Mental Health Bill

I present a legislative statement on the Mental Health Bill.

💬 DEPUTY SPEAKER: That legislative statement is published under the authority of the House and can be found on the Parliament website.

I move, That the Mental Health Bill be now read a first time. I nominate the Health Committee to consider the bill.

It is a serious step when the State intervenes and takes control of your life. The current Mental Health Act has been criticised for not being aligned with the dominant models of mental health care in New Zealand. This bill is needed to ensure we have modern compulsory mental health care legislation. People who are subject to the legislation come from all walks of life. They could be a family member, a friend, a neighbour, or a professional or leader in our communities. These are everyday New Zealanders experiencing mental distress at a level requiring State intervention to support their recovery.

It is important that the bill comes in today with full support across all political parties in Parliament. As New Zealand’s first mental health Minister, it is important to me that Parliament takes a bipartisan approach to addressing mental health in New Zealand. This builds on the kaupapa started with Chlöe Swarbrick, Louisa Wall, and myself five years ago when we first met to set up New Zealand Parliament’s first cross-party mental health group to develop long-term policy solutions irrespective of three-year parliamentary cycles. It is important to see this bipartisan approach to mental health continue to thrive here tonight.

Can I start by acknowledging those with lived experience, specifically those who have lived experience with compulsory mental health care in New Zealand. I do hope that you will see your voices, your stories in this bill. We need to do better. I want to thank you for sharing your experiences to date and I’d like to encourage those who are still to share their story to make a submission in the select committee process so we can ensure those with lived experience are heard.

I’d also like to acknowledge those who bravely came forward to share their stories in the Royal Commission of Inquiry into Historical Abuse in State Care and in the Care of Faith-based Institutions. For some, talking about compulsory mental health care will be difficult. It is important to state that this bill will contribute to at least 10 of the Abuse in Care recommendations, relating primarily to care safety and monitoring.

My vision is an effective and comprehensive mental health and addiction continuum that puts people at the centre of their care. Making sure we have legislation that can support people who are experiencing the most acute mental distress is a key part of that continuum. That is what we are here for today.

Back in 2018, there was a Government inquiry into mental health and addiction. The resulting report, He Ara Oranga, recognised that the Mental Health Act was out of date. The report recommended new legislation that reflects a human rights - based approach, promotes supported decision-making, aligns with the recovery and wellbeing model of mental health, and provides measures to minimise compulsory or coercive treatment.

In 2021, the current Act was amended, which, as I said at the time, was an important step in addressing the He Ara Oranga recommendations, but ultimately a small step. I’m very pleased to be taking the next major step by introducing this bill to the House. This bill will modernise compulsory mental health care in New Zealand. The current Act has received substantial criticism and challenges both domestically and internationally. That includes what we heard through the Royal Commission of Inquiry into Historical Abuse in State Care and in the Care of Faith-based Institutions. Many of those 2,400 survivors who courageously shared their stories and their experiences with the Government and the public spent time in mental health facilities. This bill forms part of the Government’s response to the recommendations of the inquiry’s final report, particularly those recommendations relating to care safety.

This bill supports a future focus on safe and effective mental health care for people that require State intervention. This bill will be a critical safety net for those experiencing severe mental distress who are unable to engage in decision making about their own mental health care. It is intended to be used as a last resort only.

When this happens, a person is required to receive care either in the community or, if that is not appropriate, in an inpatient setting such as a hospital. This does not cover all specialist mental health service users. In fact, only around 6.4 percent of service users are subject to the Mental Health Act at any given time, but that is still over 11,000 Kiwis—people receiving compulsory care, either in the community or in a hospital setting.

I know that for those experiencing the most severe mental distress, compulsory care can have a significant impact on their lives and their loved ones. It can be a lifelong influence on people’s ability to live independently and engage productively in their communities. I want to highlight the three big shifts I expect to see under this bill.

Firstly, this bill is about providing more effective care. Compulsory mental health care is not a new concept, but how it is delivered is out of date and no longer represents current best practice. The legislation will support care being delivered in a way that minimises coercion and is responsive to individual needs. This will bring compulsory care in line with modern clinical practice in New Zealand. Placing a person at the centre of their care will also support safer ways of working, which will improve outcomes for people under the legislation, their families, and communities.

Secondly, the bill will recognise people’s decision-making capacity. This is why one of the most significant aspects of the bill is its approach to embedding supported decision-making. At its core, this is about putting measures in place so that people can be actively involved and assisted to make decisions about their own mental health care. You will see that the bill has measures in place to support people before they become unwell, such as through compulsory care directives. It also includes key protections when people are under the legislation, such as duties to ensure participation. Empowering individuals is fundamental to this bill.

Thirdly, the bill introduces far greater protections and safeguards. The bill will ensure people understand what is happening to them, why they’re entitled, and what they’re entitled to when they are under the legislation. One of the aspects I’m particularly pleased to be speaking to is the new independent support and advocacy roles under this bill. These roles will be critical to ensuring people have the support they need to be heard, as well as to understand and exercise their rights. People will also have more opportunities to have the decisions about them reviewed and more opportunities to exit the legislation if it is no longer needed.

We also take a hard look at restricted practices, specifically the use of seclusion. This bill ensures there will be far greater monitoring and oversight. I recognise that there are a number of practices like these, marred in history, of inappropriate use, abuse, and overuse. I am committed to seeing the reduction and elimination of seclusion over time. The bill has mechanisms to support far stricter use, with the ability to prohibit seclusion once the system is ready. I’m sure restricted practices will be a critical topic of discussion and of high importance to submitters and the select committee.

This bill has been driven by the voice of New Zealanders, and I will take some time to thank all the individuals, the families, the organisations, and others in the mental health sector who have shared their time and experiences through the public consultation process on the policy underpinning the bill back in 2021. I acknowledge there are diverse views on this piece of legislation and that people have engaged in this work in good faith. Developing this bill has involved carefully balancing all of those views. I have had people who took part in the consultation look at the bill and see how all the different views have been considered. I hope this good-faith engagement can continue across the House as the bill proceeds to the Health Committee and beyond. I commend this bill to the House.

The question is that the motion be agreed to.

Anybody who has interfaced with the mental health Act 1992 will know the trauma and the difficulty in grappling with really big issues around human rights, dealing with loved ones, dealing with crisis, dealing with safety. As somebody who has used section 12 of that Act twice on family members and had extensive experience with family members who’ve experienced mental health, I want to acknowledge that this is a very big and serious and important piece of legislation, and it is complex. It is always going to be contentious in some elements.

I want to congratulate the Minister, the Hon Matt Doocey, for bringing it to the House, for building on the work that the Labour Government did in getting it here, and I also want to thank him for his collaborative approach for reaching out and providing us with a pre-reading briefing. We take on board his invitation to suggest at the select committee that we go around the regions and seek input from New Zealanders. It’s certainly something I would support, and I also heard, in his briefing, the flexibility of the Minister to consider some of the more contentious elements.

The bill does go a long way in terms of moving the 1992 current law from a very sort of brightline situation, where people are either deemed requiring compulsory care or not, into a much more nuanced approach. I’m not going to go into the differences. I think others can speak to them, but I’d like to just lay out some of the things that we would be very interested in, as the Opposition, to hear from submitters.

We are cautious about certain areas of it. There is a change to the threshold that requires people to be kept under compulsory care. In some ways, it looks to have been broadened, which could be concerning, but we also see that it is proportionate. There is a proportionality test, and so I’d be really keen to hear from people, especially those with lived experience and those working in the sector, as to what they see the impact of that would be.

We are very concerned about electroconvulsive therapy (ECT), and for this reason, we will support the bill to the first reading in its current form. I have heard the Minister say in the briefing and tonight in the House that he is flexible about this, and our concerns come about because of our sensitivity to the evidence and the recommendations from the royal commission into abuse in care. We need to now temper that with the pre-consultation that happened before this bill came up, and I’m hearing that the Minister may be flexible, but we do also have real concerns around the use of ECT that is still allowed under the Act for under-18-year-olds in certain situations, and we want to hear more about what the appropriate consenting process should be and what the safeguards are.

The Minister has mentioned seclusion. Our concern here is we understand there are workforce pressures, but we also feel that to use a pragmatic reason to override human rights as the sole reason is problematic. We want to see what can be done around seclusion to strengthen the human rights element and ensure that it is used only in the rarest of circumstances. The same probably applies to the other treatments that the Minister referred to.

In general, I think the bill will be much stronger if we can just ensure that there is greater compliance, and that is because the policy statement refers to a level of compliance needed to achieve its objectives as being very high and also specifically in the need to secure efforts to secure compliance. Now, those are things that I’m sure can be done through some panel beating of the legislation. And, again, Labour will be really listening hard to see where we can strengthen that. It will be around the reporting requirements afterwards, I imagine, after certain powers have been used under the Act but also in the processes that are used to evaluate people, so that we can be sure that we are really fine-tuning the balance of making sure we take the best care of people when they’re in crisis and need to be kept in a safe environment, not necessarily with their consent, and that they get the care and support afterwards that they need. So with those caveats, we do support this to first reading, and I look forward to the many submissions that we will get.

Thank you, Madam Speaker. All of us deserve to be treated with respect and dignity, no matter where our mental health is at, and I think this is really significant because, for quite some time, in our communities and through our systems built by political decisions, that hasn’t been the case. I want to mihi to the 11,000 people who are subjected to compulsory care every year, their whānau, and their communities, and everybody who has contributed to the political process that has led us to this day where we are debating the Mental Health Bill, which will seek to overhaul the Mental Health (Compulsory Assessment and Treatment) Act 1992.

Even though that bill is quite old and would have been seen as progressive at the time, it has now been really well documented about how it is actually quite out of date and it doesn’t reflect the rights that we aim to uphold for disabled people. Most recently, we had He Ara Oranga, the report on the Government inquiry into mental health and addiction, that called for our mental health Act to be overhauled and with a human rights - centred approach. I want to acknowledge the Minister for Mental Health’s intent in here to do that and to actually uphold the voices of people who have contributed to this process to this day.

Aso, if we look at this same report, the findings of the report also identify that in order for this bill to be successful, the Minister, and the Government more broadly, will need to take an all-systems approach to improving the wellbeing of our communities. It will rely on addressing workforce issues and it will rely on addressing the social and economic determinants of health. That very same report talks about how poverty is a huge contributor to people’s mental health. Therefore, I think, in order to address some of those rights-based approaches, we’ll need to also look outside the scope of this bill, and that will be key for it to be a success.

I also want to acknowledge the abuse in State care inquiry, which shed another light on practices such as compulsory care and how they have often been used under the guise of care by the State. I think this is another reflection that we need to take into account as we honour the voices of survivors and people with State care experience.

The Green Party, though, notes that this legislation will deserve really, really strong scrutiny from us and our broader communities. I also want to echo how we welcome the invitation from the Minister to get the select committee in charge of this bill to travel across the motu to adequately hear and take into account the voices of our communities who need to be at the centre of this bill.

Again, we do aim to eliminate these restrictive practices, which have been well documented, and we call on the Minister to be a strong champion to address everything else that will need to be done to ensure that our people are safe, because at the end of the day, for example, if we’re going to acknowledge in this legislation the particular need to address Māori mental health and take a Te Tiriti approach to mental health, that cannot be done if, at the same time, land continues to be dispossessed, people continue to be stripped of their culture, and if access to te reo Māori continues to be deprived.

Those things are actually all connected. We have a bill that acknowledges the importance of Māori mental health and Te Tiriti o Waitangi and, therefore, I call on the Minister that, alongside this bill—and I really commend his good-faith approach—he also becomes a champion to address the critical feedback we have received across so many reports, across so many events, and from so many community members on the need to address all the other parts of the mental health system that go beyond this bill.

We look forward to participating in the select committee process, to adequately looking at whether any amendments need to be made to strengthen this legislation, and to encouraging members of our communities to submit. I also want to acknowledge that, when people have lived experience in the mental health system, particularly when it comes to issues around compulsory care, there are barriers to participating in processes like the select committee. I hope that we take an accessible approach to ensure that we take care on what could be re-traumatising experiences that are yet to be shared. I look forward to working constructively, and I know that Hūhana Lyndon, who will be representing us on that select committee, will be a strong champion to ensure that we take really good care in upholding those voices in a way that doesn’t retraumatise people.

Thank you, Madam Speaker. I rise to represent the ACT Party in support of this bill at the first reading. Firstly, I want to acknowledge the work of the Minister, Matt Doocey, and congratulate him on bringing this bill to this House. I also want to acknowledge the collaborative approach that we have, because I think there are some things like this that kind of go beyond the political back and forward, to-ing and fro-ing. It is such a serious piece of legislation, and I think it is really important that we all collaborate and get together and make sure we’re on the same page with this. I’d like to congratulate you on that. Also, a bit of a shout-out to the other people that are on the cross-party mental health group that we’re working together with, and to the likes of those that will be on the Health Committee that will champion this bill through.

The old legislation is from 1992, more than 30 years old, and is no longer fit for purpose. I think that is more than obvious. This bill provides the guidelines for when a person can be subjected to compulsory mental health care without their consent. It provides a safety net for those who need urgent intervention as a last resort. It also defines legal protections and process from the justice system for those individuals requiring mental health care, ensuring a secure environment for treatment. This bill is about providing more effective care, supporting compulsory mental health care to be delivered in a way that minimises coercion and is responsive to individual needs. It sets out important guidelines to improve the effectiveness of the mental health and addiction support services in New Zealand, protecting patients and staff.

The major areas of change: this bill aims to modernise the mental health care system while also driving a human rights - based framework for compulsory mental health care. Some of these main changes I note are that there’s going to be a foundation for personal centred care, including the ability for patients to make statements in regard to their future care, and it allows patients to specify the care that they consent to and do not consent to. I think this is really important, and having this plan in place before we head down those steps to needing that State intervention, I think, would have a major difference in people’s lives. I really find that part to be one of the biggest features here that I’d really like to get behind.

The aim is to minimise compulsory treatment. I do feel like that is quite an ambitious goal, and I see where the framework is heading with it, but, at the same time, I think that we do need to realise that there is a fine balance between the safety of the individual and the safety of staff and everybody that is involved in that care. I do think it is ambitious and I think it is something that can be worked towards. The legislation sets a new standard for when compulsory treatment can be used. The use of compulsory treatment can be only permitted when someone has seriously impaired mental health that causes severe adverse effects and they lack that decision-making capacity.

Focusing on recovery and supported decision-making: Part 2 of the bill provides guidelines for supported decision-making to ensure individuals can make their own decisions regarding compulsory mental health where possible, which I think I talked about before, and this is a really, really important part to the bill. I also note that He Ara Oranga, a Government inquiry into mental health and addiction, identified various issues, and a lot of these seem to be addressed from that report: enhanced protections for children, specific provisions for forensic patients, cultural considerations, and a focus on reducing mental health disparities.

There are some potential unintended impacts, and I think I potentially spoke about that before. The goal of this bill is to support and protect patients’ rights in improving mental health outcomes. However, this bill could create a complex web of new processes, meetings, and administrative requirements that could actually delay the treatment for those that are in crisis, and that is something that I do actually worry about. I think that during the whole select committee process, we would like to see how these processes will be carried out, and we want to hear from the voices of those with that lived experience. Like the speakers before me, I do urge anybody that has that lived experience to please come forward to the select committee, those that work in this area and those that feel like they have something to contribute. It is extremely important. This is a very important bill, and I commend it to the House. Thank you.

Thank you, Madam Speaker. I rise on behalf of New Zealand First in support of the Mental Health Bill. It is very much a welcome piece of legislation. As I was reading through it, it really did take me back to many individuals—in fact, I didn’t realise how many—I have walked through this compulsory care journey with. It’s not only, obviously, incredibly traumatic for them but also for their family. I really thought about the systemic family effects that happen when this process is happening. I just want to acknowledge everyone out there who is struggling at the moment, and their families; it is a very difficult road. We really do welcome this legislation.

Now, one of the things that I was very happy to see was the theme of our human rights being acknowledged so much in the process, through the Act—it was mentioned quite a lot. I’m just going to touch on a couple of areas because I know we’ll be able to speak a bit longer in the second and third readings. I was really happy to see that and that there is a focus on recovery—therapeutic support; not just a band-aid but a long-term plan—in order to help people transition from care to go back out into the community from compulsory care to voluntary care. It was really welcome to see this approach of wanting to see a long-term solution for an individual—a holistic approach, one might say.

The other thing that I was also very happy to see was that everyone has a care plan. It is recorded and there is a review process, so there will be some accountability in this. Processes—yes, hopefully they won’t delay, but to have secure processes in place, anything to help save a life is worth it. The more that we can do to do that, then the better.

Now, minimising coercion: I was really happy to see that, because of just witnessing some of the things that I have witnessed, and to encourage that this will not be something that will affect people’s basic human rights—there will be some leeway here—and to really ensure that things such as seclusion, as the Minister mentioned, are not going to be used as much, if possible. That was a welcome thing.

Safety—there was a mention, and I’ll speak a little bit more in detail in the later readings on children and young people. There is a real look into that side of things as well.

Now, I won’t be on that select committee, it would be great to be on it, but I will follow it very closely. I do welcome everyone especially those with lived experience, because that is how we will learn. I would welcome everyone to participate as much as they can in this select committee process. I think that’s all I want to say at the moment. I commend this bill to the House.

Tēnā koe e te Pīka. First of all, I’d like to mihi to our Minister for Mental Health, Matt Doocey. Ka nui te mihi ki a koe. Kei te tino Whakanui tēnei pire. [Huge salutations to you. I am in full support of this bill.]

I want to, first of all, acknowledge this bill. It’s the first, under this new Government, to promote Te Tiriti o Waitangi—and the ceiling hasn’t fallen in. It recognises and protects our tino rangatiratanga. This bill also seeks to promote the decision-making capacity of our people in care, supporting their mana motuhake. Ka nui te mihi, ka nui te mihi, ka nui te mihi ki a koe. [Huge compliments to you, huge compliments to you, huge compliments to you.]

What it also does is accept the recommendations from He Ara Oranga—the report of the Government Inquiry into Mental Health and Addiction. I want to mihi to many of the esteemed members: Professor Ron Paterson, who is the chair; Tā Mason Durie, founder of Te Pāti Māori; Dr Barbara Disley; Dean Rangihuna; Dr Jemaima Tiatia-Seath; and Joisiah Tualamali’i—aroha too. There were 5,200 submissions made; 400 meetings were held with tāngata whaiora and their families, members of the public, health and other service providers, iwi and kaupapa Māori providers, and many community experts.

I guess what we are seeing is, most significantly, the shift away from a system that has harmed many in our community. Our current mental health framework has completely failed our communities, and many communities. I think that going towards acknowledging Te Tiriti will benefit all of our mokopuna. The status quo system, as you know, has required a real shift from anything that has been done before, and we respect that this is the intent.

One of the things that also is emphasised is the wellbeing of the communities and the people-first approach. It is so humbling to be able to be in the House to mihi to you for that. This is what Māori input looks like—and no one has had their skin ripped off their bones. The input on what is required to radically shift from what has been failing our whole communities has been informed by experts, well-versed experts; it’s been informed by whānau who are living with and challenged by the revolting aspect of how the mental health system has let us down; and it’s been afforded, as included in Te Tiriti, to ensure that we are all able to thrive.

I guess it’s difficult not to reflect on the anti-Māori agenda and to ignore things that have been effected in the last 10, 11 months. I’m sad to see that it’s taken nearly a year for us to get to a bill that is acknowledging the deprivation—most significantly, the depth of change that’s required—so I do mihi to He Ara Oranga and the boldness of the Minister for taking this onceinageneration opportunity for change. Our own Tā Mason Durie pioneered Māori health, citing in his Māori model of health, Te Whare Tapa Whā, that our mental health is equally important as our physical health, our spiritual health, and the wider health of our whānau and our whole community.

One of the aspects also that I’d like to mihi to in this particular bill is that what we have is—I guess, sadly, when we see Māori are disproportionately represented—the boldness within us, across all parties, to be able to look at repealing and putting in place something that, as we’ve heard before, reflects our human-rights - based approach, that is promoting and supporting decision making that aligns with a whole wellbeing model of mental health, and is providing measures to minimise compulsory or coercive treatments. It’s been a long time coming, and we look forward to hearing the submissions and following this through to the third reading. Kia ora rā.

Thank you, Madam Speaker. Look, I rise to speak in favour of the first reading of the Mental Health Bill and I want to congratulate our mental health Minister, Matt Doocey, for all of the very hard work—and incredibly important work—that he is doing in this space to improve mental health outcomes across New Zealand. There’s a lot of work to do, but I know this Minister is going to work hard to make sure that we improve the situation. This bill does aim to replace outdated legislation, and it’s been commented on how the Mental Health Act doesn’t necessarily align with current mental health models across New Zealand.

The Mental Health Bill, as it comes in, somewhat intends to do several things, and one of them is to be people-centred and another one is to enable supportive decision-making. It establishes a framework for compulsory mental health care without that consent, and outlines processes for forensic patients—and many of those who are in very challenging circumstances—to get the mental health provisions that they need. It modernises the regulations for people with severe mental distress and it sets out a number of principles to promote a human rights - based, recovery-focused approach to mental health in New Zealand. It encourages supportive decision-making—as I’ve touched upon before—because we do want people to make their own mental health decisions. We want them to be at the centre of this and we also want that to be enabled, even if they lack capacity, ideally before they become unwell.

We have noted there were a number of recommendations by the royal commission of inquiry into historical abuse to promote a safer, more effective care model to minimise the need for compulsory care and instead focus on individual needs and recovery. I’m sure all members of the Health Committee who are here tonight look forward to working on this when it comes to the committee and hearing those submitters and those submissions. I’m sure some of those submissions will be quite challenging, but we will do our best to make sure that this legislation reflects the needs and where we need to go on this as best we can. I support this bill; commend it to the House. Thank you, Madam Speaker.

Thank you very much, Madam Speaker. It’s a pleasure to rise in support of this bill. I want to acknowledge the comments made by the chair of the Health Committee. I too am looking forward to the hearings on this important bill. I want to, like others have done, acknowledge the long gestation and two parents this bill has had. I was lucky to be the Minister responsible for it for the short period of time I was Minister of Health and found it well under way due to the work done by my predecessor, Andrew Little, on this bill. I’m aware that it had its genesis in the He Ara Oranga report commissioned by David Clark, so it is good to see that its new parent has continued its gestation and brought it to this important phase, its birth into our Parliament. Congratulations, Minister Doocey.

This bill has a lot to commend it, including taking a more patient-centred and modern approach that values the human rights of people suffering mental distress. I do want to just draw out some of the ways in which it does that. It is more recovery based, it does recognise Te Tiriti, it is more whānau orientated, it moves us closer to meeting some of our international obligations, and it pays more attention to human rights, including allowing advanced directives in some situations. Those are all very positive developments—developments that we should support.

I also think the inclusion of the tests that exist and review periods are important protections that have been carried over from the previous Act. One thing that is different is that the compulsory care criteria and the words “serious harm to themselves or others” that was in the old Act are no longer in this Act, though the concept is similar: the person must be suffering “impaired mental health [that] causes the person to lack capacity to make decisions about their own mental health care.” and “is likely to cause in the near future, in the absence of care, serious adverse effects”. That is different from the “serious harm to themselves or others”, and I think that sounds like a more appropriate test, but, of course, I’m sure, in select committee, we’ll hear about many different situations in which this compulsory care test is applied and be able to flesh out the meaning of that change in more detail.

I want to echo some of the comments of my colleague Ingrid Leary and note the areas where we have questions that we want to explore more in select committee. The first relates to electroconvulsive therapy (ECT). As a Minister, I was aware that electroconvulsive therapy was part of this Act, and in the course of being part of the development of this Act, sought additional information on that. I am aware that that official information says that ECT is effective. However, I still have questions to ask, and I hope that that is something we can put the select committee’s time towards. As I’ve gotten to know my select committee colleagues better, I have understood that we are very well qualified to undertake that work together. It is an important element of human rights. We are all painfully aware of the misuse of ECT at times in our country, in our health system in the past, and the bill includes provision for ECT without consent. It is upon us all to make sure that we scrutinise that particular treatment, and I hope that those who have experience of ECT or of using it in a therapeutic setting come and speak to the select committee.

I want to use my remaining moments to reflect on a meeting I had with a member of the public recently who had an experience of seclusion in compulsory mental health care that was extremely distressing. Her experience of seclusion was one in which she felt abandoned. She felt it was at odds with the very notion of being in therapeutic treatment. She felt that it isolated her from the care system. I really want to make sure we understand that it is being used in the right circumstances in this law. Thank you, Madam Speaker. I commend this bill to the House.

It is great to rise to speak about this Mental Health Bill, and it’s great to see support right across the House for this piece of legislation. I have to admit that it’s quite some legislation, with 221 clauses in this bill. I do just want to acknowledge some of the officials up in the gallery that are watching on. I do look forward to working with them on the Health Committee as we work our way through this.

It’s clearly time that we updated the Mental Health (Compulsory Assessment and Treatment) Act 1992 to bring it in line with best practice—not just best practice here in New Zealand, but to bring us in line with some best practice internationally as well. It is a very important bill, as we’ve heard, because it does deal with the serious occasion when compulsory mental health treatment is used. It does mean that we need to make sure we get this legislation right, and, as I say, I look forward to the Health Committee working through this legislation.

This repeal and replacement of the mental health Act of 1992 means that we can have a bill that better reflects a human rights - based approach that we’d expect to have in a modern society. It promotes supported decision-making and, of course, it aligns with the recovery and wellbeing model of mental health. It also allows that in times of maybe not so acute mental health distress, people can make their own mental health care decisions. I think this is a very important part of this bill, and I look forward to making sure that we can get this legislation right because it does touch on a very serious aspect of mental health. I commend this bill to the House.

Thank you, Madam Speaker, for the opportunity to stand and speak on the Mental Health Bill. Can I acknowledge the Minister. We all know that prevention is better than cure. And the Minister, in the good work that he’s doing, has continued to support Access and Choice for communities right up and down the country, which is the best way to stop whānau and individuals having to walk down the pathway that we’re debating in the Mental Health Bill this evening. So I want to acknowledge the Minister for continuing the support of that work.

In my time as an associate health Minister, I travelled the country, in particular to meet with the Māori providers who provided the Access and Choice care in communities from the top of the North to the bottom of the South. I was impressed by the work that they did and want to acknowledge the Minister for bringing this bill to the House. Because as my colleague Debbie Ngarewa-Packer has mentioned, on this side of the House we acknowledge that this bill does look towards the kind of equitable healthcare that we expect for our communities and our people and looks towards models that will support that equitable healthcare.

Whenever we speak of health models, I can’t help but think of Sir Mason Durie, Member of the Order of New Zealand, one of the greatest living New Zealanders, who continues to talk about Te Whare Tapa Whā and the need to consider all aspects of the person’s wellbeing in order to help them and support them to achieve the kind of life that we all aspire to. It’s those kinds of models of care that I think about when we look towards how we can get equitable care and how we can make sure that those who do require such mental health services can continue to get that support on their journey.

The other part of that support that’s mentioned in the bill here talks about the kind of representatives for those who do find themselves in care. I note that the bill the Minister brings to the House tonight talks about the kinds of representatives for those people. They can be whānau members, iwi members, iwi leaders, hapū leaders, people who are well known to the family or to the individual, and people who will be able to advocate on behalf of those people who find themselves needing this kind of healthcare.

This is a good step forward. As my colleague Debbie Ngarewa-Packer said, the sky hasn’t fallen in. We want to acknowledge that we can still continue to serve Māori communities and we can continue to actually acknowledge Te Tiriti o Waitangi in the work that we do. That will help all of the communities across Aotearoa New Zealand. I want to acknowledge the Minister for bringing this bill.

The next part is to acknowledge that there will be a lot of submissions. I expect those submissions to come forward to the Health Committee when this bill is up for consideration. That’s going to be important because the devil is always in the detail. The ability to look towards the bill, to pick it apart with a fine-tooth comb, to actually come forward and express what it means to give equitable healthcare to Māori whānau and Māori communities—it’s easy to say those things and it’s even harder to actually do it. To hear it firsthand through the select committee, I think, is going to be important, and I’ll encourage those in the Māori health sector and in the mental health sector in general to make sure that their voice is heard on such an important bill.

Every one of us in this House have had family members, community members, close and dear loved ones who have come across mental health challenges and have needed to access care. While He Ara Oranga looked towards the system and how we might be able to fix it, what we knew was it was going to take time to get there. Access and Choice, which is what I’ve already mentioned this evening, is one part of that. This bill is another part of that journey on he ara oranga. I look forward to the Minister driving through the recommendations and the changes that are required to achieve he ara oranga. For those that don’t know, “he ara oranga” means a pathway to wellbeing—he ara oranga. I think that’s something that we’ll all aspire to for our communities and our constituents right around the country.

I commend this bill to the House, but, as my colleague Ingrid Leary has already said, we will continue to look towards a few aspects of the bill that we have a very clear view on and a strong view on to make sure that those are heard in the select committee. I acknowledge the Minister and his bipartisan approach to such an important matter to our community. Well done, Minister. I’m looking forward for this bill continuing through its processes, and hopefully being supported right to its conclusion.

I rise in this House tonight to support the Mental Health Bill in the name of New Zealand’s first Minister of Mental Health, the Hon Matt Doocey.

This bill will replace the Mental Health (Compulsory Assessment and Treatment) Act 1992, which is more than 30 years old and is no longer fit for purpose. Currently, according to Health New Zealand, Te Whatu Ora, possibly 10,000 people in New Zealand are subject to treatment or assessment under the current Act per year. These are some of the most vulnerable members of our communities who need world-leading care, not a 30-year-old Act which was never designed for many of the challenges we face as a society today, both in my electorate and across New Zealand.

This bill introduces a purpose and set of principles to promote a human rights - based recovery-focused approach that addresses the uniqueness of individuals under compulsory care. This is a critical safety net when a person needs urgent intervention as a last resort, which, in many cases, has the potential to be lifesaving. This bill also encourages supported decision-making, to help people make their own mental health care decision, even if they lack full capacity or before they become unwell. This bill also introduces far greater protection and safeguards than the current Acts in place, ensuring people understand what is happening to them and what they are entitled to when treated, according to this bill once it become law.

If there’s one thing—one thing in this House—that we can unify on, it’s about improving the mental health system to ensure those who need help get it. Therefore, I’m looking forward to this bill progressing to the select committee, where New Zealanders will have the opportunity to provide feedback to ensure this bill best achieves this objective. I commend this bill to the House and I’m looking forward to it progressing further.

Motion agreed to.

Bill read a first time.

The question is, That the Mental Health Bill be considered by the Health Committee.

Motion agreed to.

Bill referred to the Health Committee.

I declare the House in committee for further consideration of the Contracts of Insurance Bill.