Suicidal thoughts and self-harm: The children’s counselling service facing the mental health crisis

Wednesday, 9 July 2025

Minister for Mental Health Matt Doocey has released the Government's Suicide Prevention Action Plan, as he says more must be done to reduce New Zealand's high rate of suicide.

When Kelly Macknight got a call from a counsellor working for her small non-profit to report an 11-year-old had disclosed a suicide plan, she found she wasn’t as shaken as she once might have been.

After two years of running counselling service Be Heard in Dunedin primary schools, the shock from a growing level of distress in primary-aged children has worn thinner.

“It just becomes a bit more normalised when you're working on the ground in that space,” she explained. “I'm not even sure that some parents realise what their kids are thinking.”

As well as serious distress, self-harm, and suicidal thoughts, she has found more children are distressed overall than they were two years ago.

Kelly Macknight, founder of Be Heard, which provides counselling for children in Dunedin.

Home life is a growing concern - the charity raised three reports of concern, regarding the safety or wellbeing of a child, to Oranga Tamariki last year. This year, with only two terms completed, it has already raised four — as well as discussing four other cases informally with the agency.

“I think this is just reflective of society at the moment: Cost of living, the fact that there are massive waiting lists, just everything that's going on for people,” she said.

Demand outpacing services

What Macknight is witnessing in Dunedin reflects a national trend which suggests a mounting crisis placing substantive and growing pressure on mental health and child protection services.

The Mental Health and Wellbeing Commission’s latest data, covering the year to June 30 2024, shows that young people aged up to 25 made up 36.3% of all people using specialist mental health and addiction services ‒ including 44,392 aged 0-18 and 19,662 aged 19-24.

But nearly one in four children under 18 referred by their GP to specialist mental health services were declined ‒ a rejection rate of 24.8%. This is significantly higher than the all-ages average of 15.4%. In most cases, referrals were turned down not because the children failed to meet clinical criteria, but because other services were deemed more appropriate.

Minister for Mental Health Matt Doocey, right, pictured with Health Minister Simeon Brown. (File photo)

This raises concerns about whether children and young people are getting the specialist help they need, especially given evidence of widespread distress. Macknight also noted a systemic shortage of mental health support for children aged under 18, and that wait times for specialist services are long and inconsistent.

Mental Health Minister Matt Doocey said more recent data showed a “marked improvement”, and also pointed out that a higher rate of accepted referrals wasn’t the answer.

“What we want to do is make sure that the right referrals are made and accepted. We don't just want a system where we value increasing [the] number of referrals,” he said. “We want quite the opposite, where we see a reduction in referrals because people are being seen more timely in the community, that prevents them getting into crisis and needing a specialist service as well.”

Doocey also acknowledged workforce shortages as a key challenge and promised upcoming announcements on workforce planning.

But Ingrid Leary, Labour’s spokesperson for mental health, said the situation is “clinically risky”, describing how young people often believe they are finally in the system and about to receive help, only to face months of silence, delays, or referrals to adult mental health services that aren’t appropriate for their age or needs.

But while Health New Zealand data shows it has supassed its target for faster access to primary health and addiction services, and for access to specialist mental health and addiction services, it could not readily provide more recent detailed data for how those under 18 experience the mental health system, and whether they are still being declined at higher rates than other age groups.

Oranga Tamariki has warned of looming “tipping points” where its overstretched service won’t be able to respond to serious harm affecting children in the next two years. (File photo)

Child protection services reaching ‘tipping point’

The spike in cases is far from isolated. A newly released Oranga Tamariki report reveals an almost 20% surge in child welfare concerns in 2024, driven by rising mental distress, family breakdown and chronic stress.

This trend is likely to continue, putting increasing pressure on already overstretched frontline and specialist services, the report said.

It also warned there's a more than 95% chance that, within the next two years, growing demand will leave the system unable to respond to serious harm affecting children ‒ including injuries, illness, and long-term developmental impacts. It highlights looming “tipping points” in capacity, particularly for those with high and complex needs.

CORRECTION: An earlier version of this story referred to data for children aged 0-8, when it should have said 0-18. The time period should also have said for the year to June 30 2024. (Amended: July 9, 2025, 9.17am.)