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Story: Mental health services

Around 47% of New Zealanders are likely to experience some form of mental illness at some stage in their lives. New Zealand’s first lunatic asylum opened in 1854, and for nearly 130 years most mentally ill people were generally looked after in institutions. In the 21st century most people suffering from mental illness are cared for in the community.

Story by Warwick Brunton
Main image: Mental Health Foundation poster

Story Summary

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Mental illness covers a wide range of psychological conditions, including depression, anxiety, delusions (firm but false beliefs) and addiction.

Mental illness is common – 47% of New Zealanders are likely to experience some form of mental illness at some point in their lives.

First asylums

In the 1840s mentally ill people were held in prisons, as there was nowhere else to care for them. The first ‘lunatic’ asylum was opened in 1854 in Karori, Wellington. From the 1860s larger asylums were built around the country. The main treatment was physical work and exercise. Violent or dangerous patients were sometimes tied up and restrained. People with mental illness were generally seen as incurable.

Changing attitudes

Attitudes to mental illness began to change. From 1911 asylums became known as mental hospitals and people were able to commit themselves voluntarily to get early treatment.

After the First World War many soldiers suffered from shell shock (trauma from their war experiences). They were treated with dignity and compassion, and encouraged to talk about what had caused their illness. The success in treating former soldiers meant that the same techniques were applied to other patients.

New treatments and institutional change

From the 1950s there were new drugs available to treat mental illness, and psychotherapy (talking to a counsellor) was used more often.

Institutions became known as psychiatric hospitals rather than mental hospitals. New staff such as occupational therapists were employed to prepare patients for life and work outside the hospital. However, short-term psychiatric patients often received better care than long-term patients who lost touch with life outside the institution and weren’t expected to recover.

Closing hospitals and community care

From the 1970s there was a move to care for mentally ill people outside of large institutions. By the 1990s almost all psychiatric hospitals had closed and patients moved into community care. There were concerns that patients might not receive enough support. In the early 21st century non-government organisations were becoming more involved in providing mental health services.

Contemporary issues

As psychiatric hospitals were shut down, many former patients told of being mistreated. After an inquiry in the mid-1990s into mental health services, the Mental Health Commission was set up in 1996. The Commission advised the government, encouraged research and worked to reduce discrimination against those with mental illness. It produced the first ‘blueprint’ for improving health care services in 1998.  This report focused on strategies for recovery, addressing discrimination and the specific needs of Māori and Pacific peoples.

In 2012 the Mental Health Commission published Blueprint II which explored what needed to be done to improve mental health services in New Zealand between 2012 and 2022.   The Commission was disestablished later that year and its functions incorporated into the Office of the Health and Disability Commissioner.

In January 2018 the government announced a ministerial inquiry into mental health and addiction. This follows rising demand for mental health and addiction services and high rates of suicide. Mental health providers, service users, their whānau/families, iwi and community advocacy groups have called for an inquiry. Attention to strategies for prevention, access to quality care and appropriate responses to the needs of Māori and Pacific peoples is consistent with issues identified over the last twenty years. The focus is on strategies to enable mental health, not just on intervention and treatment for mental illness.   

Māori and Pacific mental health

Since the 1990s special programmes designed to meet the needs of Māori and Pacific Islanders were started. Both groups were over-represented in mental health statistics compared to their populations.

How to cite this page:

Warwick Brunton, 'Mental health services', Te Ara - the Encyclopedia of New Zealand, (accessed 20 May 2018)

Story by Warwick Brunton, published 5 May 2011, updated 1 Feb 2018