Waikato health leaders are at odds over the key drivers of mental illness, with the DHB chair disagreeing with a report that inequality is behind many issues.
In 2016, Waikato DHB began a review of its mental health and addiction services, with a view to considering new models of care.
As part of the process, the health board commissioned a paper on the current demands on the region’s mental health system.
Waikato University professor of population health Ross Lawrenson assisted with the report and presented it to heath board members in April.
* Greens lash Waikato DHB over state of mental health services
* New mental health facility to replace Waikato’s Henry Rongomau Bennett Centre
* Cheap methamphetamine deepens health crisis
The paper also forecasts potential health service requirements through to 2033.
Waikato DHB chairman Bob Simcock said the report provided a useful description of the region’s population and health treatments offered.
However, Simcock said he struggled with the document’s conclusions.
The report’s authors write the key drivers for mental illness are largely social and economic inequalities.
“Consequently, mental illness is, as at least in part, preventable and investment in the early years of life has the greatest potential to reduce the burden of mental illness and improve population wellbeing in our society,” they wrote.
Simcock said he could have referenced the same data as the report writers and come to a different conclusion.
“The paper has very strongly emphasised social inequalities and economic inequalities as core drivers and I don’t think that’s true,” Simcock said.
“We know a lot about correlations in mental health and many of the relationships are circular, not linear. In other words, causes are also effects.”
More than 25 per cent of the region’s population live in areas which experience a relatively high level of socio-economic deprivation.
Simcock said the paper gave the view that mental health issues could be remedied by reducing income inequality and solving housing problems.
“That’s simply not true … I guess, in my view, that bias comes through quite strongly.”
Lawrenson said the paper avoided recommending any solutions.
That task would fall to a working group.
Simcock said it was important all the causes of mental illness were considered, rather than have the board “get driven down one alley because that is a dangerous place to go”.
“My view is we need to be intervening in a whole lot of places. My concern is if you emphasis one of these over others I don’t think you’re going to get the results you want.”
Board member Clyde Wade said the report, in numerous places, talked about a circular relationship between some of the causes and effects of mental illness.
As part of the assessment of the region’s health needs, a questionnaire has been sent to GPs to gain their views on mental health and addiction services.
Dr Damian Tomic, the DHB clinical director of primary and integrated care, said 40 per cent of all general practice had a mental health component.
“The management of mild to moderate anxiety and depression is bread and butter to general practice.
“Where things start to get more complicated is when you start talking about drugs and alcohol because traditionally GPs have not provided that service and therefore had no reason to learn about it,” Tomic said.