The mental health package is to be spread over five years and includes $455 million to expand access to primary mental health and addiction support, particularly for people experiencing mild to moderate mental health issues.
But Rural Health Alliance Aotearoa New Zealand executive director Marie Daly said so far there is only resounding silence from government agencies about where rural mental health sits in regard to the money.
Rural mental health has become a pressing issue with statistics recording 20 farmers taking their own lives in the year to June 2018, a figure relatively unchanged over the past five years. Rural health providers are also reporting significant increases in rural depression and mental health issues.
Daly said the Alliance worked with all rural health providers to develop a framework, completed in 2017, for improving rural mental health and addiction outcomes.
“This has provided a comprehensive framework, all signed off and agreed to, that includes funding for support agencies like rural support trusts, the Good Yarn programme and employer guidelines for staff. It is all there.
“It would simply be a case of funding coming through this framework. There is no need to go and rework it.”
However, so far those agencies have been met only with silence and Daly is less than optimistic about how much money will flow to rural areas.
“Nor is there any indication in the Government’s mental health review that Government is cognisant of dealing with the mental health challenges in rural NZ. The review was held up by Maori issues about the review but rural NZ remains absent.”
However, given it is early days in the funding allocation she hopes the Health Ministry will listen to rural voices when it puts together a plan to allocate the cash.
“The population of rural NZ makes it equivalent to the country’s second largest city in size, with the same diversity and challenges of any urban centre.
“We can’t have a uniform approach taken that treats all rural areas the same.”
The mental health framework found rural primary care services are overstretched, often propped up by locum doctors from overseas with little understanding of rural NZ’s unique demands.
The Alliance believes rural doctors and hospitals are often the key supports for mental health patients.
“Often the level of acuteness they face is more extreme in more remote areas, yet their tool box is often more limited.
“There is often a time delay in treatment so you need a primary care team that is well supported and capable.”
The Alliance worked with rural health professionals to put together the only suicide prevention training programme ever developed in NZ.
“This had rave reviews but when Ministry of Health stopped funding it, it stopped after two years.”
Daly hopes for greater investment in rural communications to better aid rural health professionals grappling with patients’ mental health challenges.
“Connectivity is still very much an issue.
“In Martinborough where I am from it is $40,000 to get fibre down the practice driveway and $70,000 to get it into the hospital.”
Rural Support Trust chairman Neil Bateup said he has also had no indication of any more funding coming the trust’s way.
“Rural has been an area where it seems it is hard to get support for people. Even if the funding went directly to those agencies who provide the services, that would be great. Six to eight weeks to get a counsellor for someone with problems, you have to ask what is the point?”
But Mental Health Foundation chief executive Shaun Robinson is confident rural mental health issues will get attention, with the detail yet to be determined.
“If you look through the Budget it acknowledges one size does not fit all and rural is one of the target groups specified. This new layer of services will be based around a community service level.
“Overall, I am quite encouraged that the Government has listened to the diverse needs and has responded.”
