as much the preserve of police reporters as health reporters, it is all too easy to forget that the people most at risk from mental illness are those who suffer them.

A person with mental illness is more often likely to be living in poverty, to be subject to discrimination, and to be the subject of personal injury by others and, in some cases, by themselves, than to be a danger to other members of the public. As a society, we forget this far too often. Yet there can be few of us who do not know someone whose life has not been touched by common illnesses like depression.

As the veil on depression and other common mental illnesses is lifted, we are entering a new phase in human understanding of illnesses that affect the spirit rather than the body. The message is slowly getting through, partly because of campaigns such as Like Minds, Like Mine, and partly thanks to the flowering of mental health advocacy.

Those attitudes are also changing because the news media is also slowly recognising that mental illness is complex, that old stereotypes in this area are no more acceptable than racism or sexism. Many journalists are also recognising something else, that when you scratch below the surface, mental health is a profoundly interesting area.

Of course, there are still those who believe that community care is a recipe for community mayhem, or a cruel way to treat people who have trouble managing their daily lives. To those people, I say two things: look at the statistics, and ask the people you are talking about if they would rather be locked up. There is simply no evidence of more violence in the community because of community care. And let me assure you, there have been plenty of attempts to find such evidence.

I would never suggest that tragedies involving mental illness should be swept under the carpet. Such tragedies do occur, and are often all the more shocking because they are often literally senseless, and because not every clinical decision is always right.

Such tragedies can make good copy by exciting fundamental emotions of dread and outrage. Such emotions sell newspapers, get people on radio talkback, and glue them to television screens.

Don’t get me wrong. Sometimes that outraged response is justified. The news media performs a vital audit on the delicate and imprecise judgement calls made every day by mental health professionals who must juggle the right of the public to safety with the rights of patients who are well to be discharged and trusted to live responsibly.

Indeed, the climate of public fear which the news media both reflects and contributes to has undoubtedly made many clinicians powerfully aware of the political risks, let alone the physical risks, of discharging patients with serious mental illnesses. How many of you here today, I wonder, are treating people who should probably be allowed to live in the community, but who are being held back, just in case?

The media also has the ability, as I mentioned, however, to develop understanding. That is why I am so pleased a superb opportunity has opened up this year for New Zealand news media through the Carter Center, a United States-based human rights advocacy agency set up by former President and First Lady Jimmy and Rosalynn Carter.

The Carter Center has chosen New Zealand as the first country outside the United States in which to offer its highly successful mental health journalism fellowships. My Cabinet colleague, Social Services Minister Steve Maharey, will have the pleasure of awarding the first two fellowships to their recipients later today.

I want to wish both fellows well, and to thank the Center for rewarding the work already occurring in New Zealand to create a fair, tolerant society in which mental illness is better understood and accepted.

On that positive note, and before I present the Australian and New Zealand Mental Health Achievement Awards, I would like to welcome you all again to Wellington, and to open this conference officially.

Over the next three days, I am sure you will add considerably to our understanding and commitment. Enjoy Wellington while you are here, and I am sure I do not have to remind the Australians among us that on their return journey they should wave at the Tri-Nations trophy as it makes its way here. Thank you for inviting me.

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