13/12/2018 - New Zealand has carried out major health and welfare reforms over the past decade but needs to do more to help people with mental health issues stay in work or find a job, according to a new OECD report.
Mental Health and Work: New Zealand says that one in five New Zealanders in any given year will experience a diagnosable mental health issue. This adversely affects well-being and costs the New Zealand economy some NZD 12-15 billion every year, equivalent to around 4-5% of its annual GDP, through increased healthcare spending, lost labour productivity and sickness absence, and social spending on people out of work.
Reforms over the past decade have improved the situation but the system remains complex and fragmented, with numerous trials, pilots and experiments in place to fill some of the institutional gaps in dealing with mental health issues. Access to services and their impact varies widely across the country and across ethnicities. The poorer outcomes for some population groups, especially Māori people, point to an urgent need for mental-health-and-work policies to be culturally-led, informed and responsive.
The OECD report says that intervention in New Zealand tends to come too late and that the provision of integrated services which address health and employment barriers alongside remains incomplete. Where good supports exist, such as services for youth with mental health issues, the uptake is often low because they are under resourced and poorly connected.
The report highlights a number of key areas for action. First, a national mental health and work strategy should be developed, with a focus on evidence-based employment services integrated with mental health treatment. This should be underpinned by more and better systematic evidence on the incidence and consequences of mental ill health, including data on sickness absence and employment status before and after treatment.
Second, to limit the risk of long-term benefit dependence, Work and Income must improve early identification of mental health issues among people claiming benefit, invest in employment support services for jobseekers with mental ill-health and encourage support once in employment. In New Zealand, people with mental health issues are three times more likely to be unemployed. Mental health claims also make up around half of all social benefit claims.
Third, the government should consider a structural reform of its accident compensation (ACC) system to also cover illness. Currently, there is a strict distinction in New Zealand between injuries, which are covered by the ACC system in an effective and well-resourced way, and illnesses, which are covered by an under‑resourced general health and means-tested welfare system. Mental health issues usually fall into the latter group.
The New Zealand government asked the OECD to assess its mental health and work policies and outcomes against the framework of the OECD’s Council Recommendation on Integrated Mental Health, Skills and Work Policy, endorsed by all health and employment ministers from all OECD countries, including New Zealand, in 2016. New Zealand was the first OECD country that asked for such a review, in its efforts to develop an effective roadmap to tackle current inequities. With its strong focus on the link between mental health and employment, the OECD report complements the findings and recommendations of the New Zealand Government Inquiry into Mental Health and Addiction (He Ara Oranga), which was released only a week ago.
Mental Health and Work: New Zealand is available at http://www.oecd.org/employment/mental-health-and-work-new-zealand-9789264307315-en.htm.
For details on the OECD Council Recommendation on Integrated Mental Health, Skills and Work Policy: https://legalinstruments.oecd.org/en/instruments/334. For more information about OECD’s Mental Health and Work project: http://www.oecd.org/employment/mental-health-and-work.htm.
Working with over 100 countries, the OECD is a global policy forum that promotes policies to improve the economic and social well-being of people around the world.