Kōrero: Public health

Whārangi 5. Healthy minds

Ngā whakaahua me ngā rauemi katoa o tēnei kōrero

Mental illness is common in New Zealand. The first national survey on mental illness (published in 2006) found that 20% of New Zealanders had experienced a mental disorder in a 12-month period, while 47% had done so at some stage in their life.

Mental health was traditionally separated from public health – and there were separate mental health and public health directorates in the Ministry of Health in the early 21st century – but its prevalence in the population, and increasing policy and service emphasis on mental wellness and illness prevention, means it can be seen as a public health issue.

Mental wellness

Until the late 20th century mental health services and practitioners focused on treating mentally ill people. The rise of mental health self-help and advocacy groups from the 1970s contributed to a new focus on creating and preserving good mental health. In the 21st century government and health providers promote mental wellness in addition to providing services for mentally ill people. There is also increased awareness of the need to provide kaupapa Māori, Pacific and youth-specific services.

Social connectedness – the relationships people have within their families, workplaces and communities – was recognised as affecting mental health, particularly when connections broke down or were not present. It was regularly measured through surveys by the Ministry of Social Development using six indicators: telephone and internet access at home, contact with family and friends, contact between young people and parents, trust in others, loneliness, and voluntary work. The ministry’s planning and decisions were influence by trends in these indicators.

Income and loneliness

As with most indicators of health and well-being indicators, loneliness appears to have a relationship with socio-economic status. The 2008 Quality of Life Survey found that loneliness rose as personal income dropped: 21% of people who earned $30,000 or less each year said they had felt lonely sometimes in the past 12 months, compared with 7% of people earning over $100,000.

Ending discrimination

Following a general inquiry into mental health services in 1995–96, a major public health education programme to reduce discrimination against people with experience of mental illness was launched. The Like Minds, Like Mine campaign was prominent on television and radio.

Ethnicity

Experience of mental illness is more prevalent and severe among Māori than other ethnic groups. Likely contributing factors include the low socio-economic status of many Māori, and the high proportion of young people in the Māori population. Māori also experience poorer health and more frequent hospitalisation and have lower life expectancy than other ethnic groups.

Governments and health officials have tried to address this disparity by developing Māori mental health strategies and funding Māori-specific mental health services and providers.

Little was known about the prevalence of mental illness among Pacific Island people until 2006, when the first national survey of mental illness was published. This survey found that Pacific Island people had higher rates of mental illness than other ethnic groups (apart from Māori). These findings contradicted previous beliefs that Pacific Island people had low levels of mental illness. In response, efforts were made to enlarge the Pacific mental health workforce and develop culturally specific services.

Suicide prevention

In the early 21st century approximately 500 people died by suicide each year, more than the number killed in road accidents. This made suicide prevention a major public health concern. Strategic responses to suicide focused on youth (those aged 15–24) until the New Zealand Suicide Prevention Strategy was released in 2006. This took an all-ages approach and recognised that suicide rates were relatively high in other age groups, particularly 25–34.

Youth suicide remains very high in New Zealand – the highest amongst Organisation for Economic Co-operation and Development countries, with Māori particularly affected. After the 2018 report of the Government Inquiry into Mental Health and Addiction, the government developed a suicide prevention strategy and action plan, Every life matters, and established a Suicide Prevention Office to strengthen national leadership on the issue.

Me pēnei te tohu i te whārangi:

Kerryn Pollock, 'Public health - Healthy minds', Te Ara - the Encyclopedia of New Zealand, http://www.TeAra.govt.nz/mi/public-health/page-5 (accessed 21 May 2022)

He kōrero nā Kerryn Pollock, i tāngia i te 5 May 2011, reviewed & revised 7 Jul 2019 with assistance from Richard Edwards