Need outstrips mental health workforce: report

It will be at least 20 years before New Zealand's mental health workforce can cope with current demand, let alone deal with new patients, the editorial in the latest issue of the New Zealand Medical Journal warns.

"New Zealand training programmes only graduate around 60 clinical psychologists per year," the editorial, written by University of Otago and University of Canterbury academics, said.

"To even double that number to meet the needs of the most severe cases it will be two decades before we can increase the workforce enough to meet the current need."

That assessment assumed all clinicians trained remained in New Zealand, worked in practice full-time, were effective with all patients and the population - and demand - did not grow over that time.

The Government Inquiry Into Mental Health and Addiction, which was released last week, highlighted the number of people with less severe mental illnesses who were not being seen by clinicians.

The NZMJ editorial concurred, and estimated at least 700,000 New Zealanders with mental illnesses might be going untreated.

"Most people with mental health problems do not receive any help at all."

New Zealand needed to train more mental health professionals, but other therapies needed to be considered and implemented, the authors said.

"There is substantial room for diversifying treatment options offered to patients."

Meanwhile, the OECD has called for the accident compensation system to be overhauled so it covers illness.

The OECD released a report entitled Mental Health and Work in New Zealand yesterday.

Commissioned at New Zealand's request in 2016, the 170-page report examines how mental illness affects the country's wellbeing.

As well as reforming the ACC, other major recommendations include instituting a national mental health strategy, and asking Work and Income to identify clients with mental health issues early and be proactive in ensuring they receive treatment.

The report authors said reforms in the past 10 years had improved the situation, but the mental system remained "complex and fragmented".

The OECD report started from the premise that working was good for people's mental health, and that workplace and employment policies should be developed from that perspective.

"Poor mental health costs the New Zealand economy some 4-5% of GDP every year through lost labour productivity, increased healthcare expenditure and social spending on people temporarily or permanently out of work," the report said.

"It is also costly in terms of individual wellbeing as, at any given moment, one in five New Zealanders have a mental health condition."

It criticised the "strict and adverse distinction" in the ACC system between injuries - which were covered - and illnesses, which were not, "with mental health problems virtually always falling into the latter group".

"The inequitable divide between injury and illness has created a two-tier health system where integrated health services and vocational rehabilitation support is prioritised for injury through ACC, and not for illness," the OECD said.

"This is particularly significant for people with mental health conditions."

The distinction also led to lower rates of people accessing mental health services, the report said.

Employment guidance and access to employment support should be a routine part of health services, the report said.