Mental Health and Wellbeing Commission Bill

I move, That the Mental Health and Wellbeing Commission Bill be now read a third time.

I’d like to acknowledge from the outset the whole House for its support in bringing this forward to its third reading. I’d particularly like to acknowledge our coalition partners, New Zealand First, for their ongoing interest and support for having an independent commission and I also acknowledge our confidence and supply partners in the Green Party, who also have been keen advocates for this outcome. I want to thank too the Health Committee for its speedy and considered recommendations that helped shape the bill that we have before us. Improving the mental health and wellbeing of New Zealanders is, and should continue to be, a focus for all of us here, and it has been pleasing to see the overall support for establishing the new commission.

This Government has taken significant steps to improve mental health and wellbeing in New Zealand. We have expanded access and choice in the primary care area and also addiction supports. We’ve developed initiatives to prevent suicide and support people bereaved by suicide. We’ve improved support for people experiencing mental distress and addiction. We’ve strengthened specialist alcohol and other drug services and expanded enhanced school-based health services, the so-called nurses in schools.

Progress has been very difficult, but there is more work to do. Sorry, I shouldn’t say “difficult”; I should say “significant”—all progress has its own challenges, but what I mean is “significant”. Transformation does take time and must be supported by a long-term commitment and focus, and it’s important New Zealand continues to prioritise mental wellbeing throughout the challenges we are facing. That is part of the commission’s role, keeping us on track. The bill delivers on the election commitments made by Labour, New Zealand First, and the Greens. It also fulfils the commitment in the coalition agreement between Labour and New Zealand First.

Now, I want to briefly speak to the commission’s role. It will provide confidence that the Government is on track, as I’ve said. By providing independent system-level oversight of mental health and wellbeing in New Zealand, it will hold the Government of the day and other decision makers to account for their contribution to the mental health and wellbeing of New Zealand.

The bill gives the commission the ability to look at the full spectrum of mental wellbeing, and this was well canvassed in the committee stage debate. That goes from the promotion of mental wellbeing to the social determinants to how the system is supporting those with serious need. The commission, therefore, has a wide scope to consider factors that contribute to mental health and wellbeing from outside the sector, and that goes to things like income, employment, poverty, housing, social connection, and discrimination. The Government’s intention is that the commission look at those determinants in so far as they impact on the mental wellbeing of all people—not all domains of wellbeing; there are other agencies involved in that work as well.

The commission has three types of main functions. The first set of functions relates to monitoring, reporting, and making recommendations. The commission will assess and report publicly on the mental health and wellbeing of people in New Zealand and that will provide transparent information to the public and to the Government and non-Government decision makers about what’s happening and how it’s working. It is important the commission is not just a monitor but that it also contributes to improving the system, so it will also make recommendations for improvements to approaches to mental wellbeing. The commission can make recommendations to any person, and that includes to Ministers, and it can compel information also from Government agencies. The commission’s functions and powers allow it to identify opportunities to increase the efficiency and effectiveness of approaches to mental health and addiction services or other areas outside the mental health and addiction sector that impact on mental health, and that goes to those areas I’ve spoken to just before.

The second function is about promoting alignment, collaboration, and communication between those involved in mental wellbeing. It is critical that we have a mental health and wellbeing system that’s joined up and accountable. The collaboration role is particularly important, given the commission’s broad focus and the many contributors to mental wellbeing from both the health sector and from other areas.

The third function of the commission is advocacy for the collective interests of people who experience mental distress and addiction and the people who support them. We know that effective advocacy can actually be an important contributor to people’s mental wellbeing and to equitable provision of services. It can ensure that the voices of people are heard and that the people who are affected remain at the centre of decision making. And the commission’s advocacy function gives it the platform to promote positive mental wellbeing and to challenge stigma, challenge discrimination, and challenge other barriers to mental wellbeing.

The commission’s role is to contribute to improved mental wellbeing for all New Zealanders. Unfortunately, we know that the burden of mental health does not fall evenly in our society; some are at a disadvantage and experience poor mental health and addiction outcomes more often than others. Equity is therefore at the heart of the commission’s role, and the importance of this aspect was reflected during the select committee process itself where, I’m informed, there was strong interest from groups who represent those people with poor mental health outcomes. Throughout the bill, the intent is clear that the commission must assess and report on precisely this area on equity and a system that contributes positively to achieving equity for Māori and for other groups that experience poorer mental health and wellbeing outcomes currently in society.

As part of its focus on equity, the commissioner must have effective means of seeking views. It must seek the views of Māori, people with personal experience of mental distress and addiction, and people who share a common identity, experience, or stage of life that increases the risk that they will experience poor mental health and wellbeing. Groups listed in the bill as being of risk of experiencing poorer mental health and outcomes include disabled people, Pacific people, rural communities, children and young people, rainbow communities, refugees, and migrants.

So, in closing, as we recover from COVID-19, I expect the commission will play a key role in assessing the ongoing impact COVID-19 has on the mental wellbeing of people in this country. I anticipate that the commission will monitor how the mental wellbeing of individuals, whānau, and communities is being supported at all levels, from community-led interventions to the all-of-Government contribution to mental health and wellbeing.

It’s important, in my view, that New Zealand continues to prioritise mental wellbeing and the commission has an important role to keep us on track and to be a voice for the collective mental wellbeing of people in this country. If the commission is effective in performing its role, it will help improve and increase trust in New Zealand’s approaches to mental wellbeing. I commend this bill to the House.

Thank you, Madam Speaker. It’s a privilege to rise on behalf of the National Party to support the third reading of the Mental Health and Wellbeing Commission Bill. This is an important day for New Zealand’s journey in not only treating mental illness but promoting mental wellbeing in our communities of Aotearoa New Zealand. I will be the only National member of Parliament taking a call in this debate this afternoon, and that’s because we believe, on this side of the House, we want to expedite this bill so it is enacted as soon as possible. In fact, through the amendments of the select committee, we were able to make a change where this bill would be brought in by 9 February 2021 or earlier, if the bill was passed. That’s why I think it’s important today that we make sure, under this urgent sitting, that this bill is finally passed this afternoon.

I do want to acknowledge my colleagues on the Health Committee, especially Health Committee chair, Louisa Wall, and the cross-party mental health group—Chlöe Swarbrick from the Greens, Jenny Marcroft from New Zealand First, David Seymour for ACT, and Louisa Wall for Labour—who are coming together to, hopefully, take a bipartisan approach to addressing the big issues we’ve faced in New Zealand around mental health and to take longer term solutions than the parliamentary three-year cycle.

I also want to thank the submitters, who I think played a big and pivotal role in the bill that’s turning up today in its third reading. We had a range of submitters, from mental health professionals, people with lived experience, families and friends of people who have been distressed by their own mental illness, advocacy groups, and stakeholder groups. I do want to highlight one submitting group, and that was the Young Nationals. I know there are other youth wings in other parties that take an active role in making sure the parties that they support are addressing mental health, and why that is important for the younger generation is we know our younger generation is highly articulate about mental health. They have the vocabulary to talk about it. They are not fearful to talk about their own mental health issues, and they are the ones who are driving us forward and I want to acknowledge them. Specifically, I’ve worked with the Young Nats as the National Party mental health spokesperson over the term. I want to put on the record one of the policies that we will be taking to the general election, and that is a contestable fund to roll out psychological first aid training. It was developed in conjunction with our Young Nationals, and I think they’ve done a fantastic job in developing that policy.

Of course, the Mental Health Commission is not new, and it is back to the future in some ways. One of the concerns when the previous Mental Health Commission was disbanded was that people felt that it had lost its teeth, its mandate, and lost its way. What we really need is an entity that will drive change. In fact, we kind of need to get mental health out of health because, as we know, it is a cross-Government, a whole-of-Government, issue—responsibilities in education, criminal justice, health, and social development. So I think it’s important that we make sure the Mental Health and Wellbeing Commission has the mandate and the authority to really drive that change.

This side of the House was disappointed that we weren’t able to amend the bill for the ability for targets to be included. The reason I point that out, and it is with respect to the initial Mental Health and Wellbeing Commission who are currently in this role, is that they’ve produced a check-in report of where we’re at. In some ways, it’s a good report; it’s a bit of a snapshot. But I will be hoping, once we have the Mental Health and Wellbeing Commission in place, that it will be picking out areas that we need to improve on with more voracity than this report.

You know, we do know after the mental health inquiry that we currently serve only about 5 percent or 6 percent of the population, providing mental health services to them. The mental health inquiry indicative target said we needed to get to 20 percent. So we need this independent entity to drive that forward to hold to account the Government of the day, the responsible Ministers. I do have a view of my own that I do hope one day in New Zealand’s Parliament we will see our first stand-alone mental health Minister. Other jurisdictions across the world have moved to that model, states in Australia as well—not necessarily a mental health ministry, but a stand-alone mental health Minister that can work across his or her Cabinet, across his or her Government, and across all the Government agencies to draw the mental health strategy forward, and to drive it forward. Because what we listen to and hear every day in our constituents’ offices is that time and time again—I even received an email from a lady last night who’s been let down by mental health services, and that’s a criticism of successive Governments. I think now that it’s incumbent on us; the time is right for mental health to make a big step change. I hope and I believe that the Mental Health and Wellbeing Commission will be a key driver of that.

Just to finish, I just want to reflect on some of the challenges, as this bill has gone through the House. One of the things we were faced with on the select committee was how you agree on targeted groups, because, of course, as soon as you start deciding groups, you start excluding groups. But I think the select committee was able to work through that very collaboratively and end up with the schedule at the end of this bill that highlights a number of key groups. One thing I think we are proud of on this side of the House was the inclusion of our rural communities. Devastatingly, in New Zealand, we have a high suicide rate. Thankfully for urban communities, that has tracked down 7 percent. But, unfortunately and devastatingly, for our rural communities, that has increased by 17 percent. I do hope that the Mental Health and Wellbeing Commission will look into that, but also to the full range of target groups. In the end, we do need to differentiate—what will work for the rural communities of New Zealand will be very different for what needs to be provided for the urban communities that we serve.

This is an important bill for New Zealand; I commend it to the House. Godspeed to the Mental Health and Wellbeing Commission to make a real change for New Zealanders.

Tēnā koe e Te Māngai o Te Whare. Tēnā koutou katoa. As the chair of the Health Committee, I’m incredibly proud of this bill, and, firstly, I want to acknowledge Minister Clark, who’s here today. This is a flagship policy for you. You’ve made it your priority, you’ve made it your focus, and, actually, through the He Ara Oranga report process, which listened to New Zealanders, this was one of the recommendations.

So I want to acknowledge that we are creating an independent Crown entity. It will be independent of Government policy, and I think that’s really important.

I want to acknowledge the 99 written submissions and the 42 oral submitters who came to the committee. I too want to thank “Team Health”, I’d call us. We’re incredibly collaborative, and, again, this is an example of that work.

The groups that have been identified in Schedule 1A—this was an innovation, and I want to thank the Parliamentary Counsel Office for allowing us that opportunity. All the groups wanted to be listed, to be honest, because part of the requirement of the commission is to identify priority groups and to consult with them. So, obviously, as has already been mentioned, Māori are there by virtue of our status as our indigenous peoples, but we’ve also prioritised Pacific peoples, refugees and migrants, the rainbow community—who particularly mobilised, I want to say—rural communities, disabled people, veterans, prisoners, young people, older people, children experiencing adverse childhood events, and children in State care.

I thank the officials. For me, I want to highlight the work of Robyn Shearer and the team from the Ministry of Health, and, I guess, my simple message to them is that if they take the people with them and if they build on the relationships through this process, then the outcomes will take care of themselves.

The only other group I wanted to highlight were men, actually, because our men are our priority. Our colleague Matt Doocey highlighted that in the rural sector, it is men who disproportionately are taking their lives, but we also know that in the construction space, it’s become an emerging issue.

So I just want to end with what is the objective of the Mental Health and Wellbeing Commission, and that is—and I quote—“better and equitable mental health and wellbeing outcomes for people in New Zealand.” I commend this bill to the House.

Tēnā koe e Te Māngai, tēnā koutou e Te Whare. It’s a pleasure to rise on behalf of the Green Party of Aotearoa New Zealand this afternoon in support of the Mental Health and Wellbeing Commission Bill. In doing so at this, the third reading, after which we will be passing through Royal assent, the commission will fully and finally be realised, moving on from its interim stage at present.

I just want to recognise all of the mahi, which the chair of the Health Committee, Louisa Wall, has echoed, in recognising those who came before the select committee and had their voices heard, as well as those who contributed to He Ara Oranga, the Government inquiry into mental health and addiction. But, alongside that, I want to recognise those who have championed this in the political and the advocacy and the activism spheres for such a long time, and I also want to recognise former Green MP Kevin Hague, who, as health spokesperson for the Greens, fought really hard against the original disestablishment of the Mental Health Commission. But what we’re talking about today, with the establishment of this Mental Health and Wellbeing Commission, is the establishment of a commission, of an entity, that will, essentially, be a watchdog, that will hold our Government—and future Governments—to account for their implementation of policies, of funding, of law, and of the impact that that has on the mental health of New Zealanders, particularly those who have been identified in this legislation as particularly of need.

I want to just actually stipulate that all of us have mental health. We often talk about mental health as though it’s this kind of thing that’s out there, that we only ever talk about it when it is poor. But, in the same way that all of us have physical health, we have mental health, and I actually think that this is perhaps best recognised in a tikanga Māori model of health, the hauora, which recognises social wellbeing, physical wellbeing, spiritual and mental or emotional wellbeing, all of those things as being interconnected and all interdependent for wellbeing at large. Actually, I think we need to recognise that the mental ill-health crises that we presently have in this country is the logical consequence of what occurs when you start to deprioritise certain elements of that hauora model. This is what happens when we try and disconnect individuals from their communities. This is what happens when people don’t have a sense of hope, a sense of purpose, a sense of belonging, and a sense of identity. I think that, hopefully, in the wake of COVID-19, as we come into this place of recovery as a country, we’re starting to recognise how deeply interconnected and interdependent we all are as communities across Aotearoa New Zealand.

Funnily enough, on the point around this interconnection and the importance of our physical, our emotional, our community, that being our social and our spiritual wellbeings, that interconnection is actually core Green kaupapa. Oftentimes we’re critiqued as a party for not only focusing on the environment but also talking about the social and community issues that people in this country face. I guess, in threading that needle to the prominence and importance that this Mental Health and Wellbeing Commission will have moving forward, it is to recognise, fundamentally, that all of this stuff is connected and, hopefully, that we can continue that conversation with a semblance of the nuance that it is owed as we move forward.

Of course, this is one of the many recommendations out of the Government inquiry into mental health and addiction that was titled He Ara Oranga. I think that that report was groundbreaking in and of itself, because, for the first time, even though we’d had multiple inquiries over the last few decades into the state of our mental health services, this was the first one that was given the mandate to look beyond solely the individual clinical forms of treatment that we may respond with as a society, as a health system, or as politicians. It was groundbreaking because it looked at individuals as part of society. It was groundbreaking because it looked at the features and the factors and the attributes and the characteristics of one’s life that can lead them to experience poor mental health, and it therefore recognised that mental ill-health does not occur in a vacuum. In fact, it reflected swathes of contemporary research which showcases that people’s environments are largely determinative of poor mental health—interestingly, in the same way that poor physical environments can be determinative of poor physical health. Again, this is the critical point that I need all of us to really reflect on today: that all of this stuff is connected and none of it happens in a vacuum.

We’re stoked, as the Greens, that this is passing today. We’re stoked because we hope that it is the start of the journey of the recognition in a systemic, institutional way that mental ill-health isn’t happening in this vacuum over or out there, but, in fact, it is deeply embedded in our lives and in society at large. I want to commend the Minister of Health, Dr David Clark, for his mahi in working, actually, across the House, from my understanding, and in speaking to the members of the newly formed mental health and addiction wellbeing cross-party group. This is important, and this will be really important to a lot of people. So I hope that we don’t take this as just lip-service, having ticked it off the list, but, in fact, that what we’re establishing today is an institution that will hold us all to account and make sure that we bloody well are holding ourselves to the promises that we are making. Very happy to commend this bill to the House.

Bill read a third time.