Could “social bond” benefit NZ mental health service?

by KE

With more people reporting long waiting time to receive mental health support, more cases recording mental health patients dying in the care of the state, and more people relying on medicine for recovery, NZ mental health are now with poor reputation in media (Garner, 2017). When we all are looking forward a better upgrading plan for NZ mental health service, a signal of privatization for mental health shined in kiwi’s life.

This February, the first social bond programme of New Zealand was launched. The private Australian firm APM will provide employment service to 1,700 clients with moderate to mild mental health illness, and it might take 7 years to see the final outcomes (Kirk, 2017). In social bond model, government collaborates with private investors or non-profit organizations providing social services for vulnerable and marginalized communities through a performance-based contract. Only effective program with achieving outcomes will be paid. By the July of 2016, 60 of this kind of projects have launched in 15 countries, 21 indicate positive social outcomes, but none of these 60 focused on mental health (Dear, et al., 2016).

I can see government’s determination of keeping more citizens’ life on track, but it appears to me that NZ government are trying to save expenditure through a gambling with the stake of 1,700 clients’ mental health and NZ citizens’ confidence toward nation’s public service. It is true that organization might have more incentive to achieve the goal within performance-based contract model, but its risk in mental health practice is inevitable. Mental disorders happened due to psycho-social causes. One’s history, experience in society and psychological factors, like loss or threats, all contribute to mental disorders (Golightley, 2014). It is irresponsible if government just put vulnerable clients into private sector settings where there is a lower proportion of professional employees with the knowledge of best practice model for mental health patient. If the investor could only get payment with achieving outcomes, i.e. good employment rate, how could we confirm the design of the practice model is not profit-motivated? In the process of delivering service, how could we prevent the side effect, like relapse of mental illness in work environment? New Zealand is with multi-culture background, what could ensure external investor to be cultural sensitive enough to support Maori, Pasifik Islander, Asian and other?

At this time, we hope to see increase funding and measures with focus on early intervention and easing workload pressure, so that people could access to mental health service easily and immediately. There are a crowd of challenges to cope with if we want to improve our systems: the shortage of professional mental health staff, the effectiveness of practice model, the good maintaining plan after recovery, and patients’ anticipation. There is no shortcut even though a public-private partnership is established. What kind of impacts will social bond bring to this, more available mental health resources or more expensive seats for treatment?  The outcomes are unpredictable at this stage ( see Henrickson, Jülich and Napan, 2016. What is the backup plan if side effect happens? Please do not say we do not have backup plan.

Bibliography

Bont, D. (2015, 06 04). Bottom line for mental health services. Retrieved from NZ Herald: http://m.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=11459339

 Dear, A., Helbitz, A., Khare, R., Lotan, R., Newman, J., Sims, G., & Zaroulis, A. (2016, 06). Social Impacts Bonds: The Early Years. Retrieved from Social Finance: http://www.socialfinance.org.uk/wp-content/uploads/2016/07/SIBs-Early-Years_Social-Finance_2016_Final-003.pdf

Garner, D. (2017, 04 22). Duncan Garner: A piece of my mind: The mental health system is failing. Retrieved from Stuff: http://www.stuff.co.nz/national/health/91772430/duncan-garner-a-piece-of-my-mind-the-mental-health-system-is-failing

Golightley, M. (2014). Social Work and Mental Health. London: SAGE.

Henrickson, M., Jülich, S., & Napan, K. (2015, 06 08). Social Experiments not the Solution for Mental Health Care. Retrieved from Re-Imagining Social Work in Aotearoa New Zealand: http://www.reimaginingsocialwork.nz/2015/06/social-experiments-not-the-solution-for-mental-health-care/

Kirk, S. (2017, 02 21). South Auckland mental health patients to start Govt’s first social bond test. Retrieved from Stuff: http://www.stuff.co.nz/national/politics/89638840/south-auckland-mental-health-patients-to-start-govts-first-social-bond-test

 

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About socialworknz

I'm a social work researcher in Aotearoa New Zealand
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