Repealing and replacing the Mental Health Act

About the Mental Health Act

The Mental Health (Compulsory Assessment and Treatment) Act 1992 (the Mental Health Act) sets out the rules for when the government may intervene in a person’s life to provide mental health treatment without their consent. It is intended to be used as a last resort for people in a vulnerable and distressed state who are otherwise unwilling or unable to engage in mental health care.

Most people in Aotearoa New Zealand who access specialist mental health and addiction services will not be placed under the Mental Health Act. In 2021/22, around 6.4% of people using specialist mental health and addiction services, were placed under the legislation.

Although the Mental Health Act is only used for a small proportion of people each year, compulsory care can have a significant impact on their lives and their loved ones. It can also have a lifelong influence on people’s ability to live independently and engage productively in their communities.

Why the Mental Health Act is being repealed and replaced

He Ara Oranga, the report of the independent Inquiry into Mental Health and Addiction, recognised that the Mental Health Act has not kept pace with the shift towards a recovery and wellbeing approach to care, and has never been comprehensively reviewed. 

The report made the following recommendation:

‘Repeal and replace the Mental Health (Compulsory Assessment and Treatment) Act 1992 so that it reflects a human rights-based approach, promotes supported decision-making, aligns with the recovery and wellbeing model of mental health, and provides measures to minimise compulsory or coercive treatment.’

The Government has accepted the recommendation to repeal and replace the Mental Health Act.

Work programme

Since 2019, the Ministry of Health has been working on immediate, short-term improvements under the current legislation. This is alongside our work to understand what issues need to be addressed in creating new mental health legislation for New Zealand. These activities are reflected in the 3 workstreams below.

Improving service user experiences under the current Mental Health Act

• Published new guidelines in September 2020
• Published the following guidelines in October 2022:
  • Guidelines to the Mental Health (Compulsory Assessment and Treatment) Act 1992
  • Guidelines for the Role and Function of Statutory Officers: Appointed under the Mental Health (Compulsory Assessment and Treatment) Act 1992
  • Special Patients and Restricted Patients: Guidelines for Regional Forensic Mental Health Services
• Published the following guidelines in April 2023:
  • Guidelines for reducing and eliminating seclusion and restraint under the Mental Health (Compulsory Assessment and Treatment) Act 1992

Initial amendments to the current Mental Health Act 

This workstream involved making initial amendments to the current Mental Health Act to better protect people’s rights and improve safety.

• The Mental Health (Compulsory Assessment and Treatment) Amendment Act 2021 passed into law in October 2021. This provided for the elimination of indefinite treatment orders, a change called for in He Ara Oranga.

Development of the Mental Health Bill to repeal and replace the Mental Health Act

• Principles to guide development of new legislation approved by Government in 2019.
• Review of previous related consultations, academic research, and international examples to understand key issues and potential options for new legislation.
• Public consultation in late 2021 and early 2022 to inform new legislation.
• Engagement with the Mental Health Act Expert Advisory Group from May 2022 to March 2023 to test and refine policy proposals.
• Policy proposals for new legislation approved by Government in December 2022 and July 2023 (see Cabinet Material: Policy decisions for transforming mental health law).
• Introduction of the Mental Health Bill approved by Government in September 2024 (see Cabinet Materials: Mental Health Bill approval for introduction.
• Briefing notes to support introduction and first reading of the Bill.

More information on the Mental Health Bill is set out below.

Introduction of the Mental Health Bill

On 1 October 2024 the Mental Health Bill was introduced to the House of Representatives. This Bill, if passed, will repeal and replace the Mental Health Act. 

View the bill on the Legislation website

Read an overview of key areas of the Bill

The Bill aims to be a modern legislative framework for compulsory mental health care that:

• shifts compulsory mental health care towards a rights-based and recovery approach,
• enables responsive needs-based care, including culturally appropriate care, that addresses the need for compulsory care,
• supports the safety of individuals and others,
• supports people to make decisions about their mental health care and ensures those who have decision-making capacity are not compelled to receive mental health care,
• minimises the use and duration of compulsory care, including minimising the need for people to re-enter compulsory care,
• includes effective safeguards and mechanisms to monitor the use and operation of legislation and respect human rights.

The Bill has a proposed commencement date of 1 July 2027. The Bill will require shifts in practice and how compulsory mental health care is provided. The commencement date is to ensure that affected mental health services and other impacted areas, such as the courts have sufficient time to prepare for new legislation.

The contents in the Bill have been guided by what was heard through public consultation (as outlined below) and an Expert Advisory Group. 

Public consultation

Public consultation opened in October 2021 and closed in January 2022. We released a discussion document, Transforming our Mental Health Law, and invited people to share their views on what new mental health legislation should look like.

An external independent research company was contracted by the Ministry to analyse all the feedback and submissions received through public consultation. The submissions analysis document contains the analysis of the feedback gathered across two public consultation channels – written submissions and consultation hui in the form of online information sessions.

The submissions analysis shows that there is a strong desire for the Mental Health Act to be more tāngata whaiora and whānau focused, that the Treaty of Waitaingi - te Tiriti o Waitangi should be the foundation for new mental health legislation, that rights should be upheld in alignment to international conventions and that the current Mental Health Act is being misused. View the consultation findings in more detail.

Mental Health Act Expert Advisory Group

Following public consultation, we established a group of experts to help balance the diverse range of views gathered through public consultation. We appointed group members following an open expressions of interest process where over 130 applications were received.

The term of the Expert Advisory Group commenced in May 2022 and ended in March 2023.

The Expert Advisory Group included the following members:

• Co-Chairs: Anthony O'Brien and Kerri Butler
• Frank Bristol
• Gemma Griffin
• Karaitiana Tickell
• Kiri Prentice
• Mark Fisher
• Patsy-Jane Tarrant
• Tereo Siataga-Kimiia
• Tui Taurua
• Wheeti Maipi.

Next steps

Now that the Mental Health Bill has been introduced, the Bill will progress through the Parliamentary stages. 

You can find more information on all of the steps involved on the New Zealand Parliament - How a Bill becomes law page.

We will provide updates on significant developments on this work through the Mental Health and Addiction newsletter. 

Contact us

Contact the Mental Health Act Team at the Ministry of Health.

Email: [email protected].