The 11th annual report of the Office of the Director of Mental Health has been released today by the Ministry of Health.
The report, covering the 2015 year, records the work of the Office of the Director of Mental Health and reports on some of the activities of the Office’s legally assigned officers. It forms part of the Office’s accountability to the sector and provides information indicative of the quality of New Zealand’s mental health services.
In presenting the 2015 report, the Director of Mental Health, Dr John Crawshaw, has acknowledged ongoing public interest in mental health services.
“Our annual reports represent active and transparent monitoring of mental health services.
“The aim of my office, along with the other agencies working to support mental health, is to ensure that New Zealanders receive quality care.”
Dr Crawshaw noted that during 2015 a record number of people had accessed specialist mental health and addiction services, an increase consistent with international trends.
“While this reflects that more New Zealanders are seeking and receiving mental health care, which is positive, services are experiencing increasing pressure.
“The Ministry is committed to the continued improvement of mental health service delivery. We are actively working to identify innovative, sustainable solutions to the increased demand on specialist services.”
Areas of note include:
The number of people engaging with specialist services has gradually increased from 143,060 people in 2011 to 162,222 people in 2015. The rise could be due to a range of factors, including better data capture, the growing New Zealand population, improved visibility of and access to services, and stronger referral relationships between providers.
In 2015, consumer satisfaction with mental health and addiction services was rated around 82 percent.
In the National Mental Health Consumer Satisfaction Survey 2014/15, 82 percent of respondents either agreed or strongly agreed with the statement ‘overall I am satisfied with the services I received.’ Ten percent gave an in-between rating, 4 percent disagreed and 4 percent strongly disagreed.
A sector-wide target for DHBs to achieve by 30 June 2015 specified that mental health or addiction services should see 80 percent of people referred for non-urgent services within three weeks, and 95 percent within eight weeks. Urgent referrals should be seen within 48 hours.
In the 2014/15 fiscal year, services saw 78 percent of all clients of mental health services within three weeks, and 93 percent within eight weeks. In addiction services (both DHB services and NGOs), services saw 84 percent of clients within three weeks, and 95 percent within eight weeks. 30 percent of new child and youth clients were seen with two days of referral.
The report acknowledges that suicide is a serious concern for New Zealand. It provides an overview of suicide deaths (and deaths of undetermined intent) among people who used specialist mental health services for 2013. This overview uses data from 2013 because it can take over two years for a coroner’s investigation into a suicide to be completed.
In summary, in 2013:
- 513 people died by suicide. There were a further 31 deaths of undetermined intent.
- approximately 37 percent of those who died by suicide or undetermined intent (among those aged 10–64) were mental health service users
- mental disorders were a significant risk factor for suicidal behaviour
- males were more likely to complete suicide than females.
New Zealand’s national strategy to address suicide is the New Zealand Suicide Prevention Strategy 2006–2016 (Associate Minister of Health 2006). The New Zealand Suicide Prevention Action Plan 2013– 2016 (Ministry of Health 2013a) implements this strategy, and reflects the Government’s commitment to addressing New Zealand’s unacceptably high suicide rates.
The development of the next Suicide Prevention Strategy and Action Plan provides an opportunity to explore further effective interventions needed to reduce the suicide rate. This work has begun – we’re talking to our communities and stakeholders, including DHBs and others working in suicide prevention, to inform our work.
Use of the Mental Health Act
In 2015, 9904 people (approximately 6.1 percent of all mental health service users) were subject to the Mental Health Act. Males were more likely to be subject to the Act than females, and people aged 25–34 years were more likely to be subject to the Act than other age groups.
Māori and the Mental Health Act
The Annual Report presents data on Māori subject to compulsory treatment orders (sections 29 and 30 of the Mental Health Act). This year the section has been expanded to include data on Māori subject to inpatient treatment orders.
In 2015 Māori were 3.6 times more likely to be subject to a community treatment order than non-Māori and 3.3 times more likely to be subject to an inpatient treatment order.
Reducing the disparity in mental health outcomes for Māori is a priority action for the Ministry of Health and DHBs.
This section of the Annual Report presents data on the use of seclusion, which the Ministry is committed to reducing (and eventually eliminating). Since 2009 the total number of people secluded in adult inpatient services nationally has decreased by 30 percent. The total number of seclusion hours has decreased by 58 percent.
In 2015, the use of seclusion steadied. Most services in New Zealand, having successfully employed best-practice strategies to reduce their use of seclusion, are now entering a re-planning phase in which they are refining and refocusing their seclusion reduction initiatives. The continued reduction (and eventual elimination) of seclusion will require strong local leadership, evidence-based initiatives, ongoing workforce development and significant organisational commitment.
The report is available online: The Office of the Director of Mental Health Annual Report 2014.