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Speech: Dunne - Like Minds, Like Mine Seminar

Hon Peter Dunne
Associate Minister of Health

Keynote Address to the Mental Health Foundation
Like Minds, Like Mine National Provider Seminar

Thursday, 12 April 2012
Waipuna, Auckland

Good morning.

It is a pleasure to be here with you today at this Like Minds, Like Mine National Provider Seminar.

Or perhaps I should say it is very satisfying to be with you because I think we all recognise the absolute importance of the issues and work being dealt with here by you.

I believe all of us are absolutely committed to continuing to promote mental health and suicide prevention activities in better, more insightful and more successful ways.

That is our work today, and it is our work every day.

It is for the absolute benefit of New Zealanders, their families and our society as a whole in dealing with the scourge of mental illness, addiction and suicide.

Te Tāhuhu – Improving Mental Health 2005-2015 – New Zealand’s mental health and addiction plan – outlines policy and priorities for mental health and addiction and provides an overall direction for investment in mental health and addiction.

This particularly important document states that:
• mental health and addiction problems, such as depression, anxiety disorders, and substance misuse can reduce an individual’s sense of belonging and participation in society;
• that stigma and discrimination can be both a consequence and a cause of social exclusion, and a major barrier to successful participation in society for excluded groups and individuals;
and that risk factors and promoting protective factors that strengthen communities – such as enhanced cultural awareness, sensitivity, and promoting access to the resources of mainstream society to encourage full participation in society – are important for mental health.

The New Zealand Suicide Prevention Strategy 2006-2016 addresses factors that influence suicide prevention and recommends promoting resiliency in population groups as well as crisis management and support.

The strategy suggests that suicide prevention is a collaborative approach involving government agencies, local government, community and iwi groups, service providers, schools, prisons, district health boards and the media.
I do not think anyone in this room would disagree.

Research undertaken by the Mental Health Commission found that discrimination is one of the biggest barriers to recovery for people with experience of mental illness or addiction.

Discrimination also prevents people from having full access to education, employment, housing, and fully participating in society.

Other findings included clear relationship between symptoms of mental distress and the isolation that people feel.

In 2008, 25 percent of people with no symptoms of mental distress felt isolated from others in the previous four weeks compared with 49 percent of people with mild symptoms, 67 percent with moderate symptoms and 77 percent of people with severe symptoms;

The research also found that people with symptoms of mental distress are more likely to have felt discriminated against than people with no symptoms of mental distress.

I am sure you will all be aware of Prime Minister John Key’s very significant announcement last week of the Youth Mental Health Package – a cross-agency project looking at improving services for young people with, or at risk of, mild to moderate mental health problems.

It is a package of interventions being designed to build on existing successful interventions and to trial new initiatives for young people in schools, the health system, their families and local communities.

The $62 million initiative is fundamentally recognition that young people will determine the future shape and prosperity of New Zealand.

But it is equally recognition that one in five of our young people will experience some form of mental health problem during the crucial transition to adulthood.

In our complex world that can be a perilous and difficult journey.

Even mild mental illness can have a wide impact on a young person’s life and on those around them.

When the worst happens and a teenager takes their own life, those left behind have a heavy burden to bear.

As the Prime Minister said at the launch – we can do better for young people with mental illness.

The Youth Mental Health package will work in four places:

• In schools
• Online
• In families and communities, and
• In the health system.

It will see nurses and specially-trained youth workers in lower-decile schools to help identify students with a mental illness and get them appropriate care early and quickly.

The Positive Behaviour School Wide programme will also be rolled out across all secondary schools to improve the environment young people are learning in.

In return, schools will be asked to take more responsibility for the wellbeing of their students.

The Education Review Office will begin measuring how well schools are doing when it comes to student wellbeing, and over time we expect them to show improvements in areas like bullying.

The Youth Mental Health package also includes several initiatives to modernise the way mentally ill young people are reached

They will be reached out to through technology and social media as never before.

We will be coming to young people; not just waiting for them to come to us

And that means smartphones, Twitter, Facebook.

While many of us have adopted these things, or in some cases had them begrudgingly forced upon us, for young people it is their natural-born world.

We need to meet them there and help them there.

Along with an overhaul of existing mental health resources, new ideas will be sought through a Social Media Innovations Fund to keep providers of youth services technologically up to date.

The package also contains several other initiatives including a lift in funding for primary mental health care, new wait-time targets for Child and Adolescent Mental Health Services and a new Whānau Ora approach.

Families are clearly one of the pillars of this package. Equipping them, enabling them, supporting them.

For anyone who has been a parent, I am sure we all know how difficult it can be raising teenagers.

It can test our resolve, our intuition, our knowledge.

As parents, we can find it hard to tell the difference between normal teenage behaviour and mild to moderate mental illness.

Some would argue, as I believe Nigel Latta did in one of his television shows, that being a teenager is by definition a special form of insanity!

While I am not that cynical or pessimistic I do agree that the task of parenting is a complex one to say the least!

But more seriously, to help parents, families and friends, the Government is going to fund NGOs to get more information out to them about what to look for and where to get help.

The Youth Mental Health package fills gaps in our current system and builds on the good work our mental health professionals are already doing in this area.

The package does not stand alone.

It comes in alongside other ongoing work and programmes.

There is the Travellers programme which is about resilience building and early intervention for year 9 students.

The aim of the programme is to enhance protective factors for young people experiencing change, loss and transition events and early stages of emotional distress.

The Government is also boosting forensic mental health services by $33 million to improve early intervention and treatment services for youth offenders.

The funding announced in November last year is spread over four years and will provide mental health, alcohol and drug assessment services for the 4200 young offenders who appear in youth courts each year.

While the cumulative steps we are taking to look after the mental health of young New Zealanders are critically important, we must remember that mental health issues can be present at other stages of the life journey.

Some current activities to strengthen mental health services for older persons include:
• 'Introduction to working with older people with problematic substance use' workshops being held in three New Zealand locations this month.
• establishment of regional Dementia Behavioural Support Advisory Services focusing on behavioural and psychological symptoms of dementia and building on what has already been achieved in dementia care;
• a regional educational programme in Canterbury for care workers in aged residential care “walking in another’s shoes”

There is also the development of an e-learning tool about dementia with a formal launch being planned in Northland.

We should also be aware of New Zealand’s national Overview of Suicide Prevention Policy and Strategies.

These are very important parts of my ongoing work as Associate Minister of Health.
Suicide prevention policy and programmes are guided by the New Zealand Suicide Prevention Strategy 2006–2016 and the New Zealand Suicide Prevention Action Plan 2008–2012.

The action plan is comprised of two documents: The Summary for Action, and The Evidence for Action.

The latter summarises the evidence underlying the goals and rationale for the respective activities.

A new action plan is being developed this year for the remaining four years of the strategy.

A key objective of the new action plan will be ensuring that inter-agency activity is focused on the areas that will result in the greatest impact.

During the development of the new action plan, the inter-agency committee on suicide prevention will also be considering population groups at greater risk of suicide, including young people.

Why does suicide happen?

It is a somewhat haunting question, as much for the number of causes and the complexities of their inter-actions as it is for the sheer tragedy that each and every suicide represents.

Suicides are complex and they are multi-layered.

It is usually caused by an accumulation of risk factors, with a mental disorder being a common factor.

Other risk factors are broad ranging and include traumatic childhood events, life stressors, social isolation, family issues and an accumulation of risk factors for Māori such as cultural alienation, institutional racism, and the influence of historical, political and social processes.

Suicides can often be connected to subsequent suicide of friends, family and whānau and the wider community.

Contagion is a perplexing, distressing and complex reality that we must at all times be aware of.

Certain risk factors, such as media influence, can lead to suicide clusters or contagion.

As recently as late last month I attended a forum with media representatives and suicide prevention experts where genuine steps were taken towards more balanced media reporting on suicide.

And this itself comes off the back of meetings I chaired last year between media, health and clinical professionals which came up with a set of media guidelines for the reporting of suicide.

Suicide has a devastating effect on whānau, hapu, iwi and Māori communities.

What can we do to stop suicide happening?

The first thing I would say is that addressing suicide is everyone’s responsibility.

There is no element of cop-out in that statement.

It is simply the truth if we are to get better at stopping people from committing suicide.

Some of the most effective prevention actions are strong friendships, healthy, supportive family relationships, and an individual’s belief in a positive future.

We all need to think about how we build connections with our community, and particularly with our taitamariki, to build a sense of purpose and enhance resilience.

Strengthening Māori suicide prevention services, providing community-based mental health support services in very high-risk populations and raising community awareness have aimed to achieve a reduction in suicides.

These activities together with improving our surveillance and monitoring of communities at risk will continue to be some of the key areas of focus if our high Māori suicide rates are to be reduced.

Some of the current activities in suicide prevention include:

• establishment of ‘postvention’ after a suicide interventions, including actions to reduce the risk of further suicides amongst bereaved whānau and friends;
• provision of bereavement support services to help communities deal with a series of suicides or cluster of suicides in the area;
• the National Depression Initiative which aims to reduce the impact of depression on the lives of New Zealanders by aiding early recognition, appropriate treatment, and recovery; and
• updating the National Suicide Prevention Action Plan as I mentioned earlier.

I am aware that I have covered a bit of ground this morning, but that reflects the reality of the work before us.

It reflects the complexity of the issues around mental health and suicide.

Your presence here reflects things too.

It reflects the importance of the work you do and – crucially – it reflects the tremendous commitment you demonstrate to that work and to the people of New Zealand and their well-being.

For that I thank you and I salute you.

And I wish you well in today’s proceedings.


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