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Over the past three decades, New Zealand's mental health system has gone through a number of significant transformations. Professor Mason Durie characterises the current stage as the fourth wave of mental health development. Increased understanding of the critical role of good mental health in the well-being and quality of life for the individual, the community, and of society have contributed to these changes. Efforts to destigmatise mental illness have reduced the barriers to seeking mental health services, and people seek care at an earlier stage, preventing deterioration into a spiral of chronicity and negative life situation. Prevention and early intervention are now one of the cornerstones of the mental health system. Yet, for those who have mild to moderate psychological conditions support services remain elusive and evidence-based interventions for high prevalence disorders in New Zealand are meagre. The demand for these services in the current mental health system is growing, yet inequity of access for certain populations is undeniable. This article will outline the transitions that have occurred since deinstitutionalisation (between the second and fourth waves) in mental health services in New Zealand, providing a background to identifying the challenges inherent in the fourth wave of mental health services. The escalating demand for mental health and wellness throughout the continuum of the lifespan is placing considerable strain on the current model of mental health care, and this paper examines how equipped the mental health service is to meet these challenges. This article, as a companion to the previous paper documenting ways England and Scotland have responded to the social, economic, and personal burden of mental illness, addresses the sustainability of the New Zealand mental health system in the context of a greater emphasis on low intensity psychological interventions across the lifespan. [ABSTRACT FROM AUTHOR]

As a colonised peoples, many Māori have engaged in various forms of political resistance. Accordingly, research suggests that socio-political consciousness, which will sometimes involve at least considering protest, is an increasingly important aspect of identifying as Māori. This paper draws on a large, nationally representative sample of Māori (N = 1,977) to examine the links between expressing support for political activism ("activism" being used here synonymously with "protest") and well-being. Support for political activism includes merely contemplating protesting and voting to support Māori issues, as well as actually signing petitions. Well-being includes self-reported mental health via the Kessler-6 and subjective health. Results show that support for political activism was strongly associated with greater subjective psychological distress and lower subjective health, above and beyond the variance explained by exhaustive demographic factors. This research presents the first empirical data in New Zealand demonstrating the strength of this relationship, and provides a good starting point for further investigation. [ABSTRACT FROM AUTHOR]

Low Intensity psychological interventions are designed to provide cost effective, brief evidence-based psychological interventions to a growing population of individuals who suffer from mild to moderate mental health problems. Low Intensity Cognitive Behavioural Therapy (LICBT) has been proposed as a paradigm shift in the delivery of mental health services aimed at increasing service access and reducing expensive specialist time. In New Zealand primary, secondary, and tertiary mental health services are clearly differentiated and psychological interventions (brief or longer term) are generally delivered by specialist practitioners at each level of service. The paper describes LICBT, developed and delivered in England as part of the National Health Service's integrated, five-tier, stepped care mental health service. This stepped care model will serve to illustrate the paradigm shift in the delivery of mental health services. The successes and challenges of such an initiative are considered. [ABSTRACT FROM AUTHOR]

There is an increasing number of people living with dementia and depression, with support for people to live well with dementia becoming a global healthcare priority and seminal to the New Zealand Framework for Dementia Care (Ministry of Health, 2013). This paper overviews the clinical protocol for the PROMOTE self-help programme to inform the delivery of a written low intensity intervention based on behavioural activation for the treatment of depression and low mood in people with dementia. The primary aim of the programme is to decrease symptoms of depression and improve quality of life in people living with dementia. Support to the person living with dementia in the use of the PROMOTE programme is provided by an informal caregiver, who themselves receive guidance over the telephone by an appropriately trained mental health professional. This model of support and guidance represents a novel feature of the intervention, and one that potentially helps to increase access within the community. [ABSTRACT FROM AUTHOR]

The circulation in 2007 of a Ministry of Health consultation paper focusing on the extension of collaborative prescribing rights to non-medical professionals has again brought the issue of psychologist prescribing into sharp relief. In the context of mental health workforce shortfalls there has been a slow expansion of psychologists prescribing in America. Closer to home, the Australian Psychological Society has recently completed a survey amongst members and developed a proposal for psychologists to prescribe. In light of these developments, and the Ministry of Health initiated discussion of collaborative prescribing, it seemed pertinent that New Zealand psychologists review their position on this issue. A survey of New Zealand psychologists was undertaken to obtain local perspectives of collaborative prescribing. A small majority of the 571 respondents indicated that they supported the idea of collaborative prescribing, and saw a need for it at least in some areas of health care. Psychologists providing clinical services indicated that collaborative prescribing could be potentially useful in their practice. Several arguments for and against prescribing were considered important, but the impact of collaborative prescribing on the nature of psychology as a profession raised the most concern. [ABSTRACT FROM AUTHOR]