This inquiry was announced early in 2018. The catalyst for the inquiry was widespread concern about mental health services, within the mental health sector and the broader community, and calls for a wide-ranging inquiry from service users, their families and whānau, people affected by suicide, people working in health, media, Iwi and advocacy groups.

The purpose of this inquiry was to:

• hear the voices of the community, people with lived experience of mental health and addiction problems, people afected by suicide, and people involved in preventing and responding to mental health and addiction problems, on New Zealand’s current approach to mental health and addiction and what needs to change
• report on how New Zealand is preventing mental health and addiction problems and responding to the needs of people with those problems
• recommend specific changes to improve New Zealand’s approach to mental health, with a particular focus on equity of access, community confidence in the mental health system and better outcomes, particularly for Māori and other groups with disproportionately poorer outcomes.

The full Terms of Reference are set out in Appendix A.

There has been no shortage of mental health inquiries and reviews in the 22 years since the last national mental health inquiry in New Zealand, led by Judge Ken Mason in 1995–1996. It too was born out of heightened public concerns and calls for change. It came in the wake of deinstitutionalisation in the 1980s and 1990s, with patients being moved out of psychiatric hospitals and into the community.

We note two important differences about this Inquiry. One is the breadth of its Terms of Reference, including mental health problems across the full spectrum from mental distress to enduring psychiatric illness, and a mandate to look beyond the health sector to other sectors and social determinants that influence mental health outcomes. We are also asked to advise how to promote mental health and wellbeing for the whole community. The inclusion of addictions and harmful use of alcohol and other drugs is also different from past reviews.

The second main difference that emerged during this Inquiry is the striking degree of consensus, from most parts of New Zealand society, about the need for change and a new direction: an emphasis on wellbeing and community, with more prevention and early intervention, expanded access to services, more treatment options, treatment closer to home, whānau- and community-based responses and cross-government action.