🧠 Our Mental Health System is Broken. Here’s how to fix it.

👀 4 minute read

If you’ve ever tried navigating New Zealand’s mental health system, here is what you’ll notice. 

It’s expensive, it’s difficult and it’s confusing.

A system that’s meant to save lives is falling short of that goal.

It’s taken decades of research and a massive cultural shift to move away from stigmatised mental health. But while society has progressed, systems haven’t. 

Our mental health system is broken and change is crucial for the future.

Why New Zealand's Mental Health Care Falls Short

I’ll say it again: our mental health system is expensive, difficult to navigate and downright confusing. 

But instead of just stating the problem, let me dig into why it’s this way and what’s really going on.

Why are mental health services so expensive?

There aren’t enough professionals and the training they need is lengthy and costly. Right now, someone might have to call 10-15 psychologists before getting an urgent appointment.

For someone in crisis, especially those at risk of suicide, this is far from acceptable. We’ve all heard the stories of people who couldn’t reach a specialist in time.

Seeing a psychologist through the DHB is free, but the wait times can be brutal. Up to 6 months in some parts of New Zealand. For those needing urgent private care, the cost is steep, with appointments ranging from $150 to $200 per hour, well beyond what most people can afford.

In physical health terms, it’s like breaking a bone, heading to A&E, and being told to come back in a few months.

Admission numbers into clinical psychology programs are shockingly low for a country grappling with a mental health crisis.

Only 14 students are admitted each year at the University of Auckland, 12 at Victoria University, and 15 at the University of Otago. With just 15 psychologists per 100,000 people, New Zealand has the lowest rate in the Western world.

For years, these programs have been gatekept by university administrators. 

As clinical psychologist Dougal Sutherland from Victoria University pointed out in an article with Stuff, "Funding for the clinical psychology programme, which is a postgraduate programme, has historically been lower than any other postgraduate science course, so there is no incentive for universities to take more students."

Meanwhile, there are over 1,000 students on waiting lists across the country, desperate to get into these courses - and they think funding is the issue?

Funding for psychology programs comes from student’s course enrolment fees, not government handouts. 

Universities in New Zealand can run psychology courses for thousands of students without relying entirely on government funding, so claiming that lack of funding is the problem is a weak argument.

If you’ve ever tried to find a therapist, you’ll notice that the process is unnecessarily difficult. 

We live in an age where we can order food to our door and have almost anything at our fingertips, yet finding the right therapist often feels like jumping through hoops, backwards and blindfolded.

I've heard countless stories of people not being matched with the right therapist on their first try, only to give up entirely. We have apps that can find us a partner or a new best friend, but none that make finding a therapist easy. Current platforms are clunky and vague therapist descriptions make the search even harder.

And it’s confusing. 

There remains a heavy reliance on medication when it comes to treating mental health. GPs are well-versed in prescribing antidepressants such as SSRI’s  but they aren't trained for in-depth psychiatric consultations—that requires a referral to a psychiatrist.

For someone desperately seeking relief, it's no surprise they’d opt for medication from a trusted GP rather than wait 3 months or more to see a specialist. 

To make matters worse, the typical GP course only includes a single module on mental health, leaving them underprepared to handle complex cases.

Current Situation

In 2019, the previous Labour government allocated $1.9 billion to mental health, yet the Mental Health and Wellbeing Commission found no improvements to services in a review the following year.

This shows that pouring money into a broken system is like trying to fill a leaky bucket. Until we address the systemic flaws, no amount of funding will make a real impact.

The current National government is taking a different approach. 

Instead of trying to run everything from Wellington, they propose to allocate funding to local non-government organizations (NGOs) such as Mike King’s Gumboot Friday and MATES in Construction.

These grassroots organisations are already providing crucial counselling and mental health services to Kiwis. Up to $20 million in funding is available for each organisation that can show how they’ll put it to effective use.

While this approach could be effective in certain communities, some may benefit more than others. It also doesn't address many of the underlying issues, like the shortage of psychologists, challenges with University programs or the need for centralised funding for a tech-driven mental health system.

The biggest issue remains the accessibility and cost of mental health professionals. 

Why can’t we have a reimbursement model like ACC but for mental health services?

New Zealand’s Mental Health Reboot

New Zealand’s mental health system needs a complete overhaul. 

Let’s call it the "Mental Health Reboot."

Universities must be held accountable for lowering the barriers to entry for counsellors, psychologists and mental health professionals. 

Courses need to be opened up, simplified and revamped. It shouldn’t take 7 years of university to become a psychologist.

Education in this area must become less tied to traditional universities and move towards online programs. 

Technology needs to be implemented that invites people in, not pushes them away.

And Politicians need to be advocating for change on behalf of the people. 

Changing a system is no easy feat, but can be done. 

According to an article from Professor of Social Policy Kristy Muir from the Paul Ramsay Foundation, there are three ways that a system can be changed:

Technical work: changes to policies, programs, practices, legislation, regulation etc, 

Changing ‍where the resources go: changes to where funding flows, who makes the decisions, how resources get used and how the work gets done.

‍Hearts and minds: understanding and changing attitudes, beliefs, values and fears.

As a society, our hearts and minds have shifted and the majority of the population considers mental health to be a considerable issue. Now it’s time to put in the technical work and the resourcing work to align with this societal shift. 

It’s up to the people to hold the government and the universities accountable.

How to hold a large organisation accountable?

Here’s a few ways:

Consumer pressure: In the case of the psychologist shortage, our lack of help needs to be heard. If you can’t get an appointment, the Ministry of Health, Health New Zealand and the Psychologist’s board of New Zealand need to hear about it.

Contacting politicians: Politicians are the gateway to change in this area. They are contactable by email and phone and need to be informed that there is a flaw to the system.

Raising Awareness: Talk about these issues is a good start. Awareness through social media, local organisations and local media can drive action from politicians. 

Transparency: Push for transparency from the government and universities by requesting data on wait times, available mental health services and workforce shortages. If these numbers aren’t available, pressure them to track and release the data.

Change is possible

Imagine a world where seeing a therapist costs no more than a visit to the physio or a hairdresser.

What would that look like? 

A positive society where violence, drug abuse and road rage are no longer the norm?

This vision isn’t as far-fetched as it may seem. 

Countries like Sweden and Norway have made great strides in improving access to mental health services. 

In Sweden, mental health care is heavily subsidised by the government, with therapy sessions costing a fraction of what they do in New Zealand. 

Norway has prioritised mental health within its healthcare system, creating programs that drastically reduce wait times for those in need of psychological care.

Even Australia has taken bold steps, introducing Medicare-subsidised mental health plans that allow citizens to receive up to 20 sessions with a psychologist each year at a low out-of-pocket cost. 

These countries show that with the correct allocation of resources and a commitment to reform, affordable mental health care can become a reality - creating a healthier, happier society.

There’s no reason why New Zealand can’t follow suit.