The 12th annual report of the Office of the Director of Mental Health has been released today by the Ministry of Health.
The report, covering the 2016 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 2016 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 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 meet the increased demand on specialist services.”
”We are also working with other agencies, including the Health Quality and Safety Commission and mental health and disability workforce organisations to reduce and eliminate the use of seclusion and restraint.”
Areas of note
The number of people engaging with specialist services gradually increased from 143,021 people in 2011 to 169,454 people in 2016.
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 2016, consumer satisfaction with mental health and addiction services was rated around 80 percent.
In the National Mental Health Consumer Satisfaction Survey 2015/16, 80 percent of respondents either agreed or strongly agreed with the statement ‘overall I am satisfied with the services I received’.
Seventy-nine percent agreed or strongly agreed that they ‘would recommend the service to friends and family if they needed similar care or treatment’. Ten percent gave an in-between rating, 5 percent disagreed and 5 percent strongly disagreed.
A sector-wide target for DHBs to achieve by 30 June 2016 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 2016, 45% of people new to mental health services were seen within 48 hours.
In the 2016 calendar year, DHB-provided services saw 78 percent of all mental health service clients within three weeks, and 93 percent within eight weeks (see Figure 4). In addiction services (both DHB services and NGOs), services saw 83 percent of clients within three weeks, and 94 percent within eight weeks.
The report acknowledges suicide is a serious concern for New Zealand. Around 500 New Zealanders die by suicide every year. Suicide affects the lives of many – whānau, families, friends, colleagues and communities. It provides a brief overview of suicide deaths and deaths of undetermined intent, with a particular focus on people who had contact with specialist mental health and addiction services in the year prior to their death. This overview uses data from 2014 as it can take several years for a coroner’s investigation into a suicide to be completed.
- 510 people died by suicide. A further 22 deaths of undetermined intent were recorded in the mortality database
- approximately 46 percent of those who died by suicide or undetermined intent (among those aged 10–64) were mental health service users
- mental disorders are one of the factors that can increase the likelihood of suicidal behaviour
- males were more likely to die by 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.
Initial consultation to inform the new draft suicide prevention strategy occurred in 2016. The draft suicide prevention strategy was released for public consultation in 2017.
Use of the Mental Health Act
In 2016 10,311 people (approximately 6.1 percent of specialist mental health and addiction service users) were subject to the Mental Health Act. This compares to 9,904 people in 2015.
Males were more likely to be subject to the Mental Health 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 statistics on Māori subject to community treatment orders (section 29 of the Mental Health Act) and inpatient treatment orders (section 30) in 2016.
In 2016 27% of voluntary and compulsory patients were Māori compared to 25% in 2013, 25% in 2014 and 26% in 2015.
In 2016, Māori access rates to services exceeded those of other groups (6.1 percent of Māori accessed mental health services in 2016, compared with 3.1 percent of non-Māori). Māori were also more likely to be subject to a compulsory treatment order. In 2016, Māori were 3.6 times more likely than non-Māori to be subject to a community treatment order, and 3.4 times more likely to be subject to an inpatient treatment order.
These statistics underline the need for the mental health sector to engage in meaningful action to address the disparity of mental health outcomes for Māori in New Zealand. Reducing this disparity is a priority action for the Ministry of Health and District Health Boards (DHB).
The use of seclusion has steadied in the context of a 7 year decline. The total number of hours of seclusion between 2015 and 2016 has decreased by 11% however the total number of people secluded has increased by 6%. Between 2009 and 2016, the total number of people secluded decreased by 25 percent. The total number of hours spent in seclusion has decreased by 62 percent since 2009.
Most services in New Zealand that use seclusion are now entering a re-planning phase, in which they are refining and refocusing 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 2016.