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The release of He Ara Oranga, the Report of the Government Inquiry into Mental Health and Addiction (https:// mentalhealth.inquiry.govt.nz/assets/Summary-reports/He-Ara-Oranga.pdf) early this month, highlighted a mental health system that is struggling to cope with the escalating number of people with mental health issues. It is encouraging to see that the increasing morbidity associated with mental illness is being recognised and taken seriously in an effort to destigmatise psychiatric symptoms in our community. The Report should play a pivotal role in improving access and services for those struggling with mental health issues and ultimately lead to enhanced outcomes.
New Zealand data are clear that there is a rising number of people suffering from mental health problems; the New Zealand Health Survey identified that the number of adults with a mood disorder went up by 56% from 2006/2007 (10.8%) to 2016/2017 (16.8%). Rates of anxiety disorders went from 4.3% to 10.3%, an increase of 140%. These estimates come from using the K10 questionnaire. Based on these scores, 5% fell in the severe range, 9% moderate and 7% mild. Children are not immune to these problems, with an almost three-fold increase in that same time period in the number with emotional and behavioural problems, from 1.8% to 4.9% (www.health.govt.nz). Overall, these most recent data indicate that about one in five New Zealanders struggle with mental health problems in any given year, rates on par with international statistics; this equates to about 950,000 people based on a population of almost five million.
The most recent figures from Pharmac show that over that same decade of rising mental health problems (2007-2016), rates of prescriptions for antidepressants went up 48% and rates of prescriptions for antipsychotics went up 40% (www.pharmac. govt.nz). However, increasing access to psychiatric medications as well as increased spending has not resulted in improved mental health outcomes.1 The Report acknowledges that "we can't medicate or treat our way out of the epidemic of mental distress" (page 10).
The Report not only described the serious shortfalls of the current state of the New Zealand mental health system, it also outlined 40 recommendations, including "more options for talk therapies" (recommendation 12) and to increase access to psychotherapy beyond the most severe cases. The report outlined "The lack of available services, especially...