Does New Zealand need to rethink the approach to addressing treatment gaps within mental health services?

New Zealand health data is unequivocal that there is a rising number of people suffering from mental health problems. Adults with a mood disorder went up by 56% between 2007-2017. Anxiety disorders rose from 4.3% to 10.3%. Children are not immune to these problems, with an almost 3X increase in that same time period in the number with emotional and behavioural problems. Nearly 1 in 5 New Zealanders struggle with mental health problems in any given year, this equates to about 950,000 people based on a population of almost five million.

We understand now that we can’t medicate, or treat our way out of the epidemic of mental distress. “Meds-and-beds” is not the solution. So, how then do we start to tackle this problem?

One of the avenues in front of us, is to focus on improving access to services. Principal among these interventions is to increase the number of health professionals available. The number of psychologists to the number of people who could benefit from psychological treatments is 1:312 or one clinical psychologist for every 145 individuals with severe mental health problems (5% of the population). However, currently, many inpatient clinics don’t have a dedicated clinical psychologist and patients aren’t able to access talk therapy. Waitlists to see a psychologist stretch to 4 months or longer. The same is true of access to regionally funded mental health services for children. Mental health services outside of the DHBs are often not accepting new referrals.


One could argue that it is impractical to ever be able to meet the demand for psychological services by increasing workforce alone. To maintain the status quo and keep pace with population growth, the secondary mental health and addiction workforce may need to grow by 4,000-5,000 FTEs over the next 10 years.

Exploring other innovative strategies that can apply a one-to-many rule is a good option going forward. This is where, once again, the social determinants of health come into play. Addressing income inequities, poverty, education, nutrition and housing are necessary long term steps to improving mental health outcomes in NZ.

An interesting point to focus in on, at this juncture, is aspiring to incorporate prevention as a strategy: reducing the prevalence of negative childhood experiences, improving maternal wellbeing, as well as parent-parent and child-parent relationships are critical pieces of the mental health blueprint for life.

40 recommendations were put forth as part of the He Ara Oranga (Pathway to Wellness) report. Perhaps its time to take a broad brush stroke approach and throw some support and funding behind as many of the recommendations as possible? It is 2022 and once again, the mental health crisis is under the spotlight. Every other year, we have a report which documents the deepening crisis. Surely, at some stage, the bough will break.