Mental Health Act

Improving mental health and addiction outcomes for Māori

Reform of the Mental Health Act (Compulsory Assessment and Treatment) Act 1992

Mental health and addiction outcomes are worse for Māori compared to the overall population, with Māori being more likely to experience mental distress and be placed in seclusion, and less likely to receive mental health and addiction care that meets their unique needs as Māori.

Te Aka Whai Ora is committed to improving mental health and addiction outcomes for Māori. We work on a range of kaupapa, with a focus on equity in mental health and addiction support and treatment, underpinned by te Tiriti o Waitangi.

Repealing and Replacing the Mental Health Act

The Mental Health (Compulsory Assessment and Treatment) Act 1992 (known as the Mental Health Act), sets out the rules for when the government may intervene in a person’s life to provide mental health treatment without their consent.

Manatū Hauora Ministry of Health is leading advice to Government on the repeal and replacement of the Mental Health Act, in response to a recommendation from this 2018 report:

He Ara Oranga: Report of the Government Inquiry into Mental Health and Addiction(external link)

The aim of this mahi is to create new legislation that protects and respects human rights, implements the principles of Te Tiriti o Waitangi, and improves equity for Māori and other priority population groups.

Te Aka Whai Ora is working closely with Manatū Hauora on this mahi.

The Government has now agreed to the suite of policy proposals for new mental health legislation.

The Cabinet papers and materials setting out the policy for new legislation are available at: 

Cabinet Material: Policy decisions for transforming mental health law | Manatū Hauora(external link)

Summary of key proposals of interest for Māori

Paper 1 – Transforming mental health law: Foundations for new mental health legislation

• Purposes and principles – new legislation will include a clear purpose and principles focussed on respecting and protecting human rights, reflecting the cultural needs of tāngata whaiora and achieving equitable mental health outcomes, particularly for Māori
• Giving effect to the Crown’s obligations under te Tiriti o Waitangi – there will be specific provisions to clarify how these obligations will be upheld, including by supporting te ao Māori approaches to recovery and wellbeing
• Updated legal criteria for compulsory mental health care – the current criteria for compulsory treatment includes a requirement of ‘serious danger’ which may have been contributing to an over-emphasis of risk in practice. The entry criteria will be updated to include greater consideration of decision-making capacity. This will mean that tāngata whaiora who have capacity to make decisions about their own mental health care will not be subject to compulsory care
• Supported decision-making – tāngata whaiora will be supported and empowered to make decisions about their own mental health care
• Whānau, hapū, and iwi – new legislation will better recognise and provide for their involvement in mental health care
• Seclusion and restraint – new legislation is intended to support more limited use of these practises
• A broader range of care options available – beyond medical interventions, including kaupapa Māori approaches and other cultural support
• More holistic and comprehensive care planning – including consideration of mental, physical, social, and cultural needs, as well as protective factors and strengths of tāngata whaiora
• Collective approaches to care – where each tangata whaiora will be looked after by a kaitiaki team which will include clinical, lived experience and cultural expertise.

Paper 2 – Transforming mental health law: Second tranche of policy decisions

• New rights in legislation for tāngata whaiora – greater rights will be provided for, including the right to make decisions and be provided with appropriate accommodations for physical, sensory, learning and other impairments. Mental health services will be obligated to ensure these new rights are upheld. Rights will also be extended to people being supported voluntarily in inpatient services
• New and enhanced oversight, monitoring, and accountability mechanisms – including strengthened requirements to report on things like the use of seclusion and restraint, as well as monitoring of equity, particularly for Māori.

Stay up-to-date on further updates on the work to repeal and replace the Mental Health Act at:

Repealing and replacing the Mental Health Act | Manatū Hauora(external link)

Next steps:

• Parliamentary Counsel Office drafts a Bill based on the Government’s agreed policy
• Manatū Hauora takes the Bill to Cabinet for approval.

After a Bill is approved by Cabinet, it will go through the Parliamentary process. This includes select committee consideration where there will be an opportunity for the public to comment on the Bill before it becomes law.

Find more information on this process at: How a bill becomes law(external link)

When there is a call for submissions on this Bill, Te Aka Whai Ora will provide further information on how to engage in that process.

Ki te Whaiao: Investigating kaupapa Māori approaches to compulsory mental health care

While the Government has agreed to the policy for new mental health legislation, there is further work to be done to bring the policy proposals to life – this will include the drafting of a Bill as well as detailed implementation planning.

As part of this further work, Te Aka Whai Ora is leading a project, Ki te Whaiao, with the support of Manatū Hauora.

Ki te Whaiao is investigating kaupapa Māori approaches to compulsory mental health care and explores whether these approaches offer any insights into the feasibility of eliminating restrictive practices such as seclusion and/ or restraint under the new mental health legislation.

This is because:

• Māori are secluded up to 4.6 times more than non-Māori
• The elimination of restrictive practices has consistently been raised in feedback by Māori on the repeal and replacement of the Mental Health Act.

This is therefore a priority issue for both Te Aka Whai Ora and Manatū Hauora. 

Ki te Whaiao is progressing alongside the development of new mental health legislation and is expected to be complete by the end of 2023.

The outcomes will inform the drafting of the Bill and detailed implementation planning (including for example, informing changes needed to operational policy, guidelines, or training).