2019 Budget is a game changer

New Zealand is several big steps closer to genuinely treating drug use as a health issue. The big ambitions of the 2019 Wellbeing Budget show the government is willing to walk the talk when it comes to a fresh new approach.

The $1.9 billion investment signalled in the Budget will significantly expand access to services, which will allow more people to access help, sooner.

The government’s response to the Mental Health and Addiction Inquiry report He Ara Oranga shows a commitment to fundamental system change. After years of neglect, this scope of thinking is exactly what the sector - and New Zealand - needs.

Earmarked funding is comprehensive and targeted at root causes. More money has been promised for mental health and addiction care in schools, in primary health care, in existing treatment centres, in hospital emergency rooms and in prisons.

Te Ara Oranga, Northland’s innovative response to methamphetamine, shows how police and health can work together for greater impact. While receiving extra treatment, people are being channelled into job placements and other social supports. The success of this localised response paves the way for similar innovation elsewhere.

The proposed changes are more than the sum of their parts. Placing the budget within a context of wellbeing ushers in a more caring and inclusive approach. We heard it from Prime Minister Jacinda Ardern when she said “We are committed to making sure everyone knows where and how to get the help they need, when they need it.” For Health Minister David Clark, “Supporting and maintaining people's mental wellbeing must become part of the normal delivery of our health services.”

But translating these good ideas into action won’t be easy. Workforce development, service design that draws on peer knowledge, and Māori and Pasifika input from the start are fundamental to success. Funding must be ring fenced, to avoid marginalising AOD services.

The framework and funding are in place, and now it’s time to get on with change on a scale we haven’t seen for many years. In the years to come we’ve got to we keep the focus on the goal of New Zealanders getting access to the support they need.

Unfinished business

However, there is unfinished business in the Mental Health and Addiction Inquiry. Recommendations called for fundamental changes to our drug law, which are essential to removing barriers to support. We must confront society’s attitudes towards people who use drugs, and stop criminalising them.

The Inquiry recommended civil responses replace criminal sanctions for the possession of drugs for personal and a full range of treatment and detox services be made available. It also recommended adopting a stricter regulatory approach to the sale and supply of alcohol.

While not rejected outright, these recommendations have been placed on hold. With no details on what “further consideration” means or when this will be done, there is a danger these recommendations could be gradually sidelined. 

The Drug Foundation’s oft-repeated view is that taking a health approach must involve replacing NZ’s obsolete Misuse of Drugs Act (1975). Rather than deferring this problem for “further consideration”, we need to set a clear process and timeline for addressing it.  

Summary of $1.9 billion budget initiatives

• $455.1 million towards a range of free services that support and maintain mental wellbeing for every New Zealander who needs it, within five years, worth $455 million
• A plan to provide 5,000 people a year with early support for alcohol and drug issues, through primary care (such as GP surgeries)
• $213.1 million of total DHB funding ring-fenced to mental health and addiction services
• $44 million over four years to improve existing drug addiction services
• Nurses in schools to reach a further 5,600 students
• $197 million for Housing First, aiming to bring 2,700 vulnerable people into permanent homes
• $128.3 million over four years for mental health and addiction services in our Corrections system
• $8 million over four years to improve responses for those who turn up at hospital emergency departments needing mental health support.

Read the full budget section on Taking mental health seriously

38 of 40 recommendations accepted

On 29 May Prime Minister Rt Hon Jacinda Ardern and Health Minister Hon David Clark announced the government response to the recommendations from He Ara Oranga: Report of the Government Inquiry into Mental Health and Addiction. Recommendations accepted include:

• Significant increase access to publicly funded mental health and addiction services for people with mild to moderate needs
• Commit to increase choice by broadening the types of services available
• Urgently complete the national suicide prevention strategy
• Establish an independent commission to provide leadership and oversight of mental health and addiction
• Repeal and replace the Mental Health (Compulsory Assessment and Treatment) Act 1992.

Read the government's formal response to recommendations of the independent Inquiry into Mental Health and Addiction.