A “rolling crisis” in youth mental healthcare is causing a growing number of children and teenagers in distress waiting weeks for help. Child psychiatrist and paediatrician Hiran Thabrew at Starship Hospital acknowledges that the mental health system is under-resourced and strained, making patients sicker. Labour’s $2 billion investment in mental health since 2019 has not made any tangible difference to his work or the lives of his patients.
The pandemic has worsened the decline in youth mental health, with a 50% increase in self-harm hospitalizations and a tripling of eating disorders. The financial consequences are affecting families and young people directly. Mental Health Foundation chief executive Shaun Robinson calls it a “rolling crisis” and criticized Wellington for not addressing this issue urgently.
Children in severe crisis are facing increased wait times for help from secondary mental health services, with many waiting for treatment unless they have attempted suicide or pose a risk to others. The number of days children in crisis wait to see a specialist mental health service has doubled between 2018 and 2022, with the proportion of under 25-year-olds waiting more than eight weeks for their first appointment rising to 12% in the year to June 2023. The rise in self-harm and eating disorders among older children is taking up more resources, often at the expense of younger children. Since the pandemic, access rates for children and infants have dramatically declined, with many children with moderate issues not receiving the support they could receive due to a lack of capacity. Andrew Little, who was health minister between December 2020 and February, rejects Thabrew’s view that the mental health system is making patients worse and has not heard any evidence supporting this claim.
The suicide rate in New Zealand has seen modest improvements in the last three years, but it is unclear if the success of the mental health system is attributed to the suicide rate. The rate did not fall significantly under Labour, and if they spent over $1.9bn to achieve that, it is incompetent. There are complex reasons why the rate has fallen between 2020 and 2023, and many of these factors have nothing to do with Labour policy. The Covid pandemic had a positive effect on suicide, as vulnerable people were around their whanau 24/7 during lockdowns. Mental health improves during a crisis as people come together in a common cause, but this effect fades and the aftermath and long tail endure.
Aotearoa still has high youth suicide rates, despite a $2b mental health package from Labour. The package provided $19m for health services and wellbeing promotion for over half a million kids. A further $90m was allocated from Budget 2022 to expand the Mana Ake programme, providing 10,500 children with access to psychologists, counsellors, and social workers by 2024.
A Cabinet paper presented to outgoing health minister Ayesha Verrall reveals that only a fifth of sessions provided by health coaches and health improvement practitioners were taken up by 12-24 year olds. The $100m from Budget 2022 allocated to specialist mental health in secondary care is at risk due to ongoing recruitment challenges and workforce shortages. Eating disorder services, community-based crisis services, and child and adolescent mental health services require significant attention or action. Clinical psychologist Dougal Sutherland expresses concern that acute care services have been hampered by the allocation of funds towards primary mental health, especially for young individuals.
Te Whatu Ora admits that long wait times are having an impact on children and their families due to increasing demand for services and workforce shortages in some areas. Mental Health and Addiction Hospital and Specialist Services lead Karla Bergquist emphasizes that when a young person needs acute care for mental health issues is referred to a specialist service, they are always prioritized and seen urgently. Budget 2022 included $18.7m for specialist child and adolescent mental health services over four years, which will result in 1300 more patients being seen each year by the end of 2025/26.
The New Zealand Counsellors Association is facing pressure to get children into specialist mental health services quickly due to oversubscription and long waiting times. Many children are waiting months to be seen, even with high needs. The association wants the government to fund one counsellor for every 400 students at a cost of $66m. The new Mental Health Minister, Matt Doocey, has pledged $6m to Gumboot Friday, a program providing free counselling sessions for young people, despite official advice that the program did not meet funding criteria. Doocey challenges the assumption that Gumboot Friday is not a good program to invest in, stating that many Kiwis want the investment to go into the program and is working with officials to ensure that happens. The National-led coalition government plans to establish a mental health innovation fund to support non-governmental organizations in fulfilling tasks that the public sector cannot undertake.
