Kia Kaha Kia Manawanui: You’re going to need it

Cross-party collaboration is key to being able to plan for long-term cooperation and investment that doesn’t change course every time there is a new captain.

This week is Mental Health Awareness Week, and rather than focusing on what hasn’t happened over the past two years since He Ara Oranga, the government inquiry into mental health and addiction, and addressing where the 2019 $1.9 billion Wellbeing Budget funding has gone, the Government has released Kia Manawanui, Aotearoa: A long-term pathway to mental wellbeing.

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 national mental health will not be fixed until we address poverty, inequality, racism, violence and cultural and social disconnection.

While previous mental health policy has been centred around addressing mental health needs of the 3 percent of society most seriously impacted by mental illness, this document sets out plans for prevention and mental wellbeing 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 document sets out short, medium and long-term plans for extensive social change which would positively contribute to everyone’s mental health. The document is centred around a model of Pae Ora (healthy futures) which situates people’s wellbeing 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 this document. As a previous mental health clinician, and as a researcher and teacher in this area, I welcome the framework it provides for change that I think could make a huge difference and I think that most people I work with would also see it this way. But most of us are probably not National or ACT voters. And this is where it all falls down.

Mental health policy has always been a political lightning rod. A Labour government commissioned the second Mason Report (1996) which led to increased and ringfenced funding for mental health and the establishment of the Mental Health Commission.

Under a National government in 2012 the Mental Health Commission was disestablished. National refused calls for an independent inquiry into mental health in 2017 and Labour responded with He Ara Oranga, Report of the Government Inquiry into Mental Health and Addiction in 2018. And in 2021, while Labour has declared its intent to establish a Māori Health Authority, ACT leader David Seymour is giving out the codes for Māori Covid vaccination appointments.

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. Kia Manawanui calls for important interventions that are likely to take generations to achieve, something not possible within the political lifecycle.

Aotearoa needs to move beyond political partisanship if we want to reduce our suicide rates, decrease rates of violence against women and children and create a society where everyone can live well and flourish. Cross-party collaboration is key to being able to plan for long-term cooperation and investment that doesn’t change course every time there is a new captain.

The theme for this year’s Mental Health Awareness Week is ‘Take time to kōrero/mā te kōrero, ka ora’. This is about taking the time to connect with people and having conversations about mental health. A good place to start may be a conversation about how we could actually make Kia Manawanui work.