The Health Committee has examined the Mental Health and Wellbeing Commission Bill and recommends that it be passed with the amendments shown.

This bill seeks to establish a Mental Health and Wellbeing Commission. This is in response to recommendations 36 to 38 in He Ara Oranga: Report of the Government Inquiry into Mental Health and Addiction.

The Commission would be established as an independent Crown entity. Its role would be to contribute to better and equitable mental health and wellbeing outcomes for people in New Zealand.

This commentary covers the main amendments we recommend to the bill as introduced. We do not discuss minor or technical amendments.

Clause 13(1) of the bill as introduced would require the Commission to seek the views of Māori, Pacific peoples, disabled people, and others who are at higher than normal risk of poorer mental health and wellbeing. It must also seek the views of children, young people, and those with personal experience of mental distress or addiction.

There was strong interest in this clause. We note that multiple submissions identified additional groups that experience poorer outcomes. Submitters recommended that the bill also list them as groups the Commission should seek the views of when carrying out its functions.

We propose a more inclusive approach to clause 13 that would acknowledge groups that experience poorer outcomes, such as rainbow communities, while providing the Commission flexibility to determine the groups it will consult.

We recommend amending clause 13 to highlight that the Commission should seek views of people at greater risk of experiencing poor mental health and wellbeing, while also explicitly referring to the 12 groups identified in He Ara Oranga as examples of groups that are at risk of experiencing poor mental health and wellbeing. This list includes the groups in the bill as introduced (Māori, Pacific peoples, disabled people, and children and young people) but also includes rainbow communities, rural communities, older people, and refugees and migrants, among others. We recommend inserting the list of groups into the bill as Schedule 1A.

We also recommend the addition of clause 13(1)(e) to explicitly state that the Commission could seek the views of any group that it considers may help it meet its objective. We note that the Commission’s mandate covers the mental health and wellbeing of all people in New Zealand, and believe this addition would reinforce that the Commission could consider any perspectives it considers necessary to fulfil its functions.

We believe these amendments would capture not only the groups specified in Schedule 1A, but also those of other groups that made submissions on this bill. These amendments also reflect the fact that the groups that are at greater risk of experiencing poor mental health and wellbeing will change over time, and the Commission needs the flexibility to seek the views of differing groups as circumstances evolve and change.

Clause 11(1) sets out the functions of the Commission. In undertaking its functions, the Commission would be required to have particular regard to the experience of, and outcomes for, Māori (clause 11(2)).

We also recommend inserting clause 11(3) to be clear that the Commission should consider evidence where relevant and that it have regard to a wide range of factors affecting mental health and wellbeing.

We believe the bill should provide more clarity about the Commission’s role in influencing and improving approaches to mental health and wellbeing. We therefore recommend the addition of clause 11(1)(ca) to emphasise that the Commission can make recommendations to influence better mental health and wellbeing.

Proposed clause 8 would allow for the board to consist of 2 to 5 members. It would also require the Minister to take into consideration the need for board members to collectively have an understanding of (amongst other things) te ao Māori and tikanga Māori; factors that affect people’s mental health and wellbeing; mental health services and addiction services; and improving overall system performance.

We recommend amending clause 8(1) to require a board of 3 to 7 members. We believe this would allow for the board to collectively cover a wider range of the recommended attributes and experience.

We also recommend amending clause 8(2)(a) to specify that consideration must also be given to potential board members’ collective knowledge, understanding, and experience of:

• the effect of environmental factors on people’s mental health and wellbeing; and

• public health and population health approaches to improving health outcomes.

We believe this amendment would encourage the Commission to consider the full range of factors that affect people’s mental health and wellbeing and the full range of interventions to promote positive mental health and wellbeing and prevent poor mental health and wellbeing.

As introduced, clause 2 specifies that this legislation would come into force on 9 February 2021. We note that the Government has already established the Initial Mental Health and Wellbeing Commission to undertake some of the proposed functions for the permanent Commission and to provide advice for the permanent Commission. We see it as important to maintain momentum from this work and from He Ara Oranga. To allow flexibility for the permanent Commission to be established earlier than 9 February 2021, we recommend that the Act come into force on the earlier of a date to be appointed by the Governor-General by Order in Council or 9 February 2021.

We recommend the following two amendments to reflect the fact that the Commission would be an independent Crown entity:

• amending clause 8(2) to make it clear that the Minister would recommend people for membership of the board, but (under the Crown Entities Act 2004) members would be appointed by the Governor-General, not the Minister

• inserting clause 11(4), requiring the Commission to act independently when performing its functions. This is a standard provision in legislation that establishes such entities.