The way without the will
The New Zealand Mental Health and Wellbeing Strategy 2026–2036 offers a sound conceptual roadmap, but its success will depend on whether the Government is willing to fund it properly and build the contemporary workforce needed to meet mental health and wellbeing needs this century. That has been the weakness of previous plans: New Zealand has often had “the way”, but what has been missing, or vague at best, is “the will”.
The focus upon lived experience, prioritising early intervention, reference to social determinants of health, the breakdown of the 10 year vision into three year implementation cycles are each commendable. These inclusions recognise some contemporary priorities in 2026.
Even so, the Strategy is cautious, benign and largely inoffensive. It reflects the core tension between the needs of communities and the limits of a legacy system. Reports such as He Ara Oranga have long called for community-level transformation, yet successive plans have too often gestured towards that ambition without making it unavoidable.
It is refreshing to see stronger official recognition of the social determinants of health. But the harder question is whether the Government, and particularly the mental health system, can consistently act on the complex and often unpredictable implications of addressing the social determinants of mental health and wellbeing. That is why both a framework and clear accountabilities matter.
If the Strategy is to be effective, accountability may also need to operate at a legislative level. Governments should be expected to consider whether proposed laws will harm the mental health and wellbeing of communities before those laws are passed. That expectation is not radical; it sits comfortably alongside the public service values of being impartial, accountable, trustworthy, respectful and responsive.[1]
In 2026, policymakers can more openly recognise that poverty, violence, abuse, the ongoing effects of colonisation, housing and employment shape mental health. Yet political short-termism, siloed agency budgets and economic models still prejudice the long-term policy integration needed to address those causes properly.
This may be one reason the Strategy remains so tightly focused on health-system actions. It pays less attention to the wider social determinants of wellbeing, including poverty, housing and systemic inequities. The Royal Australian and New Zealand College of Psychiatrists has similarly noted that, while the Strategy emphasises cross-sector collaboration and shared responsibilities, it lacks strong, legally binding accountability mechanisms.
“[While the document] …recognises the importance of housing, education, employment, justice and poverty in shaping mental health, it stops well short of clearly assigning responsibility across government for delivering measurable improvements in these areas.”
If New Zealand is serious about turning the Strategy from incremental adjustment into structural reform, these changes must be embedded directly in operational decisions, funding settings and accountability frameworks. At a minimum, five shifts are needed.
- Shift funding emphasis from crisis responses to community and neighbourhood support — the “one size fits all” approach has had its day. Flexifunding, introduced into some NGO contracts in the mid-1990s, offered a practical way to meet diverse needs, but it has not grown at the scale required. Long-running community-based alternatives to inpatient care have demonstrated both effectiveness and value for money. They too are ready to be scaled.
- Legislate cross-government accountability - we can’t just wish for this (ie. responding to social determinants) to happen. Where are the binding responsibility metrics across non-health departments? In 2026, poor mental health is a social issue – albeit with medical implications.
- Rapidly scale and diversify the workforce — this is not only about “upskilling”. Specialist professions remain vital, but they should enable, not dominate, community-based responses. They are critical but ancillary, supporting the work that happens in communities, as Dr Paul Carling argued in his TheMHS keynote in Sydney in 1993 — more than 30 years ago.
- Co-design direct intervention pathways — access to help should not depend on persistence, literacy, desperation or luck. Support must be simple, seamless and human. I remember the very first time I navigated the London Underground - anxious, but the journey was simple and seamless. I got to where I needed to go. That should be our role model!
- Shift the culture - Culture change cannot be treated as a communications exercise; it has to be designed into decision-making, accountability, contracts, and everyday practice.
Nothing appears to have changed in 2026, apart from the language used to describe NGO providers as “partners”. For that word to mean anything, partnership must be reflected in power, funding, contracting and accountability. Patrick McGorry, psychiatrist and former Australian of the Year, has warned of the sector “gaslighting[1]” communities by using political spin to conceal a false dawn in mental health reform.
He Ara Oranga, the Report of the Government Inquiry into Mental Health and Addiction[2], was published in 2018. The report of the Royal Commission of Inquiry into Abuse in Care, was published in 2024. Both are referenced in the Strategy – four and three times respectively. Are we too, guilty of failing to implement recommendations and strategies in these damning reports, that require critical mental health reforms?
New Zealand does not need another Strategy that describes the problem more elegantly through more contemporary language. It needs a Strategy that changes who is accountable, where money goes, and how people get help that is easy, responsive and relevant. Anything less is not transformation. It is a better written status quo.
[1] A contemporary term denoting a form of emotional and psychological abuse and manipulation
[2] https://mentalhealth.inquiry.govt.nz/inquiry-report/he-ara-oranga
