Closing the psychiatric hospitals might have been the right thing to do, but that didn’t make it popular. Retired Judge Ken Mason tells Laura Walters and Katie Kenny what happened when he was tasked with leading the inquiry to end all inquiries.
The panel listened to stories of “families torn apart by having a seriously unstable person with major mental illness in their midst”.
It heard from a father who estimated spending more than $200,000 over 30 years to support his mentally ill daughter, left with no retirement savings and “nothing to look forward to except constant worry about her future”.
It listened to a relative of a mentally ill mother who was “socially isolated, filthy, totally alone, living out of a public toilet” before she was given medical care, and a doctor who likened the present situation in psychiatry to that of a surgeon operating without a theatre: “It can be done, but it is not particularly pleasant and probably is quite dangerous for the patient.”
“You feel for the people who are writing to you,” Mason says. “I think if you become too involved in the sadness of it all... you then form an almost irresistible concern to make sure someone pays for it. And that’s wrong."
Until this time, the Government had relied on a mental health strategy which was “absolutely going nowhere”, he says.
“It seemed to us that a vision statement without implementation was absolutely useless.”
Using plain English, the panel made clear recommendations to tackle the issues of stigma, a lack of independent leadership, and a lack of funding.
The changes may have seemed simple but they made New Zealand a world leader in mental health.
Mental Health Foundation chief executive Shaun Robinson describes the inquiry as “a real watershed moment”.
In the end, Mason believes they achieved what they set out to do. “The real heroes, if there are heroes in this sort of thing, are the people who give the time and trouble to come along and tell us stories… It’s very difficult for someone to stand in front of three people who they don’t know and say this is what happened to me, or this is what happened to my daughter…
“These people allowed us to intrude into their lives, and that’s what we did. And so if you’re going to intrude into the life of some other person, then I think you’re under an obligation to try and alleviate some of the concerns that they have.”
He pauses, “you’re very kind to say it’s a legacy, but I don’t see it that way”.
The report recommended initiating a public awareness campaign to deal with stigma. What resulted was the world’s first national anti-stigma campaign: Like Minds, Like Mine.
The panel also recommended mental health funding be ring-fenced, meaning health boards cannot spend less than the previous year. This stipulation has remained in place since. In Budget 2017, the Government pledged a further $224 million over four years to mental health. But between population growth and staggering growth in demand, many say the funding increases haven't kept pace.
Former Health Minister and Finance Minister David Caygill says there always has been, and always will be, calls for further funding and resources. Mental health news headlines frequently feature the words “under-resourced” and “under-funded”.
But knowing how much the Government should be spending is not straightforward.
“Given that we’re talking about a public health system that’s fundamentally funded by the taxpayer… there’s essentially no end to what people can reasonably demand from a service they’re not paying for.”
There’s an idea that there’s a ‘holy grail of health’, he says.
“If only the government would spend enough then all the problems would be fixed. That’s entirely wrong.”
The minister from David Lange's fourth Labour Government (1984-1990) chooses his words carefully as he sits in the Christchurch cafe just a stone’s throw from his Merivale home.
It’s less about absolute dollars and more about political priorities, he says.
Cooper would be a formidable foe. It’s understandable why the Crown Health Financing Agency, the organisation responsible for settling the 320 claims, unflatteringly referred to her as “a dragon with three heads”.
That fierceness is apparent when she talks about what drives her to keep fighting for historic abuse sufferers.
“At the end of the day, our job is to assist this group of clients — all of them — to access justice.
“And this is a group of clients that has been down-trodden and disbelieved and silenced and accessing justice has been impossible.”
For these people, it’s about being believed.
“That’s a big part of the role we play, we believe them and we advocate for them and we tell their story where nobody else has been prepared to do it.”
Even after the last institutions had closed a paternalistic view prevailed. Former patients often weren't believed, their voices continued to be silenced by a population that refused to believe these types of abuses could take place in New Zealand, Cooper says.
The last recommendation of the Mason Report was to establish a Mental Health Commissioner — an independent leader to carry the torch.
Mary O’Hagan was New Zealand’s first and last mad Mental Health Commissioner.
The confident talker with a distinctive white bob started using mental health services during her first year of university.
While the service approach has come a long way since O’Hagan’s time in ward 10 at Dunedin’s Wakari Hospital, she says the “mad movement” hasn’t enjoyed the same success as other causes, like the gay rights movement.
O’Hagan, who has a wife and two sons, says the lack of attitudinal change is disappointing.
When people with mental illness are admitted to hospital, they’re told it’s to keep them safe.
“The subtext behind putting people in hospital is that they’re keeping the community safe,” O’Hagan says.
More than 20 years have passed since Mason’s game-changing report but he describes the current feeling towards mental health as “deja vu”.
“It seems to me that the atmosphere in 1996 was very similar to the one we have today.”
There are calls for an independent review of mental health services, talk of a “broken” or “fragmented” system, and stories of loss and desperation from family members of those suffering distress.
“The simple fact is that there’s a persistent community voice at the moment that is really concerned about the lack of mental health services,” Mason says.
“There is a groundswell of concern and these voices need to be listened to.”
Where to get help
Need to talk? 1737: free call or text 1737 any time for support from a trained counsellor
Lifeline: 0800 543 354
Youthline: 0800 376 633 free text 234 or email talk@youthline.co.nz
Samaritans: 0800 726 666
Healthline: 0800 611 116
Depression helpline: 0800 111 757 or free text 4202 or www.depression.org.nz
The Lowdown: www.thelowdown.co.nz or free text 5626
SPARX.org.nz: online e-therapy tool
OUTline NZ: 0800 688 5463 for confidential telephone support for the LGBTQI+ family, as well as their friends and families
Note: all helplines are available 24/7. For further information about supports available to you, contact the Mental Health Foundation's free resource and information service (09 623 4812 or info@mentalhealth.org.nz) during business hours.
Words: Laura Walters and Katie Kenny
Illustration and layout: Jemma Cheer
Visuals editor: Alex Liu
Copy editor: Joanne Butcher
This project was made possible by funding from the Frozen Funds Charitable Trust, through the Mental Health Foundation.