Summary of recent OECD report "Mental Health and Work: New Zealand”.

1. Christopher Prinz, economist from the OECD
Helen Lockett, consultant to the OECD
MENTAL HEALTH AND WORK: NEW ZEALAND
OECD assessment and recommendations
Launch of the report “Mental health and Work: New Zealand” on 13 December 2018

2. BACKGROUND

3. OECD’S MENTAL HEALTH AND WORK PROJECT
3
• Policy has a major role in improving the labour force status
of people with mental health conditions
• 2012 Sick on the Job?: background & evidence
• 2013-2015, in-depth case studies for 9 OECD countries
• 2015 Fit Mind, Fit Job: synthesis & policy framework
• 2016 OECD Council Recommendation: “Integrated
Mental Health, Skills and Work Policy”

4. AN INTEGRATED POLICY FRAMEWORK
Improving
labour force
participation
Education
& Youth
Policy
Health
Policy
Welfare
Policy
Workplace
Policy
A stronger
focus on
people’s
working lives
A stronger focus
on worker’s
mental health
A stronger
focus on youth
mental health

5. • A shift in WHEN to intervene:
– Action is coming too late in all relevant systems
• A shift in WHO should intervene:
– Mental health conditions not only a responsibility of the mental
health system; need to involve various frontline actors
• A shift in HOW to intervene:
– Overcome silo approach and provide integrated services
5
THREE SHIFTS ARE NEEDED: “When”–“Who”–“How”

6. THE NZ MENTAL HEALTH AND WORK PROJECT
Aug 2017
• NZ government completes OECD questionnaire
Sep-Dec
2017
• Preliminary data analysis
Dec 2017
• Stakeholder visits
Jan-Jun
2018
• Data analysis and report writing
July 2018
• Draft report to government
Oct 2018
• Launch and dissemination

7. TRENDS AND
OUTCOMES IN
NEW ZEALAND

8. 8
The prevalence of mental health conditions varies with
age, gender, level of education and ethnicity
Source: OECD (2018), Mental Health and Work: New Zealand, OECD Publishing, Paris.
MENTAL HEALTH PREVALENCE

9. 9
Mental health conditions strongly affect employment and unemployment
POOR LABOUR MARKET OUTCOMES
Wide employment gap
Source: OECD (2018), Mental Health and Work: New Zealand, OECD Publishing, Paris.

10. 10
The effects are worse for Māori, Pasifika and people with lower education (Panel C)
There have been minimal improvements since 2008 (Panel D)
POOR LABOUR MARKET OUTCOMES
Wide employment gap
Source: OECD (2018), Mental Health and Work: New Zealand, OECD Publishing, Paris.

11. 11
A large share of all types of welfare clients have mental health problems
Share of beneficiaries with a severe or moderate mental disorder as a total of each benefit, 2016/17
Higher likelihood to receive social benefits and the
system underestimates this share considerably
Source: OECD (2018), Mental Health and Work: New Zealand, OECD Publishing, Paris.

12. 12
The risk of poverty is high among those with mental health conditions
HIGH COSTS OF MENTAL ILL-HEALTH
Source: OECD (2018), Mental Health and Work: New Zealand, OECD Publishing, Paris.

13. THE WAY FORWARD:
POLICY CHANGES
NEEDED

14. OECD ASSESSMENT
14
• NZ has a good platform to build on as awareness is high
• Policy around mental health and work, however, has not
advanced enough in past twenty years
• Pilots do not get converted into structural reforms
• Health and employment services are highly fragmented
• There is a lack of cross-government leadership
• ACC creates very large inequities

15. OECD POLICY RECOMMENDATIONS
15
• Develop and implement a cross-government mental health
and work strategy
• Shift spending in various fields (health, welfare)
• Rigorously evaluate all experiments and pilots
• Systematically collect missing and highly-needed data
• Increase the focus on high-prevalence common conditions,
with non-stigmatising support
• Build the mental health competencies of all key actors
• Conduct a review of the unintended effects of the ACC
system on mental health

16. MAIN CHALLENGES
FOR EACH SYSTEM

17. 17
ESTABLISH EMPLOYMENT AS A TARGET
FOR MENTAL HEALTH CARE
• Unmet need for treatment is substantial
• There is no focus on employment outcomes
Recommendations
 Increase access to high-quality non-pharmacological
treatments
 Develop employment knowledge in primary-based care
 Integrate mental health and employment support services

18. 18
• Māori youth are overrepresented in all groups at risk
• Growing rates of youth unemployment and NEETs
• Poorer school completion of youth with mental health issues
Recommendations
 Increase mental health focus of all child and youth initiatives
 Increase support during transitions e.g. school-to-work
PRIORITISE MENTAL HEALTH IN EDUCATION
AND YOUTH SERVICES

19. 19
• Mental health is absent from Health & Safety legislation
• Obligations on employers vis-à-vis sickness are minimal
• ACC creates a number of problems
Recommendations
 Improve mental health support in the workplace
 Make return-to-work management available to all
employees with mental health conditions
STRENGTHEN WORKPLACE POLICIES

20. 20
• Mostly low-intensity employment services
• Poor outcomes for jobseekers with mental health conditions
• The need is significantly underestimated
Recommendations
 Support people before they claim welfare benefits
 Improve access to treatment integrated with employment
services for all jobseekers with mental health conditions
PRIORITISE MENTAL HEALTH IN EMPLOYMENT
AND WELFARE SYSTEM