Opportunities and challenges for psychotherapy in Aotearoa New Zealand’s new health system

A 2022 national District Health Board psychotherapy workforce survey and related discussions

Abstract

The dawning of a new national public health system in Aotearoa New Zealand offers opportunities and challenges for psychotherapists. This paper discusses these against three data sets, namely, a 2022 national District Health Board psychotherapy workforce survey, a video recording of the Psychotherapy and Public Worlds panel event at the 2022 New Zealand Association of Psychotherapists’ (NZAP) conference, and psychotherapist registration statistics supplied by The Psychotherapists Board of Aotearoa New Zealand (PBANZ). The expansion of short-term, risk-based, manualised interventions during the former DHB era did not improve mental health at a community level (Mulder et al., 2022) nor promote equity and sustainability (Berg et al., 2022). Placing Te Tiriti o Waitangi, the Treaty of Waitangi (1840) (Te Tiriti) at the centre of the new health system suits psychotherapy, whose wholistic worldview of health and wellbeing aligns with te ao Māori better than most other Western psychological approaches. Kōrero about the indigenising of psychotherapy in Aotearoa has been around since at least the 1980s. The Ministry of Health (the Ministry) has recently invited psychotherapists’ advice on workforce policy development and how to promote psychotherapy in the new health system. This task will largely fall on the psychotherapy associations and some psychotherapy training organisations. A major challenge may be whether these entities can sustain the expenditure of human and other resources necessary to represent their memberships in continuing dialogue with the Ministry and its operational partners, Te Whatu Ora, Health New Zealand (Te Whatu Ora) and Te Aka Whai Ora, Māori Health Authority (Te Aka Whai Ora). Key opportunities include the recruitment of overseas psychotherapists and the greatly expanded provision of psychotherapy student placements in public health services to stimulate new psychotherapy training programmes and workforce growth.