Mental health system ‘complex’, ‘patchy’ and ‘hard to navigate’
Tuesday, 4 November 2025
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The mental health system is under intense pressure, a new report highlights, with wait times to access crisis phone lines ticking up sharply and young people and Māori disproportionately impacted.
The Crisis Responses Monitoring Report is the first standalone monitoring report issued by the Mental Health and Wellbeing Commission. It described the system as “complex and hard to navigate” and argued that “urgent action is required” to ensure people can access support if and when they need it.
“Many people do not receive the support they need at the time they need it,” said the commission’s chairperson, Hayden Wano, in the report’s foreword.
The report has called for a national, networked crisis response system, finding that the current framework was fragmented and often inequitable.
It also found that the ability for people to access services was becoming more difficult. Over half of those seeking crisis support are doing this via crisis phone lines, but people are waiting longer to speak to someone.
In 2020, people waited an average of two minutes to talk to someone, and by the end of 2024, people waited an average of more than five minutes.
People are also staying longer in services than they were five years ago, and while overall access to specialist health and addiction services may have decreased, the reasons for this included “system constraints” and “increased complexity” of distress.
“Crisis team services shared that they have to use a wide range of skills and are often working at the top of their scope. Due to the increasing complexity of distress and needs of the people they are supporting, they told us they are often only able to respond to ‘the worst-case scenario’,” the report stated.
For Māori and young people, a higher proportion of calls are urgent compared with non-Māori and those aged over 24 years.
“Māori represent a higher proportion of people accessing services across all specialist mental health and addiction services and this is also the case for crisis services, highlighting significant inequities,” read the report.
“We heard that, when Kaupapa Māori services are well resourced and connected to the community, they can deliver agile and holistic wrap-around support that better meets the needs of tāngata whaiora and whānau.”
Karen Orsborn, the chief executive of the Mental Health and Wellbeing Commission, told The Post the report showed that the system was facing major challenges, including the fragmentation of services nationwide.
“It's hard to navigate. It's patchy and inconsistent across the country, and many people are not able to access the support that they need,” she said.
Issues with delayed call times on crisis support lines was a concern, said Orsborn. It was possible people could be slipping through the gaps.
“What we want to see is that people, when they do reach out, actually get that support that they need at that point in time, because we know that for some people, they'll keep trying - but others may not.”
Orsborn said it was becoming harder for people to access the services that they needed, which could be why the number of recorded crisis events had decreased.
“What we've heard consistently is that people aren't able to access the services when they need them. Consistently, many people are but not everybody is able to.”
Daniel Mitchell, co-chairperson of Evolve Wellington Youth Service, has lived experience of accessing mental health crisis services in his teens.
He said that, anecdotally, there was a “self-rationing” of access to mental health services by some young people, as they knew the system was under pressure.
That meant they didn’t always choose to access support when they may otherwise have.
“There's a second guessing of whether or not they're actually in dire enough need to access a service that they know is so limited,” he said.
“So that puts a big question mark … over, actually, is the way that we're framing this, or setting up the system … discouraging people to actually use it when they need it, or should be using it, and making them delay it [until] they're actually really at a crisis point.”
The drivers of crisis were often broad and complex, he told The Post. To truly support people in crisis, they need the ability to access support services that are most appropriate to their needs.
“If people have the ability to choose from, and access, a range of appropriate supports before presenting with crisis, that crisis may well be avoided or mitigated.”
Mitchell also expressed concern with the varying levels of access to services across the country.
While his initial experience in the system had been relatively efficient, that was in Auckland.
“When I moved back to Upper Hutt, they went to transfer me to the equivalent service, and it was just near impossible to get the same access to care,” he said.
“So I saw the change in having access to more specialist care in Auckland at that time, to then moving back to … Upper Hutt, where suddenly that same level of access didn't exist, which threw a little bit of the spanner in the works.”
The report noted that while some areas have “a range of crisis response services”, others, especially in rural areas, had more limited options.
“There are also limited crisis response pathways for people experiencing substance use crises.”
The report makes two key recommendations, primarily the development of a nationally cohesive, networked crisis response system by June 2027.
Ahead of that, by the end of June next year, Health NZ should progress “shorter-term” actions, such as nationwide access to 24/7 phone-based crisis support and clear, consistent pathways to crisis services from primary care.
Orsborn said that having a minister for mental health, Matt Doocey, had brought a “real focus” to the issue of mental health and there were some “good initiatives” under way, including crisis cafes and the expansion of co-response teams.
“But what we really want to see is that accelerated, but also be part of that cohesive system,” she said.