New mental health strategy gets the vision right but needs stronger accountability

The Royal Australian and New Zealand College of Psychiatrists (RANZCP) has welcomed the New Zealand Government’s new Mental Health and Wellbeing Strategy, describing it as an important step forward while cautioning that meaningful improvement will depend on clear cross-government accountability, sustained investment and disciplined implementation over the next decade.

The College says the strategy contains many positive reforms, including commitments to improved prevalence data, stronger lived experience leadership and greater continuity of care. 

However, while it rightly recognises the importance of housing, education, employment, justice and poverty in shaping mental health, it stops short of clearly assigning responsibility across government for delivering measurable improvements in these areas.

Dr Alison Masters, Deputy Chair of Tū Te Akaaka Roa, the RANZCP New Zealand National Office, said the strategy reflected many recommendations put forward by psychiatrists during consultation.

“The strategy identifies many of the right priorities and reflects much of what psychiatrists have consistently advocated for. The challenge now is ensuring those ambitions translate into measurable improvements in people’s lives.

“It recognises that mental health is shaped by factors far beyond the health system and that improving outcomes requires action on the social determinants of health. We particularly welcome the commitment to a national prevalence survey for children and young people, with adult data to follow.

“Understanding the true scale of need is fundamental to planning services, growing the workforce and ensuring people can access the care they need, when they need it. This work must also be adequately resourced to provide the robust evidence needed to guide future service planning and investment.”

Dr Masters warned that the strategy's success would not be measured by workforce targets alone, but by whether it left those facing the greatest disadvantage, complexity of need and barriers to care better off than they are today. 

"This strategy has many of the right ingredients, but ultimately its success would be measured by outcomes rather than aspirations,” Dr Masters said.

“What will matter now is whether it is backed by the accountability, coordination and long-term commitment needed to deliver meaningful change and meet the needs of tāngata whai ora living with serious mental illness and addiction.

“Ambitious reforms require ambitious implementation. Delivering the new Mental Health Act, strengthening the workforce, improving prevalence data and expanding access to care will all require dedicated long-term funding, not short-term initiatives, at a time when services are already under significant pressure and unmet need remains high.

“Another challenge is that responsibility for many of the drivers of poor mental health still appears to sit largely and solely with the Ministry of Health and Health New Zealand. If housing insecurity, poverty, violence and social disadvantage are driving poor mental health outcomes, then responsibility for addressing those issues must sit across government agencies.

“And that responsibility should be backed by long-term, ringfenced investment that is protected beyond election cycles and shifting policy priorities over the life of this ten-year strategy.”

The College also welcomed stronger commitments to lived experience leadership, recognition of the need to improve mental health outcomes for Māori, and acknowledgement of the role families and whānau play in supporting people experiencing mental illness and addiction.

“People with lived experience should be central to designing and improving mental health services. Embedding lived experience leadership across governance, commissioning, service design and quality improvement is a significant step forward.

“Te Tiriti o Waitangi underpins culturally safe health care, and we strongly support embedding Te Tiriti principles into how decisions are made, how services are funded, and how the system is held accountable for delivering equitable outcomes.

“Whānau are often the people supporting loved ones through crisis, recovery and periods of unmet need. Recognising the integral role they play is essential, but families also need the support and resources to continue providing that care rather than being expected to function as the safety net for a system under pressure.”

Dr Masters said addressing workforce shortages must remain a national priority while the strategy represented an opportunity to move beyond aspiration to deliver lasting reform.

“As it stands, Aotearoa New Zealand continues to face mounting shortages across mental health and addiction services. Alongside growing the workforce, sustained investment in specialist community-based mental health and addiction services will be essential if more people are to receive timely, evidence-based care,” Dr Masters said.

“"We have seen ambitious mental health strategies before. What people now need is delivery. This strategy presents an opportunity to move beyond aspiration and demonstrate sustained, measurable improvement in the lives of tāngata whai ora, whānau and communities.

“The College looks forward to working with the Ministry of Health, Health New Zealand, Te Hiringa Mahara and the wider mental health sector to translate this vision into lasting improvements in mental health and wellbeing across Aotearoa New Zealand.”

For media inquiries, please contact: Dishi Gahlowt on +61 437 315 911 or email media@ranzcp.org 

For all other expert mental health information visit Your Health in Mind, the RANZCP’s consumer health information website.

The Royal Australian and New Zealand College of Psychiatrists is a membership organisation that prepares medical specialists in the field of psychiatry, supports and enhances clinical practice, advocates for people affected by mental illness and advises governments and other groups on mental health care. For information about our work, our members or our history, visit www.ranzcp.org.

In Australia: If you or someone you know needs help, contact Lifeline on 13 11 14 or www.lifeline.org.au or the Suicide Callback Service on 1300 659 467 or www.suicidecallbackservice.org.au.

In New Zealand: If you or someone you know needs help, contact Lifeline NZ on 0800 543 354 or www.lifeline.org.nz or the Suicide Crisis Helpline on 0508 828 865 or www.lifeline.org.nz/suicide-prevention.