Mental Health and Wellbeing Commission Bill

I move, That the Mental Health and Wellbeing Commission Bill be now read a first time. I nominate the Health Committee to consider the bill. At the appropriate time, I intend to move that the bill be reported to the House by 30 March 2020.

This Government is taking mental health seriously. The Mental Health and Wellbeing Commission Bill before you today establishes the Mental Health and Wellbeing Commission, an independent Crown entity that will contribute to better and more equitable mental health and wellbeing for people in New Zealand. The bill delivers on the election commitments made by all three parties of Government—Labour, New Zealand First, and the Greens—to re-establish a mental health commission. It also delivers on the coalition agreement between New Zealand First and Labour to re-establish the Mental Health Commission. This bill, effectively, reverses the decision of the previous Government to disestablish the former Mental Health Commission in 2012.

He Ara Oranga, the report of the Government inquiry into mental health and addiction, identified widespread issues and low public confidence in mental health and addiction services and in the wider mental health and wellbeing system. He Ara Oranga set the tone for the system transformation that is required and laid down the challenge to the Government. This Government has responded. In Budget 2019, we announced a number of initiatives that support a transformed approach to mental health, wellbeing, and addiction in New Zealand. These include initiatives to prevent suicide and support people bereaved by suicide, improving support for people experiencing mental distress and addiction, and expanding access and choice of primary mental health and addiction supports, among other initiatives.

The commission will play a vital role in the system overhaul. Transforming the mental health and wellbeing system will take time and requires alignment across sectors and between Government and non-Government players. Improvements in mental health and wellbeing will be influenced by changes in Governments, Government priorities, and the focus of Government departments and other decision makers. An entity with an enduring role is needed to take a whole-of-system view and maintain long-term pressure on successive Governments and other decision makers that contribute to mental health and wellbeing. The bill establishes the commission to provide system-level oversight of mental health and wellbeing in New Zealand and to hold the Government of the day and other decision makers to account for their contribution to the mental health and wellbeing of people in New Zealand.

The commission will assess how the system improves equity for Māori, Pacific peoples, disabled persons, rainbow communities, and other groups that experience poorer mental health and wellbeing outcomes. The commission will build on the roles of existing organisations that contribute to mental health and wellbeing by looking across the whole mental health and wellbeing system. This includes, of course, how the system promotes mental health and wellbeing, how it builds resilience and prevents poor mental health and wellbeing, including addiction and suicide, and how it identifies and responds to people experiencing poor mental health and wellbeing.

He Ara Oranga was clear that improving mental health and addiction outcomes, including drug and other addiction issues, means understanding and addressing wider social determinants of wellbeing with a more holistic emphasis on prevention of mental ill health and distress and, indeed, promotion of mental wellbeing. Acknowledging that there are many factors that contribute to people’s mental health and wellbeing—and people rarely experience one factor in isolation—the commission’s focus spans all Government and all non-Government contributors to mental health and wellbeing. In particular, this includes the following sectors: health and disability, social welfare, housing, education, justice, and workplace relations and safety. It encompasses the social determinants of mental health and wellbeing such as income, employment, poverty, housing, social attitudes, and freedom from discrimination. It includes whether approaches to mental health and wellbeing are culturally appropriate.

The bill sets out the commission’s functions in three main groups. First, the commission will assess and report publicly on the mental health and wellbeing of people in New Zealand. This includes publicly reporting on factors that impact on people’s mental health and wellbeing, including the wider determinants of mental health and wellbeing. The commission will assess and report publicly on the effectiveness, efficiency, and adequacy of approaches to mental health and wellbeing such as policies, funding decisions, and the priorities of the day. It will also assess and report publicly on mental health and addiction services, a function currently undertaken by the Health and Disability Commissioner. These monitoring functions will ensure that the commission can hold the Government of the day and other decision makers to account for their contribution to the mental health and wellbeing of people in New Zealand.

Second, the commission will advocate for the collective interests of people who experience mental distress and/or addiction. This will include advocacy for groups of people who experience poorer mental health and wellbeing outcomes and inequity. But the commission’s role is not just to monitor and advocate, so, third, the commission will promote collaboration across entities that are involved in or contribute to mental health and wellbeing. This may involve encouraging good practice, sharing information, and working with stakeholders to identify unmet needs and service gaps.

The bill requires that the commission must have particular regard to the experience of, and outcomes for, Māori when carrying out its functions. The bill also provides that the board must ensure that the Commission maintains systems and processes to ensure that it has the capacity and capability to uphold the Treaty of Waitangi and its principles and to engage with Māori and to understand perspectives of Māori.

The bill gives the commission powers to help it effectively carry out its functions. The commission can publicly report on any matters concerning the mental health and wellbeing of people in New Zealand and make recommendations to any person, including Ministers. The bill also gives the commission powers to obtain information from Government agencies and statutory Crown entities, though this will not include personal information. The information-gathering power is critical for the commission to assess on approaches to mental health and wellbeing and the effectiveness, efficiency, and adequacy of these approaches.

Together, the functions and powers in the bill provide the commission with the levers required to build a picture of service and system performance. The functions and powers will enable the holding of decision makers to account and, ultimately, influence better and more equitable mental health and wellbeing, and, if it’s doing its job, will also increase public confidence in the mental health and wellbeing system and supports that are in place.

The bill meets an important Government commitment to establish the Mental Health and Wellbeing Commission. I want to thank our coalition partners New Zealand First for their role in making sure that was in the agreement that we had in the formation of Government. I want to thank all three parties contributing to the Government for their advocacy for such a commission when in Opposition. An independent Crown entity that will provide an enduring role to hold the current and future Governments to account is described in this bill. It will be a voice for the collective mental health and wellbeing of people in this country, New Zealand. I commend this bill to the House.

Thank you very much, Mr Speaker. As the National Party mental health spokesperson, I rise on behalf of the National Party to support the Mental Health and Wellbeing Commission Bill in its first reading. The reality is all of us will experience good and bad mental health over the course of our lives. In fact, we’re all in this together, and it’s our shared experiences that bind us together and give us a pathway forward.

If I reflect back to when I was first elected in 2014, an elderly gentleman said to me, “Matt, no need to talk about your mental health background, as a politician.” I don’t blame him for that. I don’t agree with him, but he talks of a generation that never talked about mental health, faced a lot of stigma, and were not open to talking about their own mental health issues and needs. Now things have changed quite significantly. We have a younger generation, and a not-so-younger generation, who are driving politicians forward, and I know every member of this House will have been approached and urged by young New Zealanders to do something more around mental health. I want to acknowledge all those who are members of Parliament who have talked about their own mental health issues and experiences.

I want to put on the record my own mental health journey. I was involved in a serious car accident when I was a teenager of about 18. I spent a bit of time in Timaru Hospital with head injuries and a few broken bones. Interestingly enough, when I look back, I was discharged from hospital, I had follow-up appointments around my broken bones, but I never received any follow-up support about my head injuries. Following that, I had a large period of time where I struggled to concentrate. I got very frustrated, which led to a lot of anxiety and depression, and I dropped out of university, where I was studying finance—because, of course, when you study finance, that’s the best way to make a lot of money.

So things weren’t going too well, and someone said to me, “Why don’t you talk to someone about it?” I thought, “Well, I’m not going to do that. I’m a rugby player; I don’t talk to people.” But I decided to, and it changed my life, literally. I was able to deal with some of the issues that I went through, and that actually sparked me to go and study counselling psychology. I went on to work in talk therapy roles in the mental health sector, which took me to London, where I worked for the British National Health Service for 15 years. Eventually, I got shoulder-tapped for the dark side, which wasn’t politics but it was management, and I thought, “Why would I want to work in the back office when I’d trained to work clinically at the front end?”, but I quickly learnt that the shape, design, and delivery of services has a big impact on the therapeutic alliance, as much as the front-end work. Now, thankfully, I’ve been able to continue that work around policy and legislation, and part of that work is what we’re debating today.

This mental health commission does seem a bit like Back to the Future. I have spoken to several people who are leaders in the mental health field who say it is time for a new mental health commission but weren’t upset when the last one was disestablished. Many in the field thought that mental health commission had lost its way. This one is very different. It’s taking a whole-of-system approach, because, of course, we’ve learnt a lot more in the mental health field over the last decade. Of course, now we talk about the recovery model, where it’s about putting people in the centre of their care. A lot of people with lifelong mental health issues know how to keep themselves well; we just need to listen to them and provide them with the ability to get that support. Also, we know now in mental health that we almost need to take mental health out of health. It’s a cross-Government agency issue, it’s a whole-of-system issue, and that’s exactly what this proposed mental health commission does.

But what we are disappointed on this side of the House about is there’s no mention of a social investment approach. In fact, when you read the detail of this bill, it actually speaks volumes to a social investment approach: looking across Government, taking a holistic view, and thinking about how you can put in investment and really get that bang for the buck. I’ll give you a good example. What we used to do with teen parents, I believe, is what we’re doing with people who are sitting on a benefit with mental health issues today. Why I say that is, traditionally or historically, teen mums—we would put them on the DPB and, you know, wave them goodbye a bit. History would show they would spend 20, 25, 30 years on that benefit. Now young mums can engage in schools with a fully flexible education system. Taking that approach, which is very much a social investment approach, is what we can do with people with mental health issues who are on benefit and want to get back to work.

There’s a lot of people who say, “Well, WINZ knows how to get people into employment and knows nothing about mental health.”, and the mental health services say, “Well, we know a lot about treating mental illness but don’t know much about getting people into employment.” That’s exactly what a social investment approach will take, but it is what all this whole-of-system approach that this bill talks about will take as well—taking a view over social development, taking a view over corrections, and taking a view over health and a lot of other Government agencies, including education. That is the right way forward.

National wants to work with the Government on mental health. We have heard the call from the New Zealand public, who want us to take a bipartisan approach, probably even more than on climate change, so we will work with the Government on this. But our focus remains committed to ensuring more front-line services for the growing demand of people with mental health concerns. So we want to make sure this commission will deliver more. Yes, of course we need to not only treat people with mental health issues but also promote mental wellbeing and resilience, and, of course, if we can do that better earlier, it, arguably, prevents some people from having issues further down the track. But what this bill must do is ensure that there are more front-line services for those vulnerable New Zealanders.

One thing I raised today that I’m hoping we will be able to work through over the course of this bill’s going to select committee is what is going to be the role of this mental health commission for commissioning services. Why I raise that is that when you look at international mental health commissions, in Western Australia, one of the functions is around commissioning. One of the problems we have in New Zealand is we have a postcode lottery for mental health services. There are some regions doing really well and there are some regions that are not. I don’t believe it’s right that some people are not accessing services because of where they live. In a small country like New Zealand, we could have a central commissioning agency, not necessarily to do the commissioning in the detail, but maybe to provide a templated approach of ensuring that there’s the same level of services across every jurisdiction. Melbourne, currently, has just implemented this. It’s a stepped care approach, and I think there’s real potential in this Mental Health and Wellbeing Commission to take on a function like that, to determine what level of services every jurisdiction should have, and to then hold those DHBs to account.

Many MPs in this House will have heard from the NGO sector, who are out there saying that they could be seeing more people and doing a lot better work, but, unfortunately, they’re dependent on the DHBs and getting the scraps off them. This is the funding and planning division we have in New Zealand’s DHBs. We need to think more about how we can get more resource out to the NGOs, and I know that this commission has a function in looking at the services as well.

One thing—just to conclude—is that I’ve heard it said that mental health is 50 years behind physical health. That is how much we have to catch up. There is still a lot to learn, and I welcome that this Mental Health and Wellbeing Commission will have a role in looking at developing an evidence base. That’s what we need to do: we need to develop an evidence base in New Zealand to inform future direction.

As I said, we welcome this bill. We want to work with a bipartisan approach to mental health for the betterment of New Zealanders, but we also want to see action and more services to respond to that growing demand. Thank you, Mr Speaker.

Tēnā koe e Te Māngai o Te Whare. Tēnā koutou katoa. It is an absolute pleasure, as the chair of the Health Committee, to receive the Mental Health and Wellbeing Commission Bill from the Minister of Health. Can I, firstly, congratulate the Government—obviously, our Labour team but also New Zealand First and our coalition partner, the Greens—because mental health, for us, has been a priority, but I also want to acknowledge, as espoused by Matt Doocey, that this issue, this kaupapa, is also a priority for the National Party.

I want to acknowledge that in being really clear about that priority, we, in good faith, undertook a process to establish a cross-party working group on mental health and addictions wellbeing, and that was a recommendation of He Ara Oranga. So I’d like to acknowledge the leadership of Matt Doocey, and also of Chlöe Swarbrick and Jenny Marcroft, and also David Seymour, to enable us to come together—

Chlöe Swarbrick: You’re not looking too shabby.

Thank you, Chlöe. I’m not too shabby either, and I am a member. But we, essentially, were pulled together because we are incredibly passionate about mental health and addictions wellbeing, and, as Matt Doocey has said, in the past, historically, mental health issues were seen as a terrible thing. People were incarcerated—you know, they were treated appallingly. We had institutions that locked people up for life. Then, we went through a deinstitutionalisation process, and now, actually, we’re going through a process of being really proactive about anticipating New Zealanders who are going to have mental health and addiction challenges in their lives.

So the He Ara Oranga process, I think, demonstrated how much of a priority it was for this Government. We actively went out and we heard from New Zealanders—New Zealanders like my colleagues Matt Doocey and Chlöe Swarbrick, who have shared their own personal experiences of mental health challenges. So we heard from whānau and we heard from individuals, and a lot of the disclosures have meant that the importance of establishing this Mental Health and Wellbeing Commission to, as the Minister said, coordinate and be strategic right across the Public Service is incredibly important.

I want to acknowledge within that context our advocates, and when I think about our advocates as espoused in the bill, it is Māori. So it is our kaupapa Māori providers, our Whānau Ora providers, our Pacific peoples providers, those who care for our disability sector, the rainbow sector, and in the bill it says “other groups that experience poorer mental health and wellbeing outcomes.”, and I want to specifically note the needs of rural New Zealand.

There is a divide between rural New Zealand and urban New Zealand, and within the rural context I want to specifically highlight the needs of our farmers. There may be justification in clause 13 of this bill, because what it does is say to this wonderful commission that we’re going to establish that they must seek specifically the views of Māori, Pacific, disabled, and then it says “other groups … who have disproportionately poorer mental health”, and I guess I’m putting out there that I also think of rural New Zealanders, who because of distance and because of access to services need to be taken into consideration. The difference between rural and city statistics is that in the rural communities, 16 per 100,000 suicide, and in the cities, 11.2 per 100,000 suicide.

The other issue we seem to have, in addition to the rainbow community, which I also want to specifically address—because we know, through youth health surveys and data, that if you’re a young rainbow person, you’re four times more likely to self-harm. If you’re trans, you’re five times more likely to self-harm and to attempt suicide.

So these issues are incredibly important, these communities are incredibly important, and, actually, in this debate and on International Men’s Day, I want to say that our men and men’s voices are incredibly important. If we look at our statistics, 68 percent of those who suicide are men, and we have particular issues in the 15- to 19-year-old age group and the 20- to 24-year-old age group. So here is a challenge. It’s complex. This doesn’t just affect one part of our society, and so we have a lot of work to do, which means we have a lot of people to listen to and to take into consideration.

So I want to acknowledge that of the 40 recommendations in He Ara Oranga, the establishment of this Mental Health and Wellbeing Commission was one of those recommendations. What I want to highlight is that this organisation will be an independent Crown entity. Now, the nature of an independent Crown entity is that they can hold the Government to account. They are independent, and, as the Minister said, they can report on any matter that affects any Minister.

What I want to highlight from the bill which I think is really, really important is that we’re going to look at the social determinants of mental health and addiction wellbeing. We actually care about the context of the people who are seeking help in terms of their housing, in terms of their employment situation, the relevance of poverty, what the social attitudes are to those particular groups, and are these groups experiencing discrimination, and, for me, that’s where the issue of our rainbow youth is particularly pertinent. I want to acknowledge that my colleague Marja Lubeck also has a bill here in our Parliament that wants to look at sexual orientation change efforts, because those efforts actually undermine our young people’s identity, and if they give effect to issues of self-harm and suicide, then we need to do something about that, because inherent in that is discrimination.

As I mentioned earlier, this whole issue of mental health and addictions wellbeing has gone from being one of those issues that no one talked about, and it was out of sight and out of mind, to being something that actually affects all of us—every single one of us—and particularly our children. So I want to put on the table that I’m expecting submissions from specific groups that say, “Hey, our voice isn’t specifically included in clause 13, and maybe it should be.”

I guess the other issue to highlight is that we’ve pre-empted the establishment of the Mental Health and Wellbeing Commission by appointing, in September this year, Hayden Wano, who is chairing the initial Mental Health and Wellbeing Commission. For me, that’s significant, because this is a priority. We know it’s an issue for Māori, and we have a Māori who’s the chair of this initial commission. One of the aspects that they’ve been asked to look at is to develop advice for the permanent Mental Health and Wellbeing Commission so that it can make swift progress once it is established. I think the fact that we’ve included Māori significantly—and I actually want to highlight the other members of those groups. If I look at the other Māori, we have Dr Julie Wharewera-Mika, who’s a clinical psychologist. She works in child and adolescent community mental health, and she is a specialist dealing with survivors of sexual violence, and has specific expertise in Māori mental health workforce development. I want to highlight that we have Kendall Flutey, who teaches children. So we have prioritised a particular profession that is working with our rangatahi, and I think that sends a clear signal about the priority.

I also want to acknowledge Kevin Hague, who is a member of this initial Mental Health and Wellbeing Commission. We all know Kevin—incredibly passionate advocate, smart man, has been a chair of a district health board—and I think his involvement is a signal. It is a signal—can I also say, to the rainbow community—that we matter. We also have Kelly Pope, who is a mental health advocate. She’s a young person, and she works with young people, mental health, and youth peer support.

So when I think about the platform that we’re creating, and the people that we have involved in the creation of this Mental Health and Wellbeing Commission, for me, I feel a sense of difference and transformation. This isn’t business as usual, you know. This is definitely a response to all those voices, all those people that we heard in the He Ara Oranga process. There were over 5,200 submissions over 400 meetings around the country. So I’m hoping that the people who participated in that process feel validated in the sharing of these stories; they feel validated that in the creation of this Mental Health and Wellbeing Commission, we are taking seriously what they said to the Government. As an initial response, can I say that I’m incredibly proud to be part of a Government that has prioritised mental health, that is enabling people to talk about mental health and wellbeing, and who wants to work with people across Government, non-governmental organisations, the business community, and our whānau, so that we’re able to speak up and ask for help and, actually, we have a responsive mental health and addiction system that can meet every need in the most appropriate way. Kia ora.

Thank you, Mr Speaker. I’m pleased to stand in support of this bill and echo the comments of my colleague and friend, our mental health spokesperson, Matt Doocey, one who has a considerable degree of experience in this area.

I think there is a mood of cross-party support for this. I say this with a caveat, because the Minister still can’t bring himself to acknowledge any contribution by the National Party to any part of health policy. That’s certainly the case with mental health. That’s slightly disappointing, given the leadership that Mr Doocey has shown around the establishment of the cross-party support, and the willingness of the National Party to contribute positively to making sure the effect of this bill is as positive as it can be. We want to make sure that the strategies and initiatives that are recommended and implemented by the commission and the sector as a whole are enduring, and the changes that need to be made are generational—they will transcend Governments and members of Parliament. I think it behoves the Government—well, the Minister, at least—because I know the members of the Health Committee from the other side acknowledge the contribution that Mr Doocey and the National Party have made. At least the Minister could, at some point, acknowledge that as well.

While we will support this bill, I have to signal to the House that we will oppose the motion to report back to this House on 30 March 2020. That is just four months and 11 days away. With the intermission of the Christmas break, which could see no work by the select committee—in fact, no work by National members of the select committee, at least for the period between 18 December and the end of January—my concern about this report-back date is that it will be hastened, it will be rushed, that it will be necessary, therefore, for submitters to have a shortened period of time. The Health Committee will consider that, and the chair will make her considerations on that, but it could be as little as two to three weeks. I think given how we acknowledged that it is important that we understand what the terms of reference are that we are setting down in primary legislation, it does behove us to take a more considered view of the submissions by the people who know the sector best, and therefore we will oppose a shortened report-back date.

I also want to highlight another perceived—at least, perceived by me—inconsistency in the manner in which the Government has gone about the establishment of the organisations that it will use to support it. I compare and contrast the establishment of the Mental Health and Wellbeing Commission as an independent Crown entity with the refusal of the Government to do that with the cancer agency that it scrambled to announce after the National Party did just that in July. Our announcement was of a wholly independent cancer agency, independent of the line of command from the front line to the Minister, so that it can step aside and make a clear articulation of what good cancer care looks like and hold the sector to account for delivering that. I find it a bit ironic that in the Mental Health Commission, and in the reading of the regulatory impact statement and the bill itself, that’s exactly what it seems as though the Government wants the Mental Health Commission to do. It is very inconsistent in the sense that it is not going to do that for things like cancer care. The Minister said something like, “Well, if they’re not in the line they can’t be controlled.” Well, that’s exactly how they should be, and it’s exactly how it appears as though the Government wants to establish the Mental Health and Wellbeing Commission. So I would actually encourage the Minister to take some of his own advice from mental health and apply it to cancer care.

I’m also interested in the purpose, as articulated in the bill. It says, “The Commission will contribute to better mental health and wellbeing outcomes for people in New Zealand.” But it can only do that through service delivery. I have been very disappointed, two years into this Government’s tenure, that they have done a lot of talking and a lot of listening, but very little doing. Lots of hui, no doey. In fact, the mental health and addiction report is now back out on the road. I do acknowledge that Budget 2019 had a significant sum of money for increasing mental health services, but my question is: is it actually being spent? I think we’ll find, near the end of this financial year, that the answer to that question is no. There have been some buildings announced in Porirua, Palmerston North, and somewhere further north, but actually—in terms of new services, new initiatives, extra resources actually being committed on the front line—we are seeing not only nothing but the opposite of that, because of the Government’s refusal to support the previous Government’s 17 initiatives, valued at $100 million, as part of a $223 million mental health package announced in Budget 2017. It seemed as though because it wasn’t their idea, it wasn’t a good idea. That’s the antithesis of the sort of cross-party collaboration that we have all acknowledged in this House is necessary in order to deliver improved mental health for New Zealanders.

Yes, there was a criticism that the previous Government came a bit late to the party on this, but these were very, very well-considered cross-portfolio initiatives that were very much consistent with the social investment model that we continue to promote. It had aspects of education, of police, of law and order, of social policy—a number of other areas outside the core health service delivery. As Mr Doocey mentioned, it certainly looked at what were quite well evidence-based and modern: e-therapies, talk therapies, mild to moderate focused, community-based, focused on the young; all of the things that we know are necessary to be able to deliver good mental health. They were dispensed with. I hope and trust that the Mental Health Commission, when it is established, has, firstly, the resources, and then the right teeth, I suppose, to be able to very clearly articulate what that means, without fear or favour, of what has gone before.

And if it, in its wisdom, believes that any or all of those 17 initiatives were the right thing to do, are the right thing to do, then they should be able to recommend that and the Government should have the good grace to accept that advice. The role of the commission, as stated in the general policy statement, of contributing to better mental health can only be the case if the Government accepts the recommendations and the advice of the commission, and so that’s where that independence is going to be so important.

I will finish just on the issue of suicide. It’s been a particularly concerning issue to monitor over the years. I recently read a report that surprised me, when one distinguishes and stratifies between urban and rural suicidality, and this is where I think the commission will be able to make some very good inroads into understanding where the need is. While, in fact, suicide rates in urban areas had dropped by about 7 percent, suicide in rural New Zealand had gone up by 17 percent. I see my regional MP colleagues to my right nodding because they know how much stress is being brought to bear on our rural communities for a number of reasons, and how important it is to make sure that our services are committed into the areas of most need.

That’s where the commission, I think, is going to play a very important part not only in articulating what “good” looks like but where it is—where the need is the greatest. I’m confident that they will be able to see that the need is not perhaps traditionally where the providers of mental health services are. It’s going to need to be very confident and clear in its expectations that if they believe in services closer to the client, then that’s likely to mean a move away from the base hospital-type approach, the institutional approach, and to reinforce what we know—and that is: it’s the communities in our regional and rural sectors that are most poorly served at the moment by our mental health services, and that’s where the need is greatest.

But with that caveat and our opposition to the shortened report back, I’m pleased to confirm our support for it.

Tēnā koe, Mr Speaker. Thank you. It is an absolute pleasure to stand on behalf of New Zealand First to take my call on the Mental Health and Wellbeing Commission Bill in its first reading. The objective of this bill is, of course, to establish a mental health and wellbeing commission. This bill delivers on a coalition agreement between New Zealand First and Labour to re-establish the Mental Health Commission.

In 2017, at the general election, on the campaign trail, New Zealand First, Labour, and the Greens all campaigned on needing to ensure that the wellbeing of this country was at the forefront when we came into Government. So that is something we hold together, and that was a platform all of us campaigned on. So we would like to acknowledge the Minister of Health for working through this bill, the Hon Dr David Clark—working through with New Zealand First on this bill.

During that campaign in 2017, I just note that my leader, the Rt Hon Winston Peters, said that, actually, we needed to have a national inquiry. We are pleased that He Ara Oranga has produced the results from that inquiry. What it found, and what we knew, was there was a chronic lack of funding from central government for mental health, and it was showing up these alarming statistics. Mike King, who many of us know in this House, asked what is stable about a system where one had to prove they are suicidal to even access the little services that are available. So it became obvious that more funding was needed to be injected as soon as possible—and New Zealand First made the decision that that would be something we would take to our negotiations.

Recently, I had the privilege to meet with the initial Mental Health and Wellbeing Commission. We met earlier in October, along with my colleague Chlöe Swarbrick, and we met what was a very passionate group of people. It was their very first day as a commission together, and we met them at the end of their first day, in the office of the Hon Dr David Clark. And what I noticed about that group of people was that they all brought some kind of lived experience of mental health, whether they had suffered themselves or were clinicians in the field. They absolutely were excited to start their very hard mahi that was in front of them.

I’d also like to acknowledge the cross-party mental health group. We’ve actually had a couple of meetings now—we launched and then we had our first meeting. And, you know, it’s a real pleasure to be part of the group along with Matt Doocey, Louisa Wall, Chlöe Swarbrick, and David Seymour, and, you know, to work in a way that is cross-party, for the benefit of all. We heard, as we launched, from JK, and what he said was that he was going to keep an eye on us to make sure that we didn’t put politics inside of mental health. So we have that, really, sitting like a shadow upon our shoulder to make sure that we do keep working in a way that is making sure we don’t throw the politics into it. We also heard from Mike King, as well—not the group, but, you know, the advocacy of Mike King in the space that he’s working. So we know, after hearing from these people, who have championed mental health and various people in the community who are suffering, that now we can take up the mantle and ensure that we have better outcomes for all of those who are suffering, and we’ll do this by setting up the commission through this bill.

Many of us have connections to people who have either had mental health issues or somehow were involved with people in our community. I acknowledge all of those members of this House who have spoken about their own challenges; it’s very brave of you, and the more that we speak about them, the more that we can shine light on them.

There is a saying that I’ve heard from my grandmother, actually: where there is suppression, there is depression. So if we hold back and push down, the feelings that overwhelm us, ultimately, will lead towards depression. So it’s all about being able to speak up and speak out, and having that pathway to find a way through and shine a light on the darkness or the cloud that is coming down—or the black dog or whatever you might like to call it.

I’d like to talk about my mother. We used to come home from school, as a kid, and mum would be in bed every afternoon, and I just thought, “Well, she’s having a bit of a nana nap.” She died quite young. It wasn’t until I was probably 18 or 19 that I actually found out why she took to her bed in the afternoon. I thought it was maybe that she had five kids and she was exhausted. But, no, actually, in the 1950s, she was at art school and she had a very busy life and she had a big overseas trip where she’d won an award to go all around Europe, and when she got back she was exhausted. The doctor at the time, basically, said, “Lock her up. Strap some electrodes on her head and zap the bejesus out of her.” So she underwent a series of shock treatment, and when my grandmother heard about it from Wellington, she drove like a bat out of hell—in a very small car—and busted my mother out of that institution.

At the time, there wasn’t the medication that people can take today if they’re feeling depressed or have anxiety or go to counselling; it was a one-size-fits-all and let’s reset the brain by shock treatment. Now, shock treatment is still being used today; it is a very brutal form of treatment, but it is thought to be effective. But my mother just needed a rest and she needed to talk. She needed care. So my grandmother busted her out of the institution, and took her home. But there were long-term effects from that shock treatment, and I didn’t know that as a child; I only learnt about them as a teenager. So, really, what I’m trying to say about my story is that all of us somehow are connected to a story about someone who has mental health issues.

So I would like to conclude, I suppose, that setting up the Mental Health and Wellbeing Commission that will have oversight of the industry of mental health will ensure that we don’t have people slip through the nets, that they get the treatment that is appropriate to them, to their culture, to their beliefs, and that they are looked after and cared for back into a state of wellness. This commission will help to improve the outcomes for all New Zealanders that are suffering. It will help to improve equity for all those groups that aren’t able to effectively access the services that they currently need. So I’m really pleased that the commission will have particular oversight into the Māori community and the needs there, the Pasifika community, the rainbow community, the disabled community, and any other organisations or communities that need extra oversight. The commission will also hold the Government and future Governments to account, and also the decision makers to account. I think that’s really important, because what we’re achieving here today by working in this cross-party way is that mental health issues won’t go away overnight; we have to work on them together. That’s something that Matt Doocey said—we are all in this together.

I’d like to conclude there with just a final couple of thoughts. This independent body will hold the current and future Governments to account for the mental health and, more importantly, the wellbeing of all New Zealanders. So I commit this bill to the House.

Thank you, Mr Speaker. I too would like to acknowledge the formation of the cross-party group in Parliament in support of forming the commission that’s the subject of this bill. When Matt Doocey got up and spoke before, he stated that there’s been an estimate that mental health is around 50 years behind physical health for us as a society, and somehow it almost feels like it’s worse than that. So 50 years ago, when we were growing up, mental health was something that wasn’t talked about. In fact, it was probably worse than that. Tokanui is in my electorate. Everyone knew where it was. They knew what it was. It was one of those places that, you know—the people that went there were different to the rest of us. But now we know, in this day and age, the people that went there weren’t different to the rest of us; they were part of us. Unfortunately, in that time, we had no more knowledge to deal with mental health and the way it was operated at that time.

My first real experience of mental health came in 1995, when my sister lost her husband through suicide and my two young nephews, who were three and 18 months old, were left without their dad. At that time, that was really hard, because it was something that always happened to somebody else’s family. Until it happened to your own family, it’s not something that you ever think is going to happen to your family. So, you know, it’s one of those realisations, I think, now in a society that—I’m really pleased that we’ve come to accept that one in four or five of us is going to experience this, and we need to support each other on the way through it. I support what John Kirwan has asked—not to put the politics into mental health—because there’s nothing about politics that belongs in mental health.

One of the things that I would like to encourage—I’ve done a lot of work over the years, and particularly in the last five years of being an MP, with organisations like the Rural Support Trust, with organisations like Farmstrong. I even got on my bike and biked 60 kilometres down in Southland one year, and that rural support trust in Taranaki raised about $200,000 for mental health in the area. So what I see this commission as doing and what I hope is going to be successful is that all of those organisations, that are out in our community that are currently doing good work, actually gather up those organisations and see how we can support those people to do the work they are doing. The more work the people at the community level can do, the less work we’re going to need further down the track.

If we can actually encourage people as friends, neighbours, and support trusts to ask for help, to look for help—and, you know, often when there’s a drought or a downturn or something in farming, it’s often when someone goes along with a plate of scones and has a shared meeting and gives people a cup of coffee that encourages them to talk about it. It’s very easy for farmers to sink into a space in a drought or in a bad time and think it’s them that’s doing something wrong when, actually, the whole community is experiencing the same thing. So it’s about communities getting together. It’s about sharing. So, you know, my hope is that we will round up all those organisations and we will support them as much as we possibly can. I think it’s really important now that the health foundation has picked up the funding to put data points together for rural health and for rural communities.

So given that it is not going to be until 2021 that this commission will be formally and properly established so that it’s up and running, the onus must now be on urgently helping and delivering some of these front-line and community services. So I would urge the Government in the short term, because we’re already two years behind the eight ball after, you know, having the working party and going through this process—there’s a lot of things that we could have been doing in the meantime. So there’s some urgency to support some of these things while we’re waiting for the commission to be up and running.

You know, I look in our communities. There’s a whole lot of things. I’ve got 85 primary schools in my electorate, and people talk about telehealth. Telehealth on its own is not a—you know, I don’t want people having to go on Google and do their own stuff online completely. It’s a tool, and I was with the RuralFest last week and we talked about it being a tool, but actually having community and health professionals behind those people—there’s lots of facilities where we’re able to undertake that. So this is not about more buildings. This is about more community stuff, more people helping each other. I look forward to this as we work forward, and I have great pleasure in commending this bill to the House. Thank you.

E Te Māngai, tēnā koe. Tēnā koutou e Te Whare. It is a pleasure to stand on behalf of the Green Party of Aotearoa New Zealand and speak in support of this Mental Health and Wellbeing Commission Bill. As so many of those who have contributed to this debate already have showcased, mental health, and particularly mental ill health, is not ambiguous. It’s not something that kind of happens out there, over there in some other community, and we just talk about it and don’t see it. It’s very much the case that all of us have it. All of us have experiences of it, and it comes from our life experiences. It comes from the way that we were raised and the environments that we presently find ourselves in, by the situations that we are confronted by. I think that mental ill health, to think about it in an illustrative way, is much like the tip of the iceberg. It is very much the case that it’s the manifestation of all of the other things that are going on in our lives, of the baggage that we’re carrying that is so often invisible. On that note, whilst a lot of people have noted so far in this debate that something like this shouldn’t be political, I really want to re-emphasise that I personally, in my very earnest—perhaps some may characterise it as naive—point of view, come to this Chamber believing very fully that politics is personal and the personal is political, and we’ve seen that in the contributions from the debate today.

I also just want to acknowledge the point made by my colleague Jenny Marcroft from New Zealand First, who stated that those who have spoken openly about their own experiences with mental ill health are brave. I’ve spoken numerous times about the fact that I have clinical depression and I’m medicated for it, and I think that that is a shared experience for many who work in these bizarre buildings. But I don’t feel brave in saying that in any way, shape, or form. The reason that I decided to share that is because I think that in coming to a place like this Parliament, which is supposed to be a House of Representatives, it’s important to be honest and your full self, that being warts and all. That obviously didn’t stop the flood of emails that wanted to decry me as crazy, but none the less, keep them coming, folks.

I also want to speak to and acknowledge an incredible former Green MP who has been spoken about by other contributors to this debate—that being, of course, Kevin Hague. Kevin stepped down—decided not to run again for the Greens in 2016—and took on a position with Forest & Bird. He was our former health spokesperson. When he was looking to the end of his term, he wrote an op-ed for Stuff.co.nz. And he spoke about the fact that he had been campaigning for a number of years alongside the other parties that we now join in Government, as well as NGOs and those in the community, for an independent inquiry into mental health and addiction and wellbeing in this country. But I just wanted to quote a piece from this op-ed that he wrote for Stuff. It says, “Had I been Minister of Health, re-establishing the commission would have been a first step. Government spending on something this sensitive must be monitored, and it’s clear that this isn’t occurring adequately. No one I speak to in the sector believes that the ring-fence is anything more than a ‘nice idea’ these days.” It is immense and wonderful that Kevin has ended up as one of the talented members on the diverse interim committee establishing this Mental Health and Wellbeing Commission, and I want to acknowledge him for the experience that he brings to that.

I also want to acknowledge colleagues from across the House, many of whom have spoken about their own experiences, particularly Matt Doocey for the work that he has engaged in with all of us—that being, primarily, my colleague Jenny Marcroft, Louisa Wall, and David Seymour and myself—on the establishment of the cross-party group into mental health and addiction wellbeing. That is a really fundamental step forward to bring a cross-partisan approach to this issue which affects all of us.

I also, however, want to respond to a comment that has been made by a number of National Party people who have spoken to this legislation so far, that being a calling for the social investment approach in this area. I guess, on that point, this is where it is important that we recognise that all of us do come with different ideologies and perspectives to this issue. For me and, I think, in particular, for the Greens and the experiences that we’re bringing to the table, the kind of approach that we want to take isn’t one that looks at all of these data points and, in a very Minority Report-esque way, says “These are the people who we need to reach out, pluck from their communities, and treat.” Instead, we want to make sure that we increase the standards of living for everybody.

Whilst, yes, sometimes that can cost more money, it means that certain people don’t miss out. That’s where I also think it’s important to recognise that that $1.9 billion that was allocated in this Budget—this last Budget announced by the Government this year—whilst so much of it is going to core front-line services, which are so crucially needed, particularly in the regions, as many have highlighted, it is also really crucial that we think about the environments and the contexts that New Zealanders are living in that are leading to these record levels of mental ill health. That’s where I think it’s important to highlight the communities that are actually noted explicitly in the Mental Health and Wellbeing Commission Bill. There are noted: Māori, Pacific peoples, disabled people, rainbow communities, and other groups that experience poorer mental health and wellbeing outcomes. Members have noted that this of course includes those in the regions, and particularly at times of immense struggle, particularly financially, the likes of those who work in our agricultural industries.

And I guess that prompts the question of what do these under-served communities have in common? It’s actually something that was brought together in the mental health and addiction inquiry, He Ara Oranga, which reflected a vast amount of contemporary research into wellbeing in modern society. It found that the major driving factors of poor mental health are the environments that somebody is in. Two key things which consistently presented were isolation and trauma. It’s been the case that, historically, our approach to mental ill health has been to further isolate and traumatise people. Unfortunately, I think, in the realm of the kind of addiction services, we still far too frequently take that approach as well.

So the point that I want to make is that I don’t think—when we talk about things like resilience, particularly amongst younger people, we speak of it as though it’s some commodity that you can buy off a shelf, and all of a sudden you’ve got this armour that you can wear out into the world, without us recognising that, perhaps, challenges are new and different and novel. And those challenges are different for different people, but it’s important that we see that in the circumstances that we all are faced with.

So it’s the fact that resilience isn’t a commodity; it is, in fact, a community. That is where all of us in this country, as Jenny Marcroft raised, have a role to play, and not just making transparent the fact that this issue exists, but also in making accessible that dialogue, because those are two really crucial things and two really crucially different things. Transparency is about knowing that something exists; accessibility is about recognising yourself in it and how you can contribute to that conversation.

Just in summation, I want to say that I’m really excited by the proposition that is presented by what appears to be unanimous support for the establishment of this commission across the House. I want to say that I hear members of the Opposition with their concerns, particularly around timing and otherwise, and I hope that we can work through those. As we have seen, this Parliament functions at its best when we work collaboratively. In areas particularly pertaining to mental health and wellbeing and reducing dependency on, and addiction to, substances in this country, there is no better place where we could be collaborating, because it is that conflict and that history of conflict, and the trauma that comes with it, that so many people who present with poor mental health carry in their day to day. So if we can role-model something, hopefully, at the very least, it can be collaboration in this area.

The Green Party are very happy to be supporting this legislation and look forward to submissions, particularly those from folks with lived experiences, at the Health Committee. Kia ora, Mr Speaker.

Thank you, Mr Speaker. I rise with pleasure to speak at the Mental Health and Wellbeing Commission Bill’s first reading. I will echo the sentiments of many other members in this House that cross-party cooperation and a shared sense of the importance of the work that is being undertaken is very much part of what is, I suppose, the wairua, the spirit behind this. The purpose of this bill is to establish a mental health and wellbeing commission. That is going to have a lot of power, a lot of influence, and a lot of ability to take a more holistic approach than has ever been managed before in New Zealand.

I echo what others have said as well—that it’s up to all of us, not just some of us. And so, to the people of New Zealand, that invitation to collaborate, cooperate, and be part of how this commission will work is very much welcomed through the select committee process. We all need to work together, not only in this House, not only across party, but also through the whole of New Zealand. We need to be more open, as many have said, about mental health issues. Traditionally, New Zealanders don’t tend to speak of these things. I acknowledge Jenny Marcroft and others in this House who’ve shared their own family experiences. These are not easy things to talk about, but thankfully they’re easier now than they ever were before, and long may that continue. So there does need to be, in the interim—and it is good there is an interim commission. There’s a lot of work to be done. And that initial group, with a board of two to five members, has a great deal of work to do to guide that groundwork for the permanent commission.

There does need to be, though, in the meantime, I think, no lack of focus on early interventions and increasing accessibility across the country. We can’t afford to sit back and say, “Oh good, there’s a commission, it’s coming over the horizon, and on 9 February 2021 it will be with us and it will solve all our problems.”—no it won’t. So in the meantime we need to be vigilant. We need to continue to put the resourcing and the intellectual rigour into trying to help the people who are at the front line and are really suffering. They can’t wait for a commission to deliver for them, but contributing to better mental health and wellbeing outcomes for New Zealanders is a vision we must all embrace. And I think doing that through establishing an independent Crown entity, which will have independence from the Government of the day but will also have that accountability to need to report, to need to measure, and to need to stick to its goals.

I think that when you look at the reporting and auditing requirements under the Act, and that’s the Crown Entities Act, “preparing statements, performance expectations, and annual reports” might cause the eyes of members of the public to glaze over and for them to slump to the ground and lose the will to live. But for those of us who know how important it is to have accountability and to have proper reporting if things are to work, that is a very important and key ingredient of this new Crown entity that we’re talking about establishing through this legislation. I think that publicly reporting on any matters concerning the mental health and wellbeing of New Zealanders is a laudable aim, and that’s a proposed function, but also from that and further to that, to be able to make recommendations to all people—so that’s not just including the Minister of the Crown responsible in the day, but on any matters concerning mental health and wellbeing. That’s a freedom and a breadth of vision that has not been seen before in New Zealand mental health care and I commend it.

I think also that it’s well placed to obtain information from Government departments and other Crown entities and other NGOs who might be a little less than forthcoming. This entity will have the power to require information, and I think that that is a good thing, as is the transparency that will come with the structure. So we’re very much in favour of the development of an independent Mental Health and Wellbeing Commission that also has at its core particular regard to the experiences of, and the outcomes for, Māori. It is extremely important that independent complaints, while taken into account, are not the business of the commission, because otherwise the commission would spend all of its time, effort, and energy on those individual things. There does need to be a broader vision, and we support that.

The one element of this that we don’t support, really, and are concerned about is the shortened select committee process and the report-back date. My colleague Michael Woodhouse, who is very fond of the figures—four months and 11 days before it is reported back to the House. I only hope that’s time enough to allow the level of public participation in the select committee process that this bill deserves and requires.

So on a practical level, on a philosophical and visionary level, National very much supports the Mental Health and Wellbeing Commission Bill and I commend it to the House.

This is a split call. I call Jo Luxton—five minutes.

Thank you, Mr Speaker. It’s with pleasure that I rise in support of the Mental Health and Wellbeing Commission Bill. Mental health is not a new phenomenon, right? We’ve heard tonight from a couple of members—well, several members, actually—who’ve spoken about their journey and their experience, either personally or of family members who have been affected by mental health within our society here in New Zealand. We’ve also heard that in the past, mental health was something that we hadn’t spoken about. It is not a new phenomenon. It is something that in the past was not spoken about. It was almost hidden under a cloud of shame, if you like, or people that had mental health issues were simply pushed away, sent to institutions, and were somebody else’s problem.

And as we heard from my colleague Jenny Marcroft, what many of these people need is just time, love, care, and support. So I believe that the Mental Health and Wellbeing Commission that is going to be established, being focused on improving mental health and wellbeing outcomes for New Zealanders, will go a long way to working towards this. I like the fact that it is going to be independent from Government. It is going to hold Government to account.

Something that the honourable Barbara Kuriger brought up with regard to a commission such as this, in hoping that it will scoop up and work alongside other agencies—I read here that it says it will promote alignment, collaboration, and communication between entities involved in mental health and wellbeing. I think that’s hugely important when I think particularly about rural communities, because we know that there are a lot of agencies that work within our rural communities already, and many people in our rural communities suffer from mental ill health. Not to say that those in all areas of New Zealand don’t necessarily suffer from mental ill health, but I note I come from a rural community and we’ve seen the impact that mental health has on many of our people, particularly in the farming sector. We saw a lot of that with regard to when M. bovis broke out and the suffering of many people when going through the process of working through that.

I think it’s important that we should never assume that we know what somebody else is going through. And I like what Matt Doocey said about the fact that we are all in this together. There is no place for politics when working through mental health for the betterment of our people here in New Zealand. So, without further ado, I just want to commend this bill to the House.

I call Jo Hayes—five minutes.

Thank you, Mr Speaker. I am very proud to stand up and speak on the Mental Health and Wellbeing Commission Bill. It’s been some years, actually—I managed a providership back when there was the old Mental Health Commission—and I’m pleased to see that this has done a big circle and actually come back and will be established, and that everybody in the House is supporting it.

I want to say that ring-fencing of mental health funds actually worked back then, and I’m pleased to actually see that it’s part and parcel of this commission bill. I also want to say that it’s really good to have a focus on Māori mental health, because in Māoridom we don’t talk about mental health as openly as what we do on any other health issue. I just want to say that we have people on the commission like Hayden Wano, who comes with a wealth of experience in Māori mental health, the Māori health sector, and Māori development per se. His wealth of knowledge will go down well as part and parcel of this commissioning agency, this Mental Health and Wellbeing Commission body. I also want to make note of Moe Milne as well. Moe also comes with a big background within Māori mental health, and it’s good that she has been part and parcel of its development, moving forward, because we cannot lose sight of the issues of Māori mental health in this country.

I want to talk a little bit about a contribution on this side from Barbara Kuriger, who talked a little bit about Tokanui. Well, back in the day—and I remember this very well—when I set up the youth one-stop shop in Palmerston North, we had a number of Māori men that came through our youth one-stop shop who had suffered from mental health issues. These were people that had ended up being sent to Lake Alice as young rangatahi. Some of the treatments in Lake Alice that happened to them—electric shock treatment—were absolutely appalling. And what had happened was that I was left dealing with these adult men who were, I would say, victims of that type of mental health treatment, back in the day. I just wanted to bring that forward because I’m pleased that we have moved on from that type of treatment and to not ever have it again in our mental health system, no matter that people may think it’s a way to adjust a behaviour. I don’t believe that. I think there are other ways to address mental health treatment.

I’m pleased that it’s going across all systems, this Mental Health and Wellbeing Commission. It is very much like Whānau Ora whereby it places the people at the centre of the services. So in the past, mental health always worked off the Te Whare Tapa Whā model; Te Pae Māhutonga was also another model, a Māori health model that was used within mental health. And I’m pleased to see that the Whānau Ora way of delivering services through navigation is going to be highlighted through this particular commission, even though they may not say it, but the action will actually be a navigation service. I’m pleased to see that other agencies are going to be part and parcel of the wellbeing approach. It always should have been in the past, and I’m pleased to see that this is what’s going to happen.

I just want to touch a little bit on corrections as well, and ensuring that this commission also reaches out into the area of corrections. Some of the inmates that are there do suffer mental health issues and will benefit from a commissioning process that this bill is proposing.

So without any further ado, I want to support the bill through to the next stage. This side of the House has been strong in our approach. We have had a number of ideas and proposals go forward, and even though it may not seem that they’ve been picked up, I think that they will do well.

Sitting suspended from 6 p.m. to 7.30 p.m.

Thank you, Madam Speaker. I wish to speak in support of this bill, as everyone so far in this House has. Like many, many people in this House it’s an issue that I care very deeply about, more so than I thought I would 18 months ago, but events took a different course.

Like everyone else in this House, I wish to commend the Government for progressing this legislation, and commend the Minister for the establishment of the Mental Health and Wellbeing Commission. It seems that the issue of mental health is one of the very few issues in this House where we actually have cross-party support, where we have everyone agreeing, and where everyone’s trying to head in the same direction; it’s quite rare to see that in this Parliament. But it’s good to see, as a few speakers have already said, that mental health is no longer a political issue. It certainly was at the last election. I recall fronting up at meeting after meeting as people were very, very unhappy about the approach taken to mental health. But it’s good to see that progress is being made.

It’s also good to see that there has been the significant investment into mental health that we saw in the last Budget. The inquiry that was set up certainly recommended a mental health and wellbeing commission to provide leadership and advocacy and hold the Government to account, hold the Parliament to account too on what it does on the issues of mental health. All strength to that future commission on what it does.

I have to say, though, when we think about what this Parliament has done in regards to mental health in the now more than two years, we’ve done a lot but mostly in the space of discussion and around groups. We had the inquiry. What are what are the big successes so far that we can talk about when it comes to mental health that have come out of this Parliament? The inquiry that’s been set up. A lot of people had their voice heard. A lot of recommendations came back. The cross-party mental health group was set up. That’s great. It’s good to see politicians working together on this important issue. Now the Mental Health and Wellbeing Commission is being set up as well. But we have to ask ourselves, when we go to voters in about 10 months’ time, when MPs from across the House front up at public meetings or front up in front of the people that care deeply about this—we have to wonder what have we actually delivered. What has this Parliament actually delivered that is making a real and meaningful impact in the day-to-day lives of people?

The number one recommendation from the mental health and wellbeing inquiry was to (1) agree to significantly increase access to publicly funded mental health and addiction services for people with mild to moderate and moderate to severe mental health and addiction needs. The Minister has delivered $1.8 billion in the Budget. The finance Minister fronted up and agreed to a significant funding boost, far more than the $100 million that the last Government was talking about just in the lead up to an election. But when the person who is struggling to get access to services, when the mother of a child who is struggling to get—desperately struggling—assistance for her child says “What have I seen out of this funding?”, the answer so far is “Not very much.”

When the wife of a person who’s struggling has police knocking at her door because her husband is suffering a mental health crisis and she is desperate to get support but hasn’t been able to so far because there just isn’t enough support up until the point at which someone is actually trying to harm themselves, can we say to her that there are deliverables, that there’s more people on the ground, that there’s more services available? We are seeing a number of announcements coming, but it’s not enough yet. I hope this Mental Health and Wellbeing Commission drives policy and drives the wellbeing and mental health focus that the Government and the Minister want, and that is admirable and that is great; that is what we need. But also we need to see funding and services on the ground.

When the Prime Minister and the Minister fronted up at a South Auckland doctors’ clinic to talk about greater primary health services, primary health - mental health services, that was a great example of something that needs to be done. But we need that in thousands of doctors’ clinics across the country. We need to be able to say to the person whose child is trying to harm themselves or the spouse whose partner is suffering great difficulty that there are now services in front of them, that we are now seeing deliverables, and we aren’t yet seeing that.

We had a great promise to the nation around mental health, but I don’t think it’s been fully implemented yet. I hope the Government is able to achieve more. I hope the Minister is able to deliver more for people in the next 10 months, but time is ticking. We’ve spent too much time talking and having inquiries and having discussions. People need more services on the ground—that is required, that needs to be delivered, and I wish the Government luck with that.

I’m sorry I didn’t announce at the start this was a split call. I call Willow-Jean Prime.

Tēnā koe e Te Māngai o Te Whare. E tino harikoa ana ahau te tū i tēnei pō ki te kōrero e pā ana ki te pānuitanga tuatahi o tēnei pire. Tuatahi māku, e hiahia ana ahau ki te tuku mihi ki Te Minita, nāna i tīmata ake ngā kōrero i roto i tēnei Whare i tēnei ahiahi e pā ana ki tēnei pire. E mihi hoki ana ki Te Kāwanatanga kia whakauru tēnei kaupapa i roto i tēnei Whare i tēnei pō.

Ā, e mōhio ana tātou katoa, kua rongo tātou katoa i roto i ngā kōrero i tēnei pō, he take nui tēnei i roto i Aotearoa. E mōhio ana ahau i roto i tōku ake rohe o Te Tai Tokerau i a au e hāereere ana i te rohe, e rongo atu ana ahau, e kite atu ana ahau i tēnei take. He take nui mō Te Tai Tokerau.

Tēnā pea kua rongo koutou, kua kite koutou i ētahi o ngā kōrero i runga i Pukamata, i runga i te pouaka whakaata, mō ngā taitamariki i roto i Te Tai Tokerau. Kua rongo ahau 12 noa iho ngā tau o ngā taitamariki e whakamomori ana. He tino kino tērā āhuatanga i roto i a tātou.

Kātahi anō ka puta mai ētahi atu tatauranga mō tēnei tau, kua piki ake te nama o ngā whakamomori i roto i Aotearoa, i roto i Te Tai Tokerau anō hoki. Nō reira e tautoko ana ahau i tēnei pire, pau te kaha, nā te mea e mōhio ana ahau ka whakamāmā ake i tērā āhuatanga i roto i a tātou.

Nā, ka puta mai tēnei whakaaro, tēnei pire, i tēnei o ngā rīpoata, arā ko te, He Ara Oranga. E hiahia ana ahau te mihi ki ngā kaimahi i runga i taua, ngā mema i runga i taua kaupapa nā rātou i āta titiro tēnei take mō tātou katoa. Ko tētahi o ngā kaupapa i roto i taua rīpoata ko te whakatū i tētahi komihana. He komihana motuhake, ā, arā motuhake i Te Kāwana o tēnei rā, ngā Kāwana e heke mai nei. He mea pai tērā noho motuhake ka taea e rātou te āta tātari, te āta aromatawai tēnei kaupapa, ngā ture, te pūtea ka whiwhi i ngā tari Kāwanatanga, ngā kaupapa anō hoki, me ngā kaupapahere.

Nā, e toru, e whā pea ngā mea nui o tēnei komihana. Tuatahi, ia tau, oh, tuatahi, ka whai mana rātou ki te tuhi i tētahi rīpoata, te tuku ki Aotearoa whānui e pā ana ki tēnei take i roto i Aotearoa. Ehara nō mātou Te Karauna tērā kōrero, engari nō tētahi komihana motuhake kē. Tuarua, ko te āta titiro te pai, te kāhore rānei, a ngā kaupapahere o Te Kāwanatanga. Te tika, kāhore rānei o ngā kaupapa mō tēnei take.

He kaupapa anō tō te komiha—ā, aroha mai, tēnei kaupapa. Ko tērā ko te āta akiaki i a rātou e mahi ana i roto i tēnei kaupapa kia mahi ngātahi, kia kōrero tahi, kia tutuki pai ngā wawata, ngā kaupapahere. Hei aha? Hei painga mō tātou katoa o Aotearoa, hei oranga, hei painga, mō ngā tāngata, mō ō rātou whānau anō hoki.

Kua rongo ngā kōrero i roto i tēnei Whare. Ko te kotahi o ia tokorima tāngata ka pāngia e tēnei mate. Nō reira he mate tēnei, he māuiui tēnei, he āhuatanga tēnei ka pāngia e tātou katoa, ō tātou whānau, hapori anō hoki i roto i tēnei Whare.

Kua rongo koutou i te mahi ngātahi o ngā pāti i roto i Te Whare Pāremata, he tohu pai tēnā. Kua tae ki te wā ki te mahi tahi, ki te whakatutuki i tēnei āhuatanga. I te mutunga, e hiahia ana ahau ki te mihi ki tēnei Kāwanatanga nā te mea e whakatū ana i tēnei komihana, kua tuku tata ki te rua piriona tāra ki tēnei take. Koirā te take nui o ngā take katoa i puta mai i te tahua pūtea, te tahua oranga i tēnei tau. Ā, nō reira, i runga i tēnā, e Te Māngai o Te Whare, e tautoko ana ahau i tēnei pire, pau te kaha.

[Greetings to the Speaker. I am very pleased to stand tonight to speak about the first reading of this bill. Firstly, I wish to give my congratulations to the Minister who commenced the speeches in the House this afternoon pertaining to this bill. I also congratulate the Government for introducing this initiative into the House tonight.

And, we all know, we have all heard in tonight’s speeches, this is a significant issue in New Zealand. I know that in my region of Northland when I am travelling around the region, I hear and see things about this matter. It is a significant issue for Northland.

Perhaps you have heard or seen some of the commentary on Facebook or the television about the youth of Northland. I have heard that youth as young as 12 years old are committing suicide. That is an awful situation to have amongst us.

Some other statistics for this year have just come out; the number of suicides in New Zealand has risen, and also in Northland. Therefore, I support this bill to my utmost, because I know it will ease that situation that we are facing.

So this thought emerged, this bill, from a particular report—namely, He Ara Oranga. I want to acknowledge the staff on that, the members on that project who carefully looked into this issue for us all. One of the matters in that report was to establish a commission, an independent commission, that is independent of today’s Government, and the Governments to come. That independent status is a good thing so that they can carefully analyse, carefully assess this topic, the laws, the funding received by Government departments, and the various initiatives and policies.

Now, there are three or four main things for this commission. Firstly, every year—oh, firstly, they have the power to write a report and distribute it to the New Zealand public about this issue in New Zealand. What is said will not come from the Crown but instead from an independent commission. Secondly, to carefully examine the suitability or otherwise of the Government’s policies; the appropriateness, or not, of the initiatives for this matter.

There is another initiative pertaining to this matter. That is to really encourage those working in this area to collaborate, to communicate with each other, to achieve the aspirations and the policies. Why? To benefit all of us New Zealanders, for the wellbeing and benefit for the people, and for their families.

The speeches in this House have been heard. One out of every five people is affected by this problem. So it is a problem, a sickness, and a phenomenon that affects all of us in this House, our families, and our communities.

You have heard of the cooperation between the parties in Parliament, and that is a good sign. It has come to the time to collaborate, to progress this matter. To conclude, I wish to acknowledge this Government for establishing this commission, and directing close to $2 billion to this issue. It is the biggest issue of all issues across the Budget, the Wellbeing Budget, this year. And, therefore, on that note, I support this bill to my utmost.]

Thank you, Madam Speaker. I’m pleased to rise this evening to speak on what is an important bill that we are supporting this evening, the Mental Health and Wellbeing Commission Bill. It is nice to rise and speak in support of a bill (a) that’s important, but (b) that the Parliament as a whole has been working on together and it all agrees on. As a speaker earlier said, it’s not something that we’ve always agreed on and come together on and worked on, and it is nice that, in this case, we have come together, we’ve agreed, and we’ve worked cross-party—and for a number of reasons I’ll talk about later in my speech—because mental health, no matter where you’re from, where you live in New Zealand, touches everybody. I’ve had some recent experiences in my electorate that I’ll share with you in my short call.

A lot of what’s been said tonight has covered what the bill is all about, so I won’t go into that in too much detail. But, you know, we understand that, basically, all this bill is doing is setting up an independent Crown entity which will advise Governments around mental health and wellbeing. Obviously, the aim of that is to improve the mental health and wellbeing of New Zealanders and, in particular, those who are most marginalised when it comes to mental health wellbeing: so Māori and Pasifika, our disability sector, our rainbow community, and others who experience poor mental health outcomes. The commission will be between two and five members and will be in place in 2021.

We support the establishment of this mental health commission. They are a body of independent experts who will advise the Government of the day, but it is part of what is a much larger puzzle which will lead to the improvement of the mental health and wellbeing of New Zealanders. The commission will report publicly, they’ll make recommendations, and they’ll have the power to obtain information from Government departments and statutory Crown entities. As I said, we support the establishment of this commission. It is important that we worked in a cross-party fashion to come to this point, and it’s important that we continue to work in a cross-party way when it comes to mental health outcomes for New Zealanders.

There are a few other points I would like to make, though. Firstly, they are around the mental health and addictions inquiry. While this was a worthwhile exercise, a good democratic process to take part in for many New Zealanders who got to have their say and their input, what we had for two years from this Government while that inquiry was under way was inaction and, potentially for another couple of years, inaction with no real action. Speakers before me have mentioned this tonight, because while we waited for that report to come out, actual mental health investment in mental health outcomes for New Zealanders was lacking. That part of the puzzle was missing.

So instead of acting and investing, this Government canned 17 National Party initiatives that were tied to a $100 million social investment package. Now, these initiatives would have increased access to services, which is so vital; improved responses; and provided more wraparound services. So while we all waited for a working group to report back, actual programmes and actual services and actual funding that would have made a difference were missing. And that is wasted time where we could have been helping New Zealanders who were so desperately in need of help. We know that mental health outcomes in this country are getting worse. Suicide statistics that have been reported recently showed 685 people dying in the year to July, which is a rise of 2.5 percent.

In my electorate, I see the surge of mental health cases through my electorate door. I’ve worked in that electorate office for almost six, seven years; I have never seen the amount of mental health cases as I have in the last year or so. I hear it from the police in my district, who are telling me that they are overwhelmed with mental health cases and that a large majority of the events that they are turning up to are mental health - related. And now I’m hearing it from my local principals—and this is the heartbreaking stuff—who now cite it as their number one issue that they’re dealing with. I have principals who are now employing multiple, full-time mental health workers to deal with the explosion of extremely serious cases they simply are not equipped to deal with, and the ministry are not funding them.

These are kids in the East Coast Bays. They are in decile 10 schools in relatively well-off areas. And my schools are lucky in that they can afford to hire, in some cases, these mental health support workers. And when I see my principals and hear their stories, it is so upsetting to sit there knowing that one of the 17 National Government initiatives that was scrapped was around increased mental health provision in schools. And now I have got intermediate schools in my electorate, decile 10 schools, with up to 35 kids on self-harm watch lists and kids who are self-harming in class, and that is unacceptable. This could have made such a huge difference if we’d acted earlier. The scale of the problem is overwhelming and it’s upsetting.

While this bill is a part of the puzzle, it is only one part. And while we support another advisory committee, the message to this Government is loud and it is clear and it is not just from me; it is from my police and it is from my principals: the mental health of New Zealanders is getting worse and real action is required not in two years but now. Thank you.

Thank you, Madam Speaker. It’s a real pleasure to rise and speak in support of this bill, because what this bill will do is establish a new Mental Health and Wellbeing Commission for our country. And what that Mental Health and Wellbeing Commission will do is hold the current Government, but also future Governments, to account for what they’re doing to improve mental health and wellbeing. And what I want to do tonight is just focus on why we need a Mental Health and Wellbeing Commission, because I think if we look back to the Government inquiry into mental health and addiction, I think what it does is it shows a very, very clear picture of what happens if we don’t take mental health seriously. And it also provides a very clear picture of the situation that we inherited when we came into Government. And so what I’d like to do is just look through a few of the quotes coming out of that report.

What the inquiry said is “We heard of services stretched to breaking point, a lack of timely, responsive and culturally appropriate access, few options and a lack of 24/7 services, disjointed care, and limited wellbeing and [preventive] interventions and initiatives.” Scattered throughout the inquiry’s report, they actually included some quotes from service users from whānau, family members, and also from staff in mental health services. And I would just like to read out a couple of those quotes because I think they reflect some of the situation in terms of what the inquiry heard.

So one service user noted, “People have to fight and beg their way into services, and wait far too long. In the meantime everything gets worse and permanent damage is done … Most people find it incredibly hard to reach out for help. So why are we forced to prove that we’re worthy?” And I think that basically sums up how some people were feeling about their access to services. Another quote from a staff member working in some of the mental health services says, “We are under-staffed, burning out, told to just get on with it and suck it up. No breaks are allowed [in the] afternoon shift as they pay us for this time. Abuse towards staff is on the rise … We are always over 100 percent capacity. We are asked to do double shifts every day, and we feel under-valued and paid.”

I think just reflecting on, you know: how did we get in to that situation—and so the inquiry also talks about the common perception that came up when they were talking to people about a lack of clear leadership and national direction in terms of mental health and addiction. And they also reflected on the diminished role of the mental health commissioner, because we did have a former Mental Health Commission, but what they highlighted is that it was really great back when it was established in 1996 and at that time they felt it performed a really powerful role in terms of independent oversight. What it was doing was providing oversight in terms of the implementation of the national mental health strategy and also looking at the performance of the Ministry of Health and regional health authorities, which were the precursors to the district health boards. But what they noticed is that then, over time, the resourcing got less and less, and then, in 2012, the Mental Health Commission was disestablished by the previous Government and its roles were folded into the mental health and disability commission. Basically, they were sort of reflecting on where the leadership had gone in that area.

What they noted is—they, basically, said—the role of an independent oversight of the whole system by a powerful commission is an important and missing piece in this puzzle. That’s why they were recommending that we do exactly what we’re doing today and reinstate and create a Mental Health and Wellbeing Commission.

Just looking at some of the things that this Mental Health and Wellbeing Commission will do: basically, it’s an independent Crown entity, and the aim is to hold current and future Governments to account for improving mental health and wellbeing. What we’ve got at the moment is the current Government is taking mental health incredibly seriously. We’ve seen the $1.9 billion investment in our Wellbeing Budget this year into mental health services and facilities. But what we need to make sure is that that oversight, that strategic direction, and that prioritisation continues on with successive Governments. I think the question is: how do we do that? I think one of the most important things is visibility—make sure that mental health and wellbeing needs remain in the public eye, public vision, as we move forward.

What the bill does is it talks about some of the functions of the commission. I’ll just go through them briefly. The first one is to assess and report publicly on the mental health and wellbeing of people in New Zealand. I think you can’t underestimate the power of having access to good information. Certainly, in my previous role, in terms of monitoring child and youth health, what we found is that if we had data for things like hospital admissions for children for respiratory infections, then the funding and planning people that were looking at health needs took notice because the information was right there in front of them. What we really struggled with was finding decent information on those with mental health issues or disabilities.

Often, what we were concerned about is the fact that the needs of those children and young people often slip below the radar because we just didn’t have the data available. So one of the functions of the commission is to assess and report publicly on the mental health and wellbeing of people in New Zealand, and that will, basically, keep those needs in the public view—and also, then, basically, having that prioritisation in terms of funding and planning decisions.

One of the other things that the bill’s going to be doing is—basically, the commission assesses and reports publicly on factors that affect people’s mental health and wellbeing. This is thinking about those underlying determinants of mental health and of wellbeing.

Again, in my previous role, monitoring child and youth health but also women’s health, what became apparent is that things like household crowding and really bad housing and having to move house numerous times—start schools and move into different communities—were incredibly, incredibly detrimental to families’ wellbeing. So the role decent housing and stable tenure has is incredibly important. Also, things like family income—because often what you found is that as the family income went down, the stress and interpersonal conflict actually went up. So making sure that people have got adequate incomes, adequate access to health services, to social security, and to justice—all the basic services that we as a country need to provide; making sure that we have got oversight of those as well. And so when it’s looking at one of the roles of the Mental Health and Wellbeing Commission, it’s to, basically, assess and report publicly on some of these underlying determinants.

One of the other things in terms of its function is to assess and report publicly on the effectiveness, efficiency, and adequacy of approaches to mental health and wellbeing. This is actually an umbrella that looks at the adequacy of mental health services, because what we’ve had at the moment is—I mean, you do wonder whether, if we had this function in and had continued on over the last decade, we would have ended up quite in the same situation that we ended up in when we listen to the stories coming out of the inquiry into mental health and addiction. So, again, making sure that this commission is having a look at those on a regular basis and making sure that we’re holding decision makers to account on the delivery of those services.

And then, basically, advocating for the collective interests of people who experience mental distress and addictions and also their whānau/family. I think this is a situation, when you’re talking to those that have actually experienced mental health and wellbeing issues, where what you find is that their ability to simultaneously go out and advocate is actually—it’s often very difficult to do that. And so having the commission looking across and thinking about how they can advocate collectively is incredibly important.

So there’s a whole range of functions that are outlined in the bill. One of the other roles of the commission is to actually collect information. That’s, basically, the power to obtain information, that is also talked about in the bill. And, basically, the ability to request specific entities, you know, ministries—the Ministry of Health, the Ministry of Justice, the Ministry of Social Development—to provide the information that that commission needs is incredibly important.

I do note, though, that it does restrict that, so that the commission isn’t going to be collecting personal information as defined in the Privacy Act. I think what that does is suggests that what the role of the commission is is that collective advocacy, rather than focusing on individual cases and drilling into those. So, basically, it’s that broader advocacy role in that respect.

There’s been a number of comments made in terms of timeliness tonight in the House. While the bill doesn’t come into force until February 2021, what we’ve already had signalled is that an interim commission has already been announced, which was in September, and we’re having those commissioners in place, because what we need to do is start that urgent work. There’s a whole range of tasks that need to be done, and so, basically, we need to get under way much sooner than that, and we are.

But also, just reflecting on that huge contribution—the $1.9 billion investment in terms of the mental health package in this year’s Budget—what that’s doing is providing that resourcing to put front-line mental health services in primary care, and also looking at things like telephone counselling services, internet-based services, and also looking at suicide prevention in much more detail. So while this is one of those recommendations that the current Government is very happy to implement in terms of setting up the commission, we’re also getting on and doing much, much more. So it’s a real pleasure to commend this bill to the House.

Bill read a first time.

Bill referred to the Health Committee.

I move, That the Mental Health and Wellbeing Commission Bill be reported to the House by 30 March 2020.