National | Mental Health

Mental health: Report faults ‘unacceptable inequities for Māori’

Maraea Johns Māori Director for Mental Health and Wellbeing Commission

The immense pressure on the mental health and addiction workforce, especially in specialist services, is reducing the number of people accessing these services, and having an especially poor effect on Māori accessing support.

That’s one of several key findings of Kua Tīmata Te Haerenga | The Journey Has Begun, a Mental Health Commission report that shows while access to mental health and addiction services in primary care has increased significantly in the last five years, the number of people accessing specialist services is declining.

The report, at a glance

The report highlights several critical points about the mental health access and outcomes for Māori in New Zealand:

  • Higher levels of psychological distress: According to the 2022/23 New Zealand Health Survey, 18.2% of Māori aged 15 and over reported high or very high levels of psychological distress in the past four weeks. This is significantly higher than 11.9% of the general population in the same age group.
  • Overrepresentation in mental health services: Māori make up 29.1% of those using specialist mental health and addiction services, indicating a disproportionate need for these services relative to their population size.
  • Impact of social determinants: Social determinants such as low income, high unemployment rates, lower home ownership and overcrowded living conditions heavily influence the mental health and wellbeing of Māori. These factors contribute to higher rates of psychological distress and mental health issues among Māori.
  • Data limitations: There is a need for improved data collection and governance to accurately monitor trends and experiences of Māori within the mental health system. The current data are insufficient for a comprehensive understanding of Māori mental health needs and outcomes.
  • Increased funding for kaupapa Māori services: Expenditure on Māori mental health and addiction services has increased by 57.3% over five years, reaching $235.4 million in 2022/23. The majority of this funding is directed towards kaupapa Māori services, which are culturally tailored and community based.
  • Access and Choice programme: The Access and Choice programme has established 32 kaupapa Māori services across Aotearoa, which served 31,677 people in 2022/23. These services are praised for their cultural appropriateness and community-based approach.
  • Barriers to access: Māori face several barriers to accessing mental health services, including cost, transportation and long wait times. Negative past experiences with the healthcare system also deter Māori from seeking help.

The findings show some serious mental health challenges for the Māori population, driven by both past and present social inequalities. The high levels of psychological distress among Māori are alarming, and make it clear that targeted mental health support is needed, the report says.

But while Māori are using mental health services more than other groups, pointing to high demand, it also reveals deeper systemic issues. Economic hardship and unstable housing are big factors making mental health worse for Māori.

The report calls for better data collection to understand and address the needs of Māori, saying it’s crucial for creating effective policies and support systems.

While the report praises the recent increases in funding for Kaupapa Māori services in recognising the importance of culturally appropriate care, it still calls for more investment and awareness across the health sector.

It identifies access to mental health services as a continuing issue, fuelled by financial constraints, transport issues, and long waiting times that prevent Māori from getting the help they need, worsened by individuals’ past bad experiences with the healthcare system and the lack of trust born out of those experiences.

The clinical approach can be very sterile and intimidating. Whānau need to feel they are coming into a space that is welcoming, safe and can trust the people there to support their needs.

—  Māori Focus Group - Kua Tīmata Te Haerenga | The Journey Has Begun