Families With Attitude - Matt Robson Speech
Saturday 15 September 2001
Embargoed until 9.15am Hon Matt Robson Speech Notes
Opening address to the Schizophrenia Fellowship Conference
Novotel Tainui Hotel, Hamilton
It’s a sad commentary on where we have come to, that the Minister of Corrections is here to open your conference.
Mental health does not belong in the corrections system.
As a society, as families, as professionals and as individuals we know that.
But far too often, our failures in mental health end up in corrections.
And if we are going to do something about that, it has to start with acknowledgment of the problem.
What do we do in the long term to change the failures?
And what do we do in the short term to cope with the effects.
One authoritative estimate says that at least two thirds of prison inmates are suffering serious mental problems, including schizophrenia and chronic depression.
Of course treatment of the mental health in the prison system is a responsibility for the health system.
But the issue is not merely one of treating the sick once they are in the corrections system.
The issue at a much more fundamental level is why are so many people in jail, when it is beyond dispute that their mental illnesses helped to put them there?
The question for government and the community is: why don’t they receive the treatment they need before they commit the offences that land them in prison?
Before they hurt themselves and others.
It is true that for many years the mental health system has failed New Zealand.
Countless reports in recent years show that.
Too many reports and too little action.
As an opposition politician I campaigned on this issue again and gain, alongside my colleagues in the Labour-Alliance Coalition Government.
I’m pleased to say that there is some real progress being made by this Government.
Changes are being made to strengthen the health system.
The mental health commission has been given teeth, and very significant funding increases have been made to improve treatment.
But it is clear also that much more needs to be done.
On that point, everyone who believes there needs to be more funding has an equal responsibility to state clearly where the funding will come from.
Governments do not wave magic wands to create resources.
New Zealanders need to own the solutions as well as the problems.
We know that mental health needs much better resourcing.
The entire health sector is under pressure, much of which is caused by years of chronic under-funding.
No one knows that better than this Government.
But anyone who acknowledges the need to provide more, must also take responsibility for volunteering to pay their share of the cost of providing more.
I represent a party that said it would pay for the funding increases required, and proposed the tax policies to pay for it.
From those who could afford to pay a fairer share, and to those who need it.
It’s fair to say that we have not been heavily rewarded for that stance.
As in life, so in Governments: You get what you pay for.
New Zealanders pay for a mental health system that is barely able to cope with the demands on it.
I believe there is not a single New Zealander who would dispute that, and those of us who make funding decisions are acutely aware.
There have been multiple surveys of the extent of mental illness in New Zealand.
The picture is bleak.
The prevalence of illness in the general public is dwarfed by the prevalence in the prison system.
As one of your key note speakers has said, prisons are in many ways warehouses for the mentally ill.
The costs that are not met in treatment are too often met by agencies such as police and corrections.
The costs are almost always imposed on families who are left to pick up the pieces.
Not economic costs, but costs in coping, in social effects and in hurt.
And above all, the costs are met not only by by the individuals themselves, but by the victims of their offending.
But there is hope, too.
Hope because there are hopeful, effective things the Government is already doing.
And hope because we are prepared to acknowledge the ways we can do better.
Solutions lie in improvement to the mental health system, of course.
Solutions also lie in acknowledging as a society that there are features of our society that make mental illness more likely and more prevalent.
Defining those features is a sociological as well as psychological task, and I don’t presume to know them.
But we can identify a few features of our social structure that contribute to mental illness:
A society where too many feel excluded or hopeless.
A society where inequality is prevalent and rising.
A society that places complex pressures on people, and then abandons them to cope alone or in cultural isolation.
A society that offers too many easy substitutes for coping, whether through substance abuse or through the many other devices we know about.
I don’t know how many of these are decisive, and I doubt anyone does.
And nor do I believe for a moment that government policy alone is responsible for changing the social structures that contribute to mental illness.
Though government policy is important, many social causes of mental illness are beyond the reach of government policy.
They lie in the pressures we place on individuals, through images and values.
They lie in the way we value human beings and teach people to value themselves.
They lie in the way our various cultures relate to each other, and in the support systems that we create.
Whatever the causes, only an idealist would say they could be dealt with speedily.
Therefore, we have to deal with the effects of mental illness in the present.
The effects on families, on the individuals concerned, on the victims, and also at the level of institutional policy.
Within the corrections system there are forensic services available and there is some treatment.
And there is also evidence – in a report released as recently as last March – which shows that there is nowhere near enough treatment.
I believe we also need to make a difference much earlier.
A few months ago I released a report called About Time.
It identified the many conditions that lie behind offending and a life of crime.
And its broad conclusions will not come as any surprise to anyone:
That those born to mothers who are poor, isolated, abused or abusive are far more likely to grow up into a lifetime of offending.
And when all or many of these conditions appear together, the risk to a child is increased many times over.
And as that child grows up and certain characteristics begin to appear, it becomes easier to predict a lifetime of adult difficulties.
Those difficulties include defiance and anger at a very young age, poor participation and behavioural difficulties in the pre-teen years, then substance abuse and a pattern of offending as a teenager.
If we can intervene in these early years, we can make enormous differences. Intervene by offering support where it is needed.
Early intervention works best and costs less. That is how we might set out to cope at the level of government policy.
At the more practical level, families themselves need strategies to cope.
Families know, too often, the burdens and the costs.
Families also know, so often, the value of individuals and the difference that support can provide.
Families with attitude can make a difference. I believe that Governments with attitude can make a difference too.
As Minister of Corrections, I believe we really can make changes that are positive for society as a whole, for families, and above all for the mentally ill.
Corrections will never be an adequate substitute for mental health care.
I want to close by encouraging you to use this conference to gain and share knowledge, to improve the support you can provide and to build networks.
I hope that you will see the Government as enthusiastic to play its part as well.
I hope you will maintain strong, regular contact with me and my colleagues in the Labour-Alliance Coalition Government.
I wish you well for your conference. You have important topics to discuss and vital insights to discover.
I have much pleasure in formally opening your conference.