“There Is No Mental Health Funding In New Zealand”
Over the past few weeks we’ve seen a heightened level of scrutiny for the seeming non-spending of public money on an escalating public health crisis. Or, if you’re the National Party, public health money instead being spent on financing the phantasms of organized crime rather than Mike King’s Gumboot Friday initiative. Now, leaving aside the ins and outs of that escalating series of brouhahas (wherein it doesn’t appear that anything untoward has happened with $2.75 million dollars going toward methamphetamine rehab, and Mike King doesn’t appear to have applied for Ministry of Health funding for his project) … we’re nevertheless left with a pretty important question.
Namely, if everybody seemingly agrees that mental health in New Zealand is at a bit of a crisis point – why isn’t the Government ‘Doing Something’ about it?
Does Mike King have a point when he proclaims to all and sundry that the Government is one of inaction here?
Part of the trouble is that what he’s protesting about … isn’t really addressable via funding increases. They certainly help and are vitally necessary – but we’re finding out right now that the Government can literally make available tens of millions of dollars in additional mental health funding …
… yet only expand total capacity by a few beds across the entire country. This is something that recently happened and they’ve been castigated for it.
Except that’s … the problem.
There’s an old English saying “if you want a good longbowman, start with his grandfather”. It’s not quite so dire with this sector, but basically to get more mental health workers, it takes several years for people to go through training and qualify as such – particularly if they’re becoming highly skilled and more specialized, which is what’s needed for the high-needs stuff.
It also obviously takes awhile to build facilities that are fit for purpose; and while in the old days, the Before Times prior to 2020, the skilled labour input issue could be semi solved via importing people with the relevant qualifications and experience
… that’s uh … that’s not really much of an option right now. In part because – and this is a broader medical sector problem – we’re apparently not able to offer hugely competitive wages relative to cost of living for people who might want to come here (and also because, you know, the border’s mostly closed to non-citizens/residents), and we’re also losing workers to Australia etc.
The trouble is that the whole “we can’t offer hugely competitive wages relative to cost of living” thing is that people only hear the former, and – justifiably – think the Government should pay nurses and mental health workers more. I agree.
Except unless cost of living across the board is somehow addressed, it doesn’t actually make that much difference. It’s simply much cheaper to live in many other countries, regardless of wages, so you’re still further ahead.
Additionally … private sector mental health support is basically either unaffordable / inaccessible for a lot of people to meaningfully engage with (seriously, counselling’s like $80 an hour-long session and goes up from there, and I’m not sure how many people with pretty intractable problems manage to sort what ails them inside only a few of those; for actual more specialized psychology it’s .. hundreds of dollars for even a half-hour) – so it’s a bit difficult to pay them more, unless I suppose, we start rolling out broader subsidies so that many more Kiwis can basically go through the private system rather than the public one, part-paying themselves and part-paid-for by the taxpayer.
Which isn’t a bad idea at all.
Except for the slight issue that it’s already rather difficult to get expeditious appointments a lot of places precisely due to demand relative to supply, which leads us back to point number one.
All up, we’re seeing the net impacts of a rather massive under-investment and under-support of the health sector in general , and mental health specifically , for … many many years now; and because Labour indicated they were keen to doing something about it, they’ve come under a lot of pressure for not having sorted the entire thing out inside a single Parliamentary term.
It’s totally understandable – and even, I’d argue, justifiable – to feel frustrated with the pace things have been going at.
However, I’m not entirely sure how much faster or more efficient things could actually really be – in the short term, anyway.
The simple, lamentable truth is that there is no Golden Bullet in this situation. If there were, I’d like to imagine that the Government would have fired it already.
Unfortunately, delays in this sphere can quite literally be lethal. However, I’d also have to question whether making a politicized hot-button issue out of an impossibility – that is to say, hammering the Government for something they don’t necessarily have a huge degree of control over – is really the best use of anybody’s time or mental-psychoemotive bandwidth.
I leave it for other, more informed minds to let us know what could be feasibly done in the short or even medium term to change this situation for the better. Whether there’s some easy institutional fixes to expand accession and capacity, make it more affordable for people to get into what’s already out there perhaps.
The point is – it’s not such a black-and-white situation as people either want to believe, or have been lead to believe. We don’t really do very well with communicating complex, nuanced issues through either our adversarial politics or our often ‘gotcha-‘ oriented commentariat/media. And that can lead to – as in this case – a misimpression that the Government is being callous (rather than cautious, or constrained by circumstance). A perception most definitely fostered by those either genuinely passionate about attempting to prod and/or bull-whip them into doing more, more quickly (i.e. King), or some certain other voices who are basically just looking for any excuse to attempt to dent our Government. Potentially so that they can then have themselves a go of presiding over non-action instead.
Mental health is a societal issue of materialist consumer culture in its last days worshiping the addictive god of exceptionalism. I agree! this will not be solved buy throwing fiat money at it while that fiat money is evaporating in value! There’s the paradigm. The gig is up with humanity’s sojourn into ego competitive materialism.https://www.youtube.com/watch?v=7PucjQXO2k0&t=5375s
Still going on about the flag referendum when it was Labour party policy to hold a referendum for many years… If you think this current government haven’t wasted money you’re deluded. Those in glass houses and all that.
My understanding of the situation regarding the health sector and mental health is that we had three terms of National governments, relatively low inflation rates during that time period, and funding to those areas in accordance with necessity and an increased emphasis on efficiency, but the increasing population wasn’t taken into account, so per capita, the funding was effectively reduced.
It will therefore take more than one or two terms of Labour for them to sort the issues out. There are also the issues which have emerged in the meantime, such as the coronavirus pandemic and the nurses’ strike.
I understand your perspective Curwen and concede that you are right but even as a Labour voter, I cant get behind your belief in the goodness of our government.
“The simple, lamentable truth is that there is no Golden Bullet in this situation. If there were, I’d like to imagine that the Government would have fired it already.”
I no longer believe this government is trying to care about NZ as the evidence is that there is non delivery across all the areas for which New Zealanders voted them in. The urgently needed change has not come about in any area and whilst your scenario of long term neglect is true in each of them, we have had no ‘breakthrough’ moments in any of them except those that relate to radical social (and ultimately) political change.
This government is going hell for leather to make ideological changes at great cost to New Zealand’s taxpayer and culture and to tens of thousands of New Zealanders who are screaming out for help. Its not coincidental, nor are the vast sums being spent on media, advertising, PR and Comms. It believes that if it can change the fabric of society somehow it will put NZ on a better path and the long term stuff will get fixed eventually.
When Labour got in, in 2017 – we were 20 years overdue for change and needs were huge but there was no change!!! Now they are in with a majority and what is changing? The horrendous over reach of hate speech laws including political provisions which can be used to limit dissent, Maori Co Governance, increased Crime (including gun crime), the splintering of NZ into a dozen small factions and a deep contempt for consensus and democracy.
@blinky. Yes, agreed. Fair and accurate comments.
What a great meme you almost had me there feeling sorry of the amount of tax payers money spent .
2.7 mil for less than 1090 people gangs no doubt.
Or a chance to bring all New Zealanders into a “conversation” about changing the flag.
While we are at it how much tax dollars are spent on conversations ? While these clowns are in place .
An Unpopular Perspective:
One of the ‘gifts of the spirit’ is a ‘sound mind’. That’s not to say there aren’t some fruit-loops out there. Though I am suggesting [tough crowd here] that aligning one’s mind with spiritual principles/values would improve mental health.
Now I’m not suggesting we establish ‘religious re-education camps’, heaven forbid.. freedom to choose is a core tenant in my personal and spiritual beliefs.
Virtues are like muscles, you exercise to get more. You want to become more patient – exercise patience. So too I’d argue with mental health – exercise right thinking.
Now obviously we live in a secular society, so what to do? For obvious reasons we all want our fellow citizen to be balanced.
We need to examine the culture. Culture = Cult.. therefore a countries culture could arguably be what that country worships. What does NZ worship; money, housing, rugby, soundbites ?? Are virtues and wisdom venerated in our culture?
I think Social Justice and [extreme] environmentalism is paving over the decay of culture, globally. That’s not to say there isn’t value in such things.
Better current affairs shows, more publicly attended debates and A REAL effort on housing – these could be starting points to get Kiwis’ mental health on track.
But yes, the culture needs to be improve. All that money given to TVNZ and TV3 [or whatever they’re called today], such a wasted opportunity and perpetuation of decay. A root canal when an extraction was required.
I imagine there are only so many choice, publicly funded media jobs? Yet the same people hold these jobs despite their media companies needing near constant bailouts – dodgy! Better broadcasters would help.
While it is true that many problems we have require multiple parliamentry terms to sort out, they have been made worse by the structures for delivery of services being dismantled by the previous National government. That being said I am remindeded of the shortage of radiographers that was in the news for a decade. The problem it seemed was that we were not training enough and there didnt seem to be a solution. The solution it turned out, was to provide additional funding for training and incentives. It worked. People who had lived in NZ for some time recalled that we used to base funding for training on projected demand and couldnt understand why this had not occured to someone to restore. Similarly start training now, promote the sector and subsidise training. Similarly we have a situation with construction workers, which I recall hearing about over a decade ago. Day one labour should have set about providiing large numbers of training positions for construction. They would have qualified in the first term and we would now have a pool of skilled NZ workers available for construction. A reconstituted MOW could have smoothed out the boom and bust and kept a reliable delivery component available. So to this extent the current government are responsible as they dont seem to understand that they can intervene and shape outcomes. We have seen the effects of hands off non-interventionism for the past thirty years. Where ever it has been implemented the outcome is the same. We also need to explain (start a conversation LOL) that this is what happens when you reduce taxes and need to hollow out service provision to pay for it. We still have fewer hospital beds that we did in the 1970’s with a much larger population. I expect the amount per capita spent on health adjusted for inflation is also lower. Mental health is always the poor relation that is raided to pay for ‘real’ illness, the extra funding most likely just filled in the holes left by that. Result. We got 4 more beds. I expect that after Covid, it will be back to business as usual and we will be talking about it for another decade.