The government has released the much-awaited report on the enquiry into country’s mental health services and addiction on Tuesday, December 4, which has confirmed what was widely anticipated: that New Zealand was going through a severe mental health crisis.
Releasing the report to Public Health Minister Dr David Clark said, “The Inquiry into Mental Health and Addiction represents a once-in-a-generation opportunity to rethink how we handle some of the biggest challenges we face as a country.” The government will formally respond to the report in March next year.
The report is being considered as the country's sixth and the most comprehensive since the Mason Report 22 years ago.
Ron Patterson, former Health and Disability Commissioner who led the enquiry, reflecting upon the depressing state of affairs around mental health issues said, “The outcomes for Maori were worse than for the overall population, and Maori were subject to much greater use of compulsory treatment and seclusion. There are also unmet mental health needs for Pacific peoples, disabled people, Rainbow communities, the prison population and refugees and migrants.”
What’s in it for Asian-migrant communities?
Clearly, Asian-migrants are at the lowest end, of an already crowded ladder, who are outside the pale of existing mental health services in New Zealand, despite its obvious failure as pointed in the report.
While releasing of this report has sparked a national debate around seemingly failing mental health system in the country, it is apt to revisit the almost non-existent preference within Asian-migrant communities, including the Kiwi-Indian community, to seek help from the current existing mental health system.
Indeed, Asian migrants, including Indians, are renowned for their under-utilisation of mental health services in New Zealand.
According to a paper titled Mental health service use by Asians: a New Zealand census published in The New Zealand Medical Journal in September 2017, there is consistent evidence that individuals from Asian cultures regardless of their age, gender and location have lower rates of mental health service utilisation than other ethnic groups.
The paper also cited that this low level of mental health service utilisation by the Asia-migrants was consistent with other international studies.
The study used the data from Ministry of Health’s Program for the Integration of Mental Health Data (PRIMHD) – a single national mental health and addiction information collection of service activity – from a period between 2008- 2013.
The study found that the number of Indians, who were likely to present themselves before mental health services, was more than the number of the Chinese.
However, the study could not delve into the factors responsible for such low-utilisation of mental health services.
Why low-level utilisation of mental health services
In the absence of more scientific studies explaining the low-level utilisation of mental health services, anecdotal evidence suggests that there is a strong cultural bias within our communities against the entire gamut of dealing with mental health issues.
The stigma attached to mental health issues is a major obstacle preventing Asian migrants from using mainstream mental health services.
Besides, a lack of English proficiency, inadequate knowledge and awareness of existing services, and cultural differences in the assessment and treatment of mental illness, are additional barriers to their use of the mental health care system.
How Asian-migrants fare on commonly diagnosed mental disorders?
According to the paper Mental health service use by Asians: a New Zealand census, Asians had lower rates of substance-related disorders when contrasted with other ethnic groups and lower rates of personality disorders.
Measured in the number of diagnoses per 100 people over five years, Asian migrant suffering from substance-related disorder was at lowly 5.64, as opposed to 15.26 amongst Europeans and 21.96 amongst Maoris.
The single most significant commonly prevalent disorder affecting Asian-migrants, including Indians was the mood disorder, similar to Europeans (though actual numbers would vary).
Asian rates of adjustment disorders were also somewhat higher than all other ethnic groups – European, Maori and Pacific.
What Asian-migrants can cheer about mental health issues
Despite a clear under-utilisation of mental health issues by Asian-migrants, not everything is damning and stigmatising as might be perceived.
The recently released report has clearly found that despite the current level of investment in mental health ($1.4 billion in 2016/17), New Zealand was not getting the outcomes it wanted for its people.
The report has argued that despite access to costly biomedical treatment, something central to recovery appeared to be missing in the social fabric of developed countries.
It is to say that there is a bigger sense of perceived or real sense of isolation, loneliness, deprivation, exclusion, social deprivation, which obviously translates into mental distress and poor mental well-being.
In contrast, Asian communities have a different sense of social-cultural inclusion, despite material lacking, which are likely to assist in enduring or preventing mental distress.
In that sense, there might be an opportunity for some learning, as NZ embarks on a thorough revamping on the manner in which mental health issue is addressed in this country.