Story: Public health
Page 5 – Healthy minds
Mental illness is common in New Zealand. The first national survey on mental illness (published in 2006) found that 20% of New Zealanders experienced a mental disorder in a 12-month period, while 47% had at some stage in their life.
Mental health was traditionally separated from public health – and there were separate mental health and public health directorates at the Ministry of Health in the 2000s – but its prevalence in the population, and increasing policy and service emphasis on mental wellness and illness prevention, means it can be seen as a public health issue.
Until the late 20th century mental health services and practitioners focused on treating mentally ill people. The rise of mental health self-help and advocacy groups from the 1970s contributed to a new focus on creating and preserving good mental health. In the 2000s government and health providers promoted mental wellness in addition to providing services for mentally ill people.
Social connectedness – the relationships people have within their families, workplaces and communities – was recognised as affecting mental health, particularly when connections broke down or were not present. This was regularly measured through surveys by the Ministry of Social Development using six indicators: telephone and internet access at home, contact with family and friends, contact between young people and parents, trust in others, loneliness, and voluntary work. The ministry’s planning and decisions were influence by trends in these indicators.
Income and loneliness
As with most health and well-being indicators, loneliness appears to have a relationship with socio-economic position. The 2008 Quality of Life Survey reported that loneliness rose as personal income dropped: 21% of people who earned $30,000 or less each year said they felt lonely sometimes in the past 12 months, compared with 7% of people earning over $100,000.
As a result of a general inquiry into mental health services in 1995–96, a major public health education programme to reduce discrimination against people with experience of mental illness was launched. The Like Minds, Like Mine campaign was prominent on television and radio.
Experience of mental illness is more prevalent and severe among Māori than other ethnic groups. Likely contributing factors include the low socio-economic position of many Māori, and the high proportion of young people in the Māori population. Māori also experience poorer health, more frequent hospitalisation and lower life expectancy than other groups.
Governments and health officials have tried to address this disparity by developing Māori mental health strategies and funding Māori-specific mental health services and providers.
Little was known about the prevalence of mental illness among Pacific Island people until 2006, when the first national survey of mental illness was published. This survey found that Pacific Island people had higher rates of mental illnesses than other ethnic groups apart from Māori. These findings contradicted previous beliefs that Pacific Island people had low levels of mental illness. In response, efforts were made to improve the Pacific mental health workforce and develop culturally specific services.
In the early 2000s approximately 500 people died from suicide each year, which was higher than road-accident deaths. This made suicide prevention a major public health concern. Strategic responses to suicide focused on youth (aged 15–24) until the New Zealand Suicide Prevention Strategy was released in 2006. This took an all-ages approach to suicide and recognised that suicide rates were relatively high in other age groups, particularly the mid-20s to mid-30s.