Barbara Staniforth: good policies need impartial support

In September, the government released Kia Manawanui, Aotearoa: Long-term Pathway to Mental Well-being, a revolutionary piece of social policy.

This inspired document finally acknowledges that the causes of mental health and distress are firmly rooted in all aspects of our society, and that while providing adequate resources to support people with high needs within existing services is important, problems with our national mental health will not be fixed until we address poverty, inequality, racism, cultural and social disconnection, and violence against women and children.

While previous mental health policies have centred on addressing mental health needs of the three percent of society most seriously affected by mental illness, Kia Manawanui sets out plans for prevention and mental well-being for everyone.

It is a revolutionary piece of social policy but, unless big things change, it is destined to fail.

By now we are all aware that Aotearoa New Zealand has some of the highest rates of youth suicide, violence against women and children, and child poverty. Covid-19 has exacerbated these issues. And racism has certainly been evident in the casting of blame for Covid cases on Māori and Pacific communities. However, Covid may also have given us the opportunity to re-evaluate our priorities as a nation and consider what “being kind” means. Many of these priorities are evident in Kia Manawanui.

The pathway is modelled on the government’s Pae Ora Healthy Futures which situates people’s well-being within their whānau, communities and their wider environments and sees these as essential and interrelated. It acknowledges society’s responsibilities under Te Tiriti o Waitangi and sees the need for widespread intervention through working with communities, iwi, schools and social services while also teaching people about what they can do to build their own resilience. It moves beyond a medical paradigm and recognises the important role that people who have experienced mental distress can play in supporting others and contributing to research and policy for mental health.

There is nothing that I don’t love about Kia Manawanui. As a former mental health clinician and as a researcher and teacher in this area, I welcome the framework it provides for change. I think it could make a huge difference and I think most people I work with would also see it this way. But if politics gets in the way, it will all fall down.

Mental health policy has always been a political lightning rod. A Labour government commissioned the second Mason Report (1996, by judge Ken Mason) which was labelled a Journey of Recovery for the New Zealand Mental Health Sector. It led to increased and ring-fenced funding for mental health and the establishment of the Mental Health Commission.

In 2012, the Commission was disestablished by the National government which in 2017 refused calls for an independent inquiry into mental health. Labour responded with He Ara Oranga, Report of the Government Inquiry into Mental Health and Addiction in 2018. Then, in 2021, the Labour government declared its intent to establish a Māori Health Authority.

While different approaches to policy exist in the arena of mental health, they are nothing compared to other philosophical and economic differences that exist in areas such as wealth distribution and addressing inequality and the impacts of colonisation. What one government introduces, the other is likely to reject.

This alternating approach is not limited to mental health. The Government Joint Venture, a cross-agency organisation made up of ten government departments, has been developing a national strategy to end family violence and sexual violence in Aotearoa New Zealand. With ongoing shocking violence and death statistics, the United Nations called on Aotearoa to develop a national strategy in 2018, so it is long overdue. Consultation closed in June and the anticipated national strategy and action plans are due to be released later this year. Similar themes to those expressed in Kia Manawanui have emerged, including community engagement, a focus on well-being and the need to address issues of structural power and inequity.

These are not likely to be short-term fixes. The national strategy for ending family violence and sexual violence will likely call for important interventions that may take generations to achieve, just like Kia Manawanui. These are not problems that are ‘fixable’ within the political lifecycle. Aotearoa needs to move beyond political partisanship and election cycles if we want to reduce our suicide rates, stop violence against women and children and create a society where everyone can live well and flourish.

Cross-party collaboration, like we’ve seen recently with housing, is key to being able to plan for long-term co-operation and investment that doesn’t change course every time there is a new captain. Responses to Covid-19 and climate change have also given us glimpses of this possibility. Hopefully, we can stay the course.

White Ribbon Day is 25 November. See whiteribbon.org.nz