Mental Health and Wellbeing Commission Bill

on behalf of the Minister of Health: I move, That the Mental Health and Wellbeing Commission Bill be now read a second time.

The bill establishes the Mental Health and Wellbeing Commission, which is an independent Crown entity that will contribute to better and equitable mental health and wellbeing for the people of New Zealand. For those who are going through tumultuous times and stressful change, it will be of extraordinary, great comfort.

I want to begin by thanking the chair and members of the Health Committee for their thoughtful consideration of the bill and for delivering their report in a timely fashion. I also want to acknowledge all of those who submitted. Mental health and addiction affects all of us, and this was reflected in the range of submissions received. The committee received 99 submissions from all walks of life—people with lived experience of mental distress and addiction, whānau and people experiencing mental stress or addiction, and people bereaved by suicide. The committee also heard from mental health and addiction service providers; organisations supporting people with lived experience; academics; monitoring agencies; and a number of organisations that provided a strong voice for population groups, including Māori, rainbow communities, rural populations, children and youth, disabled people, and Asian peoples. I’m informed that almost all submitters on the bill supported the establishment of the commission and that the submitters provided valuable suggestions and comments. These important perspectives are reflected in the committee’s report and, indeed, in the revised bill. The Government supports all of the changes proposed by the committee, and I’ll briefly touch on some of the key recommendations.

The committee has recommended amendments to the functions of the commission to clarify the scope of the commission’s role and how it will perform its functions. In the bill, the commission’s functions broadly fall into three areas: the commission will assess and report publicly on the mental health and wellbeing of people in New Zealand; it will advocate for the collective interests of people who experience mental distress and addiction; and it will promote alignment, collaboration, and communication between entities involved in mental health and wellbeing.

The committee has added a new function to be clear that the commission will make recommendations to improve the effectiveness, efficiency, and adequacy of approaches to mental health and wellbeing in New Zealand. These recommendations can be made to any person, including Ministers. Collectively, these functions give the commission the levers it needs to maintain pressure on decision makers, identify issues, influence improvements, and speak for people that have experience of mental health and addiction.

The bill has also been amended to provide that, when performing its functions, the commission should have regard to certain factors. Firstly, the commission must consider available evidence. This means that the commission will be expected to use evidence to support its reporting and recommendations where it’s appropriate to do so. It also means that the commission may identify evidence of gaps and make recommendations for improvements to the evidence base. Secondly, the commission must also consider the wider determinants of mental health and wellbeing, and it will take into account the broader social determinants and the cultural, economic, spiritual, societal, environmental, and other factors that affect people’s mental health and wellbeing. Thirdly, the bill now makes explicit that the commission must consider actions undertaken or actions that could be undertaken to improve mental health and wellbeing. Actions may be across the full spectrum of mental health and wellbeing, from promotion and the prevention of mental distress and addiction through to treatment for people living with serious mental health conditions.

The commission will have a particular focus on Māori. The bill is drafted throughout to give effect to the principles of the Treaty of Waitangi. In addition, the commission must have particular regard to Māori when performing its functions.

The next amendment that I want to discuss relates to the commission’s requirement to seek the views of different groups when performing its functions. This is an important provision. Consultation is consistent with placing people at the centre of mental health and wellbeing systems, as envisioned by He Ara Oranga and accepted by the Government in response. The bill therefore requires the commission to consider a range of perspectives when assessing and reporting on the mental health and wellbeing of people in New Zealand. As I highlighted earlier, Māori mental health and wellbeing is a focus of the bill, and the commission must have effective means of seeking the views of Māori.

The commission must be able to consult with people who have experienced mental distress or addiction; it is important that the commission understands their perspectives, including their experience of health services as well as any other support or service. The commission must also understand the perspectives of people who may need support but have been unable or have chosen not to access services. The commission must also be able to consider the perspectives of people most at risk of experiencing poor mental health and wellbeing. When my colleague the Hon David Clark first introduced the bill, this clause listed a small number of groups we know experience poor mental health and wellbeing, while also recognising other groups that experience poor outcomes.

A focus of many submissions was that they wanted more groups to be explicitly named in the bill; this posed a challenge for the Health Committee to recognise and acknowledge groups without excluding those not named. The bill in front of us today recognises that people may share a common identity, experience, or stage in life that increases the risk of poor mental health and wellbeing. Firstly, people who share a common identity—for example, people who share a particular sexual orientation or ethnicity may experience exclusion and discrimination, which are key contributors to mental distress and addiction. Secondly, common experiences such as trauma, isolation, and disconnection contribute to mental health, physical health, and addiction challenges. Thirdly, different stages in life, such as childhood, pregnancy, and motherhood, and transitions between stages, such as entering or leaving the workforce, often present specific changes that can have an effect on people’s mental health and wellbeing.

The bill now acknowledges groups identified in the report of the Government inquiry into mental health and addiction as examples of people at risk of poor mental health and wellbeing. These groups include those listed in the bill when it was introduced: Pacific people, disabled people, and children and young people. It also includes rainbow communities, rural communities, older people, refugees, and migrants—amongst others. I commend the Health Committee for finding a way to be more inclusive of all groups at an increased risk of experiencing poor mental health and wellbeing.

Many submissions made recommendations about the board of the commission, which the Health Committee has addressed in its recommendations. The Government supports increasing the board size from being two to five members to being three to seven members. Increasing the board size will help ensure the appointment of members that collectively cover the recommended attributes and experience.

I want to turn to another area, and that is the timing. Government is committed to having the commission up and running as soon as possible. We support the committee’s recommendation to provide flexibility for the bill to come into force earlier than February 2021. Work is already under way to recruit a chair and board members after the bill is passed. To ensure the commission can hit the ground running, the board will initially act in a designate capacity and oversee key establishment work and strategic planning for the commission until its formal commencement.

In conclusion, the Government is establishing the commission to perform a significant role and a challenging one. It will make sure that we and future Governments work towards better and equitable mental health and wellbeing. I’m expecting the commission to put pressure on Government and others to provide better and more culturally appropriate services and supports, develop better policies, build a better evidence base, and put pressure on others to invest where it is needed. We ultimately want people to experience a system that works for them and we want it to achieve better and equitable mental health and wellbeing. The commission’s role is vital to achieving this.

I’d like to finish by again thanking the Health Committee for their work, and all three parties of Government—Labour, New Zealand First, and the Greens—for the commitment to establishing the Mental Health and Wellbeing Commission. This Government continues to prioritise better mental health and wellbeing in New Zealand, and the commission will play a crucial role in a transformed system. On that basis, I commend this bill to the House.

Thank you very much, Mr Speaker. It’s a pleasure to rise on behalf of the National Party in support of the Mental Health and Wellbeing Commission Bill. I do want to start—because this is a second reading and, normally, in a second reading we stay focused on the business of the select committee and the discussions there and the amendments. But, with your—what’s the word I’m looking for?

💬 Hon Members: Indulgence.

Indulgence—that’s right. It’s a big word at this hour of the night. I do want to just touch a bit more on context. I know that is more of a first reading speech, but I believe that things have changed since we had the first reading—the context. Why I say that is COVID-19. Because we heard on the Epidemic Response Committee from Sir Peter Gluckman, who told us that he was forecasting that there would be, of all the people who lose their job or income—and if we’re looking at maybe 200,000 or 300,000 people—10 percent of them are going to develop post-traumatic stress disorder. That is a serious mental illness. So we are looking at tens of thousands of New Zealanders who are going to develop serious mental illness as a result of the impacts—the economic impacts—of COVID-19. You match that up to the context that we spoke about in the first reading, of the huge wave we’re seeing in demand for mental health services, and this reinforces how vital it is that not only Government but Parliament responds to the mental health issues of New Zealanders—not just about treating mental illness but also about promoting mental wellbeing.

I stand here tonight as a proud member of the cross-party mental health group, and I do hope that that group will be able to look at long-term strategies and solutions—longer than the three-year parliamentary cycle—to address this growing wave of demand that our mental health services are going to receive in the short and medium term. Because what we believe over here in the National Party is that we also need to make sure that we are very clear at what we are trying to achieve. So we are supporting the Mental Health and Wellbeing Commission. This is a bit Back to the Future, because we have been here before. It was disestablished, and many in the mental health sector would have agreed with that decision; it was felt that the Mental Health and Wellbeing Commission had lost its way. I’m confident that we do have a framework here that will make a difference, but I think it’s important for all members of this House to make sure this framework that we are proposing here tonight will actually deliver a change.

When we hear words like “influence”, that seems awfully passive, and over here, in the National Party, we would like to see words like “targets”. The indicative target of the mental health inquiry said we needed to increase access from 7 percent of New Zealanders to 20 percent. So we need to make sure this mental health commission will have the authority to make a difference and make a change. No one wants to see any entity just writing reports that make recommendations that sit on a shelf. So I do hope, by the end of this, we will have a bill that will be enacted and ultimately result in an independent entity that will be able to hold Government departments and other organisations to account. For us here in the National Party, that was a key focus of the select committee process.

I think we had a good selection of submissions. We had 99 of them. A range of them were from academics, they were from health professionals, and, most importantly, a number of people who were telling their story of lived experience, and I would want to thank all those submitters, and I think they have supported the changes that we are going to be debating tonight to make this bill a better bill to come back in the second reading.

One of the important parts of this bill was to help identify key groups that the Mental Health and Wellbeing Commission would focus on. The problem is, when you start to look at key groups, as soon as you want to put one in, you feel like you’re excluding another. And the list gets bigger and bigger and bigger. But, where the committee landed on, we were able to put a schedule at the back of this bill, where it outlined a number of groups this commission will focus on. One of them was important for us in the National Party, and that was our rural communities. The department of health has recently published statistics that show, unfortunately, in New Zealand our suicide rate has increased in our urban population by 7 percent but, unfortunately, in our rural population by 17 percent. That is why it is important that we focus, yes, on a range of groups but, equally, we make sure rural communities is a group mentioned in this bill, and that’s what comes to this Parliament tonight.

A second key part of the amendments was to ensure that we move the commission from just reporting to actually making recommendations—recommendations that will seek to advocate and to improve the mental health system. Because what we know is that we’ve got a real challenge. We’ve got a lot of Government departments working in siloes—if you look at Health, Education, Justice, and Corrections—all having an area of overlap in mental health, and what we do hope is that, with this Mental Health and Wellbeing Commission, it will develop a key strategy in making those recommendations that will be cross-Government and whole-of-Government, holding those Government departments to account and ensuring that they make a real difference. Because, in the end, we need this commission to have the authority to hold those entities to account and make sure they respond to the mental health demands in their organisations.

Another key amendment that came out of the select committee was changing the numbers of the members of the board. Originally in the bill, it was two to five members. That has now been increased from three to seven. A large discussion was around how we ensure we make sure the composite of those members has the range of experience and knowledge and talents that will, ultimately, form the strategy and the direction of this Mental Health and Wellbeing Commission.

A key area for us was ensuring that this Mental Health and Wellbeing Commission drives research. What we know in the mental health field is that we don’t know enough, and we need to build the evidence base to know what works. Because, unfortunately, in mental health, what works potentially in another country, through an international policy transfer, mightn’t be appropriate in the cultural context of New Zealand. And we do hope that this Government, or successive Governments, will ensure that there is the funding for this Mental Health and Wellbeing Commission to ensure that there is enough research going on to understand what works in mental health and build that evidence base.

It’s a real concern for us on this side of the House that we need to ensure that we get real movement on mental health. We have formed the cross-party group, and we do hope to get full buy-in from political parties to look at long-term solutions and policy settings over the three-year cycle. But, most importantly for us, the indicative target said we needed to increase access from 7 percent to 20 percent of New Zealanders, and if it’s one thing this Mental Health and Wellbeing Commission—if it can be successful in doing that, it will have made a real difference to New Zealanders’ lives. Thank you, Mr Speaker.

Mr Speaker, I want to begin my contribution by thanking the chair and the members of the Health Committee for their contributions to this particular debate, and also to the Minister of Justice for his contribution already to this debate, too—a very thoughtful contribution; I couldn’t have put it better myself.

I do want to acknowledge all of those who submitted in the process through to select committee. This bill and this commission will be better for the input of the public, for the people that have brought their wisdom and experience to the table in the setting up of this commission. I also want, at the outset, to acknowledge those who are members of the interim Mental Health and Wellbeing Commission, particularly the chair, Hayden Wano, and all of that team for their contributions so far. They have the task of holding the Government to account on its work so far in introducing a mental health package, responding to He Ara Oranga. They also have the responsibility of setting up a draft framework to be considered by the permanent commission when it is established, to understand, indeed, how they might go about their task of evaluating whether the Government is doing what it needs to do to support the mental health and wellbeing of New Zealanders.

Of course, this Government has committed very deeply to taking mental health seriously. And, of course, with the unprecedented $1.9 billion that went into mental health across a range of services across Government in the 2019 Budget, we’ve seen a shift in thinking in the possibilities for agencies and for those who are working with those who have challenges on mental health. We also have the rolling out of the access and choice initiative: half a billion dollars focused on the provision of free mental health care in our communities.

Since first proposed, the Mental Health and Wellbeing Commission that we are giving effect to through this bill has shifted to being an independent Crown entity, the most independent of possibilities for this commission. We think that’s appropriate because we want this commission to hold this and future Governments to account for ensuring that we have mental health and wellbeing well supported in our communities.

The Minister of Justice has said many of the things that I would like to have said in my contribution, but I do want to, in closing, thank New Zealand First, as our coalition partner, for their work in helping to establish this Mental Health and Wellbeing Commission. I want to thank our confidence and supply partner, the Green Party. These parties have contributed so much as we’ve worked together as a Government to establish a Mental Health and Wellbeing Commission for the whole of New Zealand’s wellbeing. I commend this bill to the House.

Thank you, Mr Speaker. I want to commend the Minister of Health for what, I’m sure, was a much more spontaneous speech that he planned to give, and all I can say to both the Minister of Health and the Minister of Justice is simply this: I’ve been there, done that, and while I don’t want to trivialise the issues of stress and anxiety, I did see the Labour Party acting whip and the Chair look very anxious for a time before the second reading was moved so eloquently.

This was, I think, a very, very cooperative and productive process by the Health Committee, ably chaired by Louisa Wall , who, I think, demonstrated as much empathy with the issues that we were dealing with than anybody in this House could, having connections with communities that suffer, I think, a disproportionate amount in mental health. And it did, I think, rather cause some stress for her in terms of the manner in which we were wanting to articulate the importance of stressing inclusion through the legislation, because, as the Minister moving the bill mentioned—and Mr Matt Doocey also, I think, touched on this as well—when you start a list of people who should be consulted and given consideration of, then the risk is that somebody else misses out. And, indeed, that was one of the underpinning themes of the submissions that the committee heard.

I think the committee came up with a very sensible, nuanced way in which we can identify those groups to the extent possible without making the legislation unwieldy or feeling like the groups were not included. Mr Doocey talked about two areas. I think a very important one is the impacts of COVID on the need for the work of the commission and also that of rural communities. I want to touch on two others that are listed in Schedule 1A in the amended bill. That is of veterans—and earlier this evening, we’ve been talking about and debating a bill to improve the support provided to veterans and, in particular, mental health support and post-traumatic stress disorder support, because there’s no doubt that there is a much wider issue there than has perhaps previously been believed.

The other group that I want to specifically touch on is young people. Now, the Speaker’s Science Forum late last year heard from two experts from the universities of Otago and Victoria on the issue of self-harm in our adolescents. It was an extraordinary journey into an issue that I don’t understand, but we are learning much, much more about not only the reasons for it but the prevalence of self-harm in our young. So I’m particularly interested in making sure that we can use the commission not only to explore but to, as the Minister of Health said, recommend.

Look, I know we’ve had a mental health commission in the past, and it was disestablished, as the Minister said, by the previous Government, but it’s really interesting to have a look through the history of that commission in the 1990s and 2000s under both National and Labour Governments, where a plethora of very good recommendations, highlights, and condemnations in some cases about the failures of mental health in certain parts of our country and certain types simply were not taken up in the way that they should have been. We actually wanted, through the amendments we’ve made in the bill, to make it very clear that this should not just be a passive process—that there should be some teeth in this and some expectation that, when they give their thoughtful consideration and recommendations to the Government of the day, that be listened to.

While I’m not overly satisfied that we’ve reached the words that I think best articulate that intention, I want to put on record my hope and expectation—and that, I think, of the Health Committee—that that be the place and case for understanding what is a rapidly evolving situation. As Mr Doocey said, you know, with COVID, there is the potential for a bow wave of stress and anxiety disorders for people who have come under a great deal of financial and emotional stress as a consequence of that. But also there are the modalities that can be used in order to address that, because that is another area of health science that is moving very quickly, and I am particularly interested in the uses of technologies, not only in mental health but right across our health sector. This is a particular issue of Mr Doocey’s—where therapies that can be deployed, particularly for our young, are able to be used in a more efficient and, dare I say, cost-effective manner.

I do acknowledge that the Government has invested a significant amount of money into mental health, particularly through Budget 2019, but I am concerned that it is not being deployed rapidly enough. And I think, as part of the commission’s role, we don’t have the strict ring-fencing, I think, that we used to have. But I think one of the mental health commission’s roles should be to ensure that value for money is got, that the investment is targeted, effective, evidence-based, and delivering the best support for mental wellbeing for these groups and anybody else who needs it.

With that, I’m very pleased to commend the committee’s report—I think they did a very good job—and the bill at second reading.

Tēnā koe, Mr Speaker. Thank you for the opportunity to take a call on this, the second reading of the Mental Health and Wellbeing Commission Bill. I’m really pleased to take a call, because today is another step forward towards the commitment between New Zealand First and Labour to deliver a mental health commission as part of our coalition agreement. So I’d like to thank the Minister, the Hon Dr David Clark, for working so well with New Zealand First. I’d also like to take the opportunity to thank the Health Committee, because it’s been a really amazing process to be part of a team of politicians from both sides of the House where we have this common purpose. Mental health and wellbeing is such an important part of the country’s and individuals’ wellbeing that we are able to work in such a way that we put our party politics to the side and we come up with legislation that will support all New Zealanders, particularly those who are suffering with mental health and wellbeing issues, whether that’s addiction or an array of mental health issues.

As a member of the cross-party mental health and wellbeing group, I’d just like to acknowledge those members who may not necessarily be on the Health Committee, but we all work together. So this is also something I’m sure we’re all proud of, that we’re taking another step forward.

Yes, there was a commission previously that was wound up, but this is a repurposed one with a new focus, which, hopefully, will be the commission that we see is necessary not just now but into the future—so if we can futureproof this commission so that they are able to make recommendations and make sure that framework to support New Zealanders is there.

The board of the commission—we did originally have a number in the original bill, two to five board members, but that was expanded out through the select committee process from three to seven members. They will need to have knowledge and understanding, particularly with a focus on Te Ao Māori, tikanga Māori, whānau-centred approaches to wellbeing, along with mental health services and addiction services, public health approaches, population health approaches, and improving health outcomes. We heard a lot of this from the submitters that came to us—99 submissions for this bill. Personal experience, lived experience—that is something we hear a lot about when we talk about mental wellbeing—and having those personal experiences really add to the fabric and the depth of what the commission will be and the work that they will be doing.

There are many of us who have, whether it’s a family member or close friend, been touched by mental health and wellbeing. I think one of the things that I’m really, really proud about and pleased with, having a bill like this and the amount of money that has gone into it and from the focus of this Government into mental health and wellbeing, is that it’s a topic that is becoming more easily able to be talked about right across society, because hiding away from the shame of mental distress and mental disorders is something that can have the light shone on it now. As leaders in this country, I think that is one of the roles that is ours to do, to enable people to start talking and seeking the help that they need.

The objective of the commission in performing its functions and exercising its powers under this Act is to contribute to better and equitable mental health and wellbeing outcomes for people in New Zealand. I think one of the things that I’ve been touched with within my Māori whakapapa is the number of suicides of young people in the North from the whānaus that I’m connected to, and it is deeply disturbing. So the commission will have a focus on Māori, and I think that’s really important.

But we did, actually, through our conversations with the submitters, realise that we need to expand out and hear from the groups that were mentioned in the report He Ara Oranga—that there were 12 groups that were identified in that report as examples of groups that are at risk and experiencing poor mental health and wellbeing. So the focus won’t just be on one particular segment. Obviously, there are concerns in the rural community, concerns in the Māori community, the disability community, the rainbow community, and right across the board. It doesn’t matter what community you come from, but there will be mental health and wellbeing issues right across the board. So focusing our attention directly to providing a way of enabling people to move through their challenges and to heal from them is a direct focus, not just of this commission but of the wider Government, indeed.

So, on that note, I don’t want to continue too much longer, but just to say that I’m very pleased that today we are here to get through the second reading of the Mental Health and Wellbeing Commission Bill, and I commend the bill to the House.

Thank you, Mr Speaker, and thank you for the opportunity to take a call on the Mental Health and Wellbeing Commission Bill in its second reading. The National Party rises in support of this piece of legislation, which is to establish a Mental Health and Wellbeing Commission that will contribute to better mental health and wellbeing outcomes for people in New Zealand.

I do just want to start by acknowledging Matt Doocey, the National Party spokesperson for mental health, for the enormous work that he’s been doing for the National Party caucus on this bill. Matt has a huge amount of experience in this field and has been able to bring that talent and experience to ensure that the National Party is providing a well-informed perspective on this issue but also to be able to work across the House so that we’re able to address what is an issue which is significant for all New Zealanders and one which I know all New Zealanders have an interest in.

I do just want to make the point that this is an issue which is very close to the new portfolios that I’ve picked up recently, the spokesperson for youth in the National Party and also the spokesperson for corrections, which are two of the areas which have been identified in the bill as areas where there are substantial poorer mental health outcomes. I’m pleased to see that this bill does ensure that those particular groups will see a particular focus by the mental health commission on them as it undertakes its work.

So this commission will have a number of functions, but I do just want to point out that I’m very pleased to see the objective of the function says, “In performing its functions and exercising its powers under this Act, the Commission’s objective is to contribute to better and equitable mental health and wellbeing outcomes for people in New Zealand.” The select committee chose to remove the word “more” prior to the word “equitable”, and I think that’s a particularly important word which was removed, because instead of the objective being to contribute towards “better and more equitable mental health and wellbeing outcomes”, it is “to contribute to better and equitable mental health and wellbeing outcomes for people in New Zealand.” I think that points to the intention of Parliament not being that we want to just head in that direction but that we actually expect that to be delivered, and that is where I think the National Party and this side of the House really wants to see the attention of Government going towards.

It’s all well and good to have a Mental Health and Wellbeing Commission, but what we want to see, as Matt Doocey has rightly pointed out, is better delivery, is more accessibility for mental health services for New Zealanders, so that they can have equitable mental health and wellbeing outcomes across New Zealand. I think that’s something which we want to see further action from this Government on. We acknowledge the money that has been put towards mental health and wellbeing and addiction services, but the reality is we want to see that money flowing through to our communities so that they have better access, they have better outcomes, so that they’re able to get the help when they need it, so that we see waiting lists which aren’t as long. That is what I hope the focus of this Mental Health and Wellbeing Commission will be: to push the Government towards making that happen.

When we left Government, we had 17 piloted initiatives ready to go. They were being funded and they were delivering and they were making a difference, and the reality is we need to get back to making a difference by putting more funding towards front-line services whilst at the same time focusing on how we can ensure that we have the right outcomes for New Zealanders, collecting the evidence, making sure that it’s flowing through.

So there were a few changes made at the committee. The bill originally listed a number of high-risk groups from which the commission would need to seek views. This list has been kept. We’ve kept the list but note that there are a number of other groups that are not on it. I do just want to make a couple of points on that, and that is in clause 13, I think, and that is the obligation on the commission to have and seek views from people. It lists a number of groups: “In performing its functions and exercising its powers under [the] Act, the Commission must ensure … it has effective means of seeking the views”—and then it lists a range of different sectors of our society whose views are particularly important: “(a) Māori … (b) people who share a common identity, experience, or stage in life … (c) people who have experienced mental distress, and the persons (including family and whānau) who support them; … (d) people who have experienced addiction, and the persons (including family and whānau) who support them; and (e) any other group the Commission considers may help … to meet its objective”.

I think it’s important to note in this wideness—or the breadth, I should say—of this clause and how it actually does require the commission to listen to an incredibly wide sector of New Zealanders’ voices, because the reality is that all New Zealanders would fit within those categories. All New Zealanders would fit in there somewhere, and that is because mental health and wellbeing or addiction is something which does affect all New Zealanders, whether it’s a lived experience that you may have yourself or whether that’s a family member or whether that’s through your connection through friends or colleagues or whatever it may be. All New Zealanders’ voices do matter in this process.

I note that, in Schedule 1A, groups identified in He Ara Oranga: Report of the Government Inquiry into Mental Health and Addiction have been listed: Māori, Pacific peoples, refugees and migrants, rainbow communities, rural communities, disabled people, veterans, prisoners, young people, older people, children experiencing adverse childhood events, and children in State care are all listed in that schedule to ensure that they are specifically required there to have their views sought in the process of the Mental Health and Wellbeing Commission Bill. But I do note I’m not listed on that, but I am pleased to see that I am listed in the breadth of clause 13, and I think that’s what makes this bill so good.

💬 Hon Michael Woodhouse: I count the member as youth.

Michael Woodhouse counts me as youth. I am not youth. I’m the spokesperson for youth, but when I had my 25th birthday, which was not just yesterday but a few years ago, I was no longer youth, and so—

💬 SPEAKER: The youth branch of the Communist Party is under 65.

Oh, right. There we are. So, somewhere in the world, I’m a young person; I’m a youth—a “yoof”, should I say. But, look, the National Party is supportive of this. We look forward to seeing the commission in operation. We look forward to New Zealanders continuing to engage in this incredibly important subject, and we look forward to the difference that it will make over many, many years to come. I commend this bill to the House.

E Te Māngai, tēnā koe. Tēnā koutou e Te Whare. Just to address the comments of the speaker before me, Simeon Brown, I’m also aware that the UN youth envoy—the representative for all youth throughout the world—is 35 years of age. So you’ve got a while to go, mate.

Coming to the legislation in front of us tonight, that being the Mental Health and Wellbeing Commission Bill in its second reading, I want to take a moment to commend a few folks who have been deeply involved in the process to get it to this point. One of them is one of our former Green MPs, Kevin Hague, who campaigned strongly for this while in Opposition, and actually now is currently a member of the interim Mental Health and Wellbeing Commission.

I also want to commend the Health Committee for what, I think, is actually one of the best reports and least, kind of, partisan presentations that I have seen in the three years that I’ve been in Parliament. This really speaks to the importance and the weight, I think, that our Parliament, across all parties, is placing on getting this right and on addressing the mental health, addiction, and substance abuse problems of people in this country, ultimately with a focus to receive better wellbeing for all. This is one of the many recommendations—this Mental Health and Wellbeing Commission—out of this Government’s inquiry into mental health and addiction, and I want to speak briefly on that because there are some parallels that came out of the select committee report which are pertinent to this second reading.

What we saw in He Ara Oranga, the mental health and addiction inquiry, was, for the first time, a mental health inquiry that not only appendaged addiction but also moved away from this medicalising, from this pathologising, of mental health—of someone’s state of being as something that you can look at under a microscope, and as disconnected from the social, from the economic, from the environmental circumstances that that person lives in. That was reflected in the nigh on 100 submissions heard by the select committee, the Health Committee, that heard—forgive me, Mr Speaker; it is past 11 p.m. at night—submissions on the Mental Health and Wellbeing Commission Bill. It heard that there needed to be greater integration of personal experience, of the lived experience that my colleague from New Zealand First, Jenny Marcroft, spoke to.

As we progress this Mental Health and Wellbeing Commission Bill with, as it seems, the support of all parties in this Parliament and, therefore, consensus on the need for there to be greater oversight on the legislation and policies that Parliament and the Government of the day are progressing with respect to this kind of kaupapa, I think it’s important to bear in mind that, sooner or later, we are also going to have to confront the question that the recommendations that come from this Mental Health and Wellbeing Commission may not solely be limited to what we are so accustomed to comfortably putting in the box of mental health, addiction, and wellbeing, but they may, in fact, be the issues that lead to mental ill health and that lead to substance abuse, dependency, and addiction. Those circumstances are vast and interconnected, and they’re often the areas that do end up being subject to partisan debate. They are the likes of housing, of education, and of access to opportunity in employment.

I guess what I’m saying to all members in the House tonight is that, with the consensus that we have here, with the immensely brilliant report that the Health Committee produced here, and with the seemingly cross-partisan support for greater movement in the area of mental health, addiction, and wellbeing, are we going to be willing to confront the potential that we may need to change in this Parliament? These are some of the conversations that have already started to emerge in the cross-party mental health, addiction, and wellbeing group, which was referenced by colleagues across the House, and I want to commend the contributions that have been made to this debate so far by Jenny Marcroft and by Matt Doocey, who are both members, along with myself and other members from Parliament, of that cross-party group.

That first report that we are undertaking into the heavily charged area of suicide is also something which this Mental Health and Wellbeing Commission is charged with looking into, and what we have seen so far in the cross-party work and conversations that we have been having is that there are going to be some challenges. When we are really confronting how we deal with these issues and it starts to move away from the consensus that there’s a problem and that perhaps we need to look at changes to our economic or our education or our housing systems, then all of a sudden things become a little bit more messy.

So, I guess, with my contribution on behalf of the Green Party of Aotearoa New Zealand tonight, I just want to celebrate this moment where we’ve all agreed that there is a problem and that we need greater accountability, and I hope that we take that spirit of collaboration, moving forward, as things do get harder—because they will—the more that we expose about this problem. The Green Party is proud to support this legislation through its second reading.

Thank you very much, Mr Speaker. I rise to speak at this the second reading of the Mental Health and Wellbeing Commission Bill and, as other members of this House have pointed out, there has been a very widespread level of cooperation and true engagement in trying to help a problem that we all know can’t be solved by one party or one policy in a short period of time. I think that the Mental Health and Wellbeing Commission Bill, which has a primary aim of establishing a wellbeing commission—we’ve had those kinds of things before but I think this one’s structured in such a way and has worked so well through the select committee process that I, for one, feel great hope that this is something that is going to make a significant contribution to our tragic suicide figures, the mental health issues which have only progressed under cover of COVID. The challenges that we face as a society need to be approached in different ways and I think this legislation will enable a better contribution to better mental health for New Zealanders than we have been able to do as a country in the past.

We still believe, on this side of the House, that we need more early intervention and more urgent front-line services. Perhaps again, as a result of COVID, the focus of people being alone, isolated, and the mental illness issues that then can emerge are things that we need to act on quickly. My particular concern through the select committee process, and I was one of the members of the Health Committee that heard some of the submissions—there were 99 in all and we heard 43. Many of the contributions that were made really did show the select committee process at its best, because the rural communities, for example, which hadn’t really been considered as part of the core framework of this bill, made their presence felt by their submissions and were listened to. The rate of rural suicides, as my colleague Matt Doocey pointed out, is at 17 percent in rural communities compared with 7 percent in urban areas; both too high, of course, but it proves that there is a need to put more resourcing and to pay more attention to what is happening in rural communities than we have done to date.

An independent Crown entity which will provide independent advice to Government is the right process and the right way to go. There are a number of options. When we put up Predator Free 2050, there were a number of structures and governance mechanisms that we considered. Because it’s all very well to be independent from Government but they also have to be accountable and deliver, and, you know, I think increasing the size of the board numbers, which we did at the select committee level, to up to seven, including those with the new buzz phrase “with lived experience”, was a really important part of establishing the credibility of this commission, which is going to perform such a crucial role. It is a shame it doesn’t come into force until February 2021. But I guess we’re hastening through it as best we can.

I think, when we looked at some of the initiatives that National had campaigned on around these 17 mental health ideas and concepts that we wanted to deliver, it was disappointing to those of us on this side of the House to see some of the more innovative and modern techniques being sidelined and scrapped—you know, e-therapy, telehealth, more mental health facilities and availability of programmes that are in modern parlance, and using tablets and so forth, should have been more available in schools more readily. So it was a shame to see those go. But it is important to focus on what’s positive in this.

I think that the high-risk groups being included—particularly for my particular area of interest, if you like, elder abuse. I’m not as youth-close as my other colleagues, and elder abuse is something I unfortunately learnt a lot about when I was the Minister for Seniors—the complexities, the isolation, the sense of shame, being part of a generation that was always too proud and didn’t want to show weakness to reach out for help, even coming back from world wars and surviving terrible traumas. The pride of the nation and the way you used to have to conduct yourself was very much in the British tradition of stiff upper lip and deal with it yourself, often through the bottle and other self-medication. But that’s another story. They are issues, though, and they are quiet issues, and for people who are proud and self-sufficient, they need to be properly resourced to draw them out. And I think it was a very useful thing to add this requirement to seek the views of people at risk as well.

I would hope that all the agencies that work in the seniors area will get behind this: the Age Concerns, all of the elder abuse agencies, Shanti Niwas, the ethnic communities as well—because, again, language becomes more of a barrier for older people, particularly if they are experiencing some aspects of onset dementia. The first thing they forget is the new language of English, and they revert back to their own language and they need very careful guidance and interpreters who are sensitive to their needs. So I have confidence and faith, dare I say, that this Mental Health and Wellbeing Commission will be able to do that.

The other thing I wanted to highlight was the way that this is going to be structured at the governance level, that the board members—up to seven of them, as I said—will be appointed by the Governor-General. So the usual process is for Ministers to decide, and it’s done at the committee level with many people chipping in. But having that added layer, I think, of having the Governor-General’s involvement and a Minister making a recommendation to the Governor-General—and for those of you that have had the experience of talking with Dame Patsy Reddy, as I have done when I was a Minister, you need to go well prepared. She asks a lot of pointed questions. It’s not good form if you can’t answer them. I think it’s another layer of an interested party with, if I dare say, the Commonwealth and a wider world view than we sometimes bring to decisions that are made in this House or at the ministerial select committees where these decisions are made. So I think that’s another safeguard that’s going to ensure more independence is guaranteed. I think that, again, it was something that emerged through the select committee process.

I could go on. I won’t, because I feel that it is important to progress this bill as quickly as we can because it has a significant contribution to make and I know others want to speak on it. It is a bit of a shame to see it coming in at this time of night under urgency. It feels a little bit rushed and strange, but none the less, COVID intervened and I think, when the select committee reported it back on 24 March, prior to everything going a bit strange, we had every hope that it would progress. So let’s see that happen. Let’s see this outbreak of consensus and wellbeing and camaraderie even around this very important intergenerational long-term issue. Let’s address that with willingness and put it through, which is why I commend this bill to the House.

It’s an absolute pleasure to rise in support of this bill, which will establish an independent Mental Health and Wellbeing Commission for our country. I commend this bill to the House.

Thank you, Mr Speaker. Indeed a pleasure to stand and take a call on this very important bill. It is a fantastic step forward, and I have really enjoyed the contributions from across the House tonight. First of all, I also would like to acknowledge the members of the Health Committee for their work and, hearing the contributions from my colleague Matt Doocey and also from Jenny Marcroft, clearly a very collaborative effort, which is heartening. Of course, we welcome the establishment of a Mental Health and Wellbeing Commission and the Government’s response to the inquiry into mental health.

I would add that the onus must now turn to delivering our front-line mental health services. It is important that more focus is placed on front-line services to support New Zealanders with mental health issues as well as to promote mental wellbeing. We should all join in working to enhance mental wellbeing and resilience in our communities. On the one hand, it is concerning that over 3.6 percent of our population had to access mental health and addiction services, but, on the other hand, it is pleasing to see that so many New Zealanders are prepared to do something about their mental health and addictions by availing themselves of the existing services. Reaching out, asking for help, and being able to receive it is very important. The focus now needs to shift to community services and increasing accessibility across New Zealand.

In any case, I will refer to some of the specifics of the bill. The bill originally listed a number of high-risk groups from which the commission would need to seek views, which are in clause 13, and I’m pleased to see that the committee has kept this list and added another requirement for the commission to seek the views of people at greater risk of experiencing poor mental health and wellbeing in general. I’m conscious of Māori needs in respect of mental health services. These are matters close to my heart, as poor mental health affects nearly every family in some way. So it’s good that the select committee has seen fit to expand its focus to the myriad of factors affecting mental health and wellbeing.

I note, as others have, the expansion of the board size from two to a maximum of seven, and I expect that the expansion will enable both clinical and non-clinical expertise to be considered as board members. There are a number of highly experienced individuals working in the sector who may make exceptional appointments, and this change will definitely facilitate greater scope of skill for the commission. I note also at clause 8(2) it requires that the commission members bring a greater understanding and experience of environmental factors on people’s mental health. The area of public health responses remains a critical component in getting the mix right. Equally, allowing greater commission independence when performing their functions is critical. It may be that the commission has views and approaches that don’t necessarily align with Government perceptions. Being able to do what is right as opposed to what their political masters want is important; so I’m pleased that these changes recognise and reflect that.

I’m pleased to see that the time has been taken to consider this bill through a fair and proper parliamentary process. I’d also just like to, finally, acknowledge the significant contribution from the submitters. There were 99 submissions, of which, I understand, 86 supported. In particular, I note some of the comments from the submitters who supported establishing the commission but did raise some concerns that the bill does not include all the functions proposed in He Ara Oranga. I’d also note some submitters noting the establishing of the commission will not be sufficient to improve mental health and wellbeing outcomes; that limitations and other aspects of the system will affect the commission’s success.

A fantastic bill at the moment. Pleased with that. Congratulations to all the people on the Health Committee. I commend this bill to the House. Thank you.

As has been said, there has been an outbreak of consensus for the establishment of this mental health commission and for the merits that have been attributed by many colleagues. I commend this bill to the House.

Yes, there has been consensus across the House, and yes, National welcomes this establishment of the Mental Health and Wellbeing Commission. It’s a good response to the Government’s inquiry into mental health, but we also believe that there really must be a focus now on urgently delivering front-line mental health services, particularly for the communities facing a post-COVID world. We believe that more front-line services are essential if we are going to support New Zealanders, perhaps with anxiety, with stress, and maybe isolation, as well as mental health issues, and also to promote mental wellbeing going forward. There needs to be more work, I think, on community services for early intervention and increasing accessibility to mental health services across New Zealand for those who have been adversely affected by the lockdown, for those who perhaps may be losing their jobs going forward, and for the other effects that the pandemic is bound to deliver.

So we’re very pleased to see this bill now in the House. We think that the select committee process was particularly collegial; it was particularly thoughtful and serious, and it has been helpful in designing a more effective commission. We think that the Mental Health and Wellbeing Commission will contribute to better health outcomes and it will provide a systems level oversight of mental health and wellbeing in New Zealand. I just want to note that it is independent, it is a Crown entity, and that will give it the opportunity to have independence from the Government of the day, but it’s important that it builds on the roles of existing organisations that contribute to mental health and wellbeing by coordinating across the whole system.

It really has three major jobs. The first is to assess and to publicly report on mental health outcomes and the wellbeing of New Zealanders—and this is going to be particularly important in the following months and years post-COVID. It’s also to advocate for the collective interests of people who have experienced mental distress and addiction. We certainly believe that we need to have some more insight into how we manage these cases. Finally, it promotes the alignment, collaboration, and coordination of all entities that are involved in mental health in the country.

We do note, and it was interesting to listen to one of our members speaking before, that the commission takes special regard to the experience of, and outcomes for, Māori in our community. Interestingly, the commission will not take individual complaints; this is about a whole-of-community response and following of policy through there.

So, in conclusion, National supports the development of an independent Mental Health and Wellbeing Commission, but our main concern at the moment is the need for urgent front-line medical health services, particularly when we’re dealing with suicide, and we’ve noted also, during the submissions, the high rate of suicide in rural communities at the moment, and certainly as we face disruption of quality of life post-COVID and understanding that many people will be stressed, will be anxious, and will be affected from things that have happened in the past and things that are going to happen in the future. It was interesting to look at the provisional suicide statistics that came out last year, which showed that 685 people died from suicide. That was a rise of 2.5 percent, and, I think, when we look at the vulnerability of our community going forward, we must make sure there’s particular support for those mental health services.

Finally, I just want to make a general comment. I think we all recognise that mental health is a particularly challenging social issue. It affects a large number of New Zealanders—in fact, somebody made the comment that everyone in New Zealand is affected, whether it’s in their own health or somebody in their family or the people that they know. I think it’s really important that we carefully consider how we can manage mental health going forward, and I think this commission will contribute to doing that, but certainly we really must advocate for increased front-line services so that we can deliver urgent support as we go forward. Thank you, Mr Speaker.

I support the establishment of the Mental Health and Wellbeing Commission and commend this bill to the House.

Bill read a second time.