My View – A transformative shift in mental health

VIEW - Ryl Jensen, chief executive, Digital Health Association (DHA)

New Zealand’s mental health services need a transformative shift. According to Statistics NZ, nearly 30 per cent of Kiwis endure poor mental health. And almost half of us (47 per cent) will experience mental distress or illness in our lifetime.

And that probably explains why New Zealand is one of three countries (together with Australia and Iran) that lead the world in terms of the highest age-standardised rates of mental disorders.

What makes our situation even more challenging is that we have limited access to support. Our mental health workforce is quite small and is already under significant pressure, along with their colleagues in other parts of the health sector.

There doesn’t appear to be a workable, or immediate solution. Certainly not if we continue to take a BAU approach to addressing New Zealand’s high rates of depression, anxiety, and other mental health disorders that, together, cost our people, our whanau, our communities, and our health system, dearly.

In the Digital Health Association’s (DHA) Briefing to the Incoming Minister – in this case to Mental Health Minister, Hon Matt Doocey, we noted that in 2017, the annual total cost of serious mental illness and addiction was estimated at $12 billion, or 5 per cent of our GDP.

Since then, we have seen a 2.4 per cent increase in the rate of psychological distress experienced by New Zealanders aged 15 years and older. This rate of growth isn’t expected to decline. And according to Health New Zealand | Te Whatu Ora’s recent BIM to the Minister of Health, nearly one in four (23.6 per cent) of our rangitahi aged between 15-24 years experienced high or very high levels of psychological distress in 2021/22. This has been a dramatic increase since 2011/12 where 5.1 percent of our young people experienced the same levels of mental distress.

While the stats and the costs – both human and fiscal – are alarming, the DHA’s Digital Wellbeing Industry Group has proposed a solution. A transformative shift in the way we deliver mental health and wellbeing support.

A national hub
We are proposing the formation of a national digital mental health and addictions hub designed specifically to service New Zealand’s ever-growing mental health needs and relieve pressure on our struggling mental health and addictions workforce.

On behalf of our digital wellbeing community, the DHA put this proposal to Minister Doocey in a recent meeting we had with him to discuss the digital hub concept in more detail. I was joined for that meeting by the Chair of our group and Just a Thought Clinical Lead, Anna Elders, and Project Director of the Health Navigator Charitable Trust, Sarah Travaglia.

The three of us explained how the hub could be created and funded, we outlined the services it would provide, and we explained the various benefits and positive outcomes having such a digital hub would create – for consumers, for our mental health workforce, for the health system itself, and for our wider productive economy.

What I really like about the digital model is that it’s a hybrid digital solution to enable much further reach of care across the motu and to facilitate meeting people where they are.

We see the hub offering services ranging from electronic self-assessment and help tools, to providing virtual support to mental health outpatients and inpatients referred from a GP, and who are on their recovery journey.

It would bring together a network of trained professionals and a range of virtual tools to help assess and treat mild to moderate mental health disorders.

Importantly, it would complement, not replace, traditional face-to-face counselling services, adding a hugely valuable option for people who can’t access a counsellor in person or who prefer to get help virtually.

Whether it’s remote rural communities or our digital native rangitahi, a new mum needing support, but finding it hard to leave the house, or anyone who needs mental health support, we believe a well-planned and well-architected hub will help alleviate some of the main pain points in the mental health system.

National direction
We certainly left the Minister with lots to think about! But we also got the strong impression that Minister Doocey wants to see change, he wants outcomes improved, and he’s prepared to turn over every stone looking for the answers.

This is evident in his recent announcement about embedding a new mental health and addiction peer support service in hospital emergency departments.

Four hospitals will get the service in its first year and four more in the second year.

While that’s great news, an initiative like our digital mental health hub could expand that service to all hospitals in the country. That’s how compelling the concept is.

What makes the concept even more attractive is that the various components of it already exist and we have phenomenal digital tools and services ready and waiting to be integrated at our fingertips, but they are currently fragmented and/or under-funded, or both, and as yet there’s no strategy to join the dots.

But once that strategy is in place, the resulting hub could eventually connect into Hira, New Zealand’s developing virtual electronic health record, providing care across a continuum and giving the patient access to their health records.

Some of the other valuable benefits include:

• Enhanced Accessibility: To diverse populations, including remote and underserved communities and will provide real-time care where and when its needed.
• Cost-Effectiveness: Reduces the costs associated with traditional in-person therapy sessions, including travel and time off work.
• Early Intervention: Enables early detection and intervention for mental health issues, potentially reducing the severity of disease, long-term costs, and the impact on the economy.
• Stigma Reduction: Offers privacy and anonymity, which can help reduce the stigma associated with seeking mental health care; more people will seek care and stay productive.
• Data Collection and Analysis: Facilitates better data collection and analysis for improving mental health and addiction services and outcomes across the motu.
• Workforce Optimisation: Allows mental health and health professionals to serve more patients/clients efficiently, optimising workforce utilisation including in primary care.
• Provides a whole of whānau approach: Digital support can reach deep into communities and improve the lives of all whānau, reducing the burden of care. It also provides choice and immediate care where waitlists used to be.
• Meeting people where they are: For example, our rangitahi are digital natives and may prefer to communicate digitally, making it easy and affordable for them to access.
  

This concept of a digital mental health and addictions hub is the brainchild of a sustained and combined effort by many amazing people in the wider DHA mental health and addictions community over the past three years,

We believe the sector is ready to embrace a hybrid digital solution to enable much further reach of care across the motu, and where multiple choices for access to support, services, and information can be easily accessed.

Hopefully their efforts, and our pitch to Minister Doocey, will help change the direction of how we deploy digital mental health solutions in New Zealand. Fingers crossed.

Picture: Ryl Jensen, chief executive, Digital Health Association (DHA)

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