NZCCP supports Te Tiriti o Waitangi and endorses this Bill in the ways that it promotes mana-enhancing treatment to tangata whaiora that is consistent with the provisions in Te Tiriti o Waitangi. We believe this alignment is critical to addressing disparities and ensuring culturally appropriate care.
Issue: While NZCCP supports the purpose of the Bill and changes made within it, we believe they have either not gone far enough, or insufficient attention hasbeen given to how the Bill would be practically implemented.
Recommendation: Greater focus is needed on implementation strategies to ensure the principlesof the Bill are effectively translated into practice.
NZCCP agrees with the principles of the MH Bill:
Compulsory care should only be used to protect, promote, and improve a person’s mental health.
Compulsory care should be applied in the least restrictive manner.
Compulsory care should be applied in a supportive and responsive manner.
These principles are consistent with the care that psychologists provide as per our code of ethics.
Issue: While NZCCP supports the notion that a person is presumed to have capacity tomake decisions about mental health care, the Bill does not outline howpractical this is to implement or assess capacity. Not all professionals are equipped to make these assessments.
Recommendation: Only appropriately trained and equipped mental health professionals should undertake capacity assessments.
Training and resources should be provided to ensure that assessments are conducted competently and ethically.
Additionally, the Bill does not adequately consider the implications of a tangata whaiora deemed to have capacity refusing treatment.This could place the tangata whaiora or others at risk and create challenging situations for clinicians.
Issue:The Bill prohibits the use of seclusion for children under 18 years. While NZCCP supports this in principle, we note that systemic changes are necessary to meet the needs of challenging youth.
Recommendation:The Bill should address how these changes will be implemented safely. Incertain situations, adhering strictly to a no-seclusion policy could pose safety risks to staff, property, and the public. Clear guidelines and alternative strategies are needed.
Issue: NZCCP supports the right of tangata whaiora to make compulsory care directives,as this upholds their capacity to make decisions about their care. However, the Bill allows these directives to be overturned in emergency care situations.
Recommendation:Tangata whaiora should be informed in advance about the limitations ofc ompulsory care directives and the circumstances under which they may be overridden.
Support: NZCCP supports the formation of the Forensic Patient Review Tribunal and the emphasis on including "suitably qualified mental health professionals with experience in forensic mental health care" in its composition. This acknowledges the diversity and expertise within mental health professions.
Recommendation: We support removing unnecessary layers of approval and ensuring that decisions about leave for forensic patients remain clinical decisions rather than administrative ones by the Ministry of Health.
Issue:Implementing the new legislation will require a well-resourced workforce
Recommendation:Invest in workforce development, including training in cultural competence, TeAo Māori perspectives, and trauma-informed care. Adequate funding must beallocated to support the transition to the new Bill.
Issue:There is a lack of robust data on mental health outcomes and disparities.
Recommendation: Establish mechanisms for comprehensive datacollection and monitoring to assess the Bill’s impact, particularly on equityand human rights outcomes
.svg){kind=spacer}