Brooke van Velden: Central mental health care agency would improve outcomes

OPINION:

Just last night, a man who’s attempted suicide multiple times reached out to me and explained the inadequacy of the support he’s been offered. He described it as about as helpful as a flea on an elephant’s back.

He’s not the only one who’s screaming out for help.

Almost nobody is satisfied with the state of our mental health and addiction services. Mike King gave back his New Zealand Order of Merit medal this month to show support to the families struggling to get the care they need for their loved ones.

Two years ago, the Government committed an extra $1.9 billion for mental health over five years. Of that $235 million was allocated to building new mental health and addiction facilities. Only five new acute mental health beds have been delivered. That’s shamefully poor delivery.

Last week, I visited a couple of community mental health facilities.

At the first, the smell of incense and warm macaroni and cheese greeted me at the door. I held the weighted teddy bears that provide comfort to patients during hard therapy conversations and met the carers who sit by the beds of patients struggling to sleep through the night. It’s more than a facility, it’s a home that provides a sense of safety, peace and security for a few days or weeks when people need it most.

At the second, I met people who will never leave. It’s a home for life.

The people who work at these facilities offer amazing care. The people who reside there desperately need the help. But there are so many other people who also desperately need help.

We’ll all encounter poor mental health at some stage of our life, whether in our own families, through work colleagues, or in our community. Recently a father opened up to me about his daughter’s battle with an eating disorder, a mother told me of her postnatal depression, and a friend was diagnosed with an anxiety disorder.

Statistically, around one in five New Zealanders face a mental health challenge in any given year.

It feels like more and more people are opening up and talking about their personal struggles, but we still have a long way to go.

Many people don’t ever reach out for help, struggle in silence, and their poor mental health goes untreated.

If we’re telling people that it’s okay not to be okay, then we need to make sure help is there for them when they do reach out.

Amazingly, no one in our health system has the job of asking “are we getting the best possible value for money?”

Over these past few years, the Government’s responded to the concerns of an outdated health system by promising more funding and proposing a health system reform that would move decision-making from local areas to Wellington.

Increasing funding will not guarantee improvements for people’s care. Neither will moving administration for mental health services from DHBs to Wellington.

It doesn’t address the issue of choice, accountability, or getting better value for money and the individuals and communities being served.

What’s been missing from the conversations about reform is what difference this will make to a person accessing the mental health care they need.

Will this reform provide the man I mentioned earlier any better options for care than he currently receives? Will parents be told there’s a shorter wait-time for their child to see a therapist than what they currently face? Will the system be easier to navigate for a person desperate for help?

We need more accountability and better transparency over the money we are spending.

It’s not acceptable to turn the system upside down without adequate answers to these questions.

We need to be a country where a person seeking help is empowered to make choices for their own therapy and care rather than simply accept what’s offered.

We need to create one stand-alone nationwide mental health commissioning agency with a clear responsibility for issuing contracts to the service provider of the person’s choice, monitoring patient outcomes, and quality of care.

Its purpose would be to use expertise and patterns of data to evaluate where the money we’re currently spending is going, to whom, and which services work to ensure people get the care they need when they’re at their most vulnerable.

Over time, it would be able to use its data to drive better performance and better outcomes based on evidence.

We can do better. We must do better. If we take the approach I’ve suggested, it’s far less likely politicians will receive heartbreaking calls for help like the one I received last night.

Brooke van Velden, MP, is the deputy leader of the Act Party.

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