Posted: 
Tuesday, 9 Jul 2019
View point: 
The Treasury

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New wellbeing analysis on mental health and loneliness

Photograph by David Straight via New Zealand Story Group

Loneliness and isolation are not just modern-day ills, but they are on the rise in New Zealand. 

An aging population, more people living on their own, and the use of technology rather than face-to-face conversations are all factors that have been linked with loneliness. The 2016 New Zealand General Social Survey found that 650,000 New Zealanders felt lonely at least some of the time and, of those, 15-24-year-olds were the most affected.  In just two years, between 2014 and 2016, the estimated number of Kiwis (aged 15+) who felt lonely all or most of the time increased by 70 percent, from 140,000 to 240,000. [1]  

Loneliness can affect anyone, at any age, and can often occur alongside mental health issues, such as anxiety and depression, and physical health problems.

Introducing the Treasury’s Living Standards Framework (LSF)

So what has this got to do with the Treasury, the Government’s lead financial and economic adviser?  We are not experts on loneliness and mental health but our Living Standards Framework (LSF) Dashboard enables us to look at the relationships between different elements of wellbeing, and also at differences in wellbeing across groups of people.

The LSF includes twelve domains of current wellbeing, and four capitals that provide the foundations for future wellbeing (for example, natural capital). The Treasury has identified specific wellbeing indicators within each of the wellbeing domains and capitals. Mental health is part of the Health domain, while loneliness is part of the Social Connections domain.

The Treasury’s LSF was developed to help us provide good advice to the Government of the day.  We want to ensure that we are consistently thinking broadly about the strategic challenges facing New Zealand and the range of impacts of policy responses on the different dimensions of wellbeing.

Economic growth has often been used as the key measure for how well the country is doing overall. But if you ask most New Zealanders about their wellbeing or their living standards, chances are that they won’t talk about how well the country is doing economically. They’re more likely to talk about being able to have or do the things that make them feel they can live their life to the full – as they see it. 

New analytical paper uses the LSF to explore relationships with mental health wellbeing

The Treasury has just released the first of a series of papers showing how it is using its Living Standards Framework to explore aspects of wellbeing. 

The paper uses the LSF to analyse the prevalence of low wellbeing for mental health [2], looking at it from several perspectives: population sub-groups (for example, by age and sex); people who have low wellbeing in other aspects of their lives; and users of mental health services and other government services. It is based on data from the New Zealand General Social Survey, combined with administrative data sources. [3]

The paper illustrates how the LSF can be used to carry out high-level wellbeing analysis across the different domains. This can supplement more in-depth and specific analysis from data sources such as Te Rau Hinengaro - New Zealand Mental Health Survey.

So, what does this LSF analysis of mental health wellbeing tell us?

First, it tells us who is more likely to be experiencing low wellbeing around mental health: at the top of the list are sole parents or people not living with family; people who are unemployed; and people living in a deprived area (see the paper for more details).

People with low mental health wellbeing are relatively likely to also have low wellbeing in other aspects of their lives, including being unemployed, on a benefit or unhappy with their job; having low material wellbeing; low cultural wellbeing (feeling unable to be themselves) and having low trust in other people and institutions; as well as poorer physical health and lower housing quality.

Loneliness was strongly associated with low mental health wellbeing. And low mental health wellbeing was, in turn, strongly linked with low life satisfaction. We can’t say what the causal relationships are between these types of low wellbeing, but people often experience them together.

An individual’s poor mental health can also crossover into other areas, such as addictions and domestic violence, which spill over to affect other people close to them and the wider community [4]

One of the charts from the paper, reproduced below, shows the percentage of people with low wellbeing for selected LSF indicators. [5] The results have been split by whether people had a referral from their GP to specialist mental health services in the past two years. We found that 37% of people with a recent mental health referral had low life satisfaction, compared with only 14% of people who did not have a recent mental health referral.

Where the orange line (people with referrals) falls outside the blue line (people without referrals), it means that a higher percentage of people with mental health referrals had low wellbeing. People with mental health referrals were much more likely to have low mental health wellbeing but also to be lonely, have low life satisfaction, low material wellbeing, and low job wellbeing.

Recent mental health referrals were particularly associated with higher prevalence for low wellbeing for mental health, low job wellbeing, low life satisfaction, low material wellbeing and loneliness.

Wellbeing and mental health: an analysis based on the Treasury’s Living Standards Framework

The paper shows the strong relationship between mental health wellbeing and overall life satisfaction – suggesting that improving people’s mental health would generally be a step forward in improving their sense of overall wellbeing.

The paper also looks at which positive factors are associated with better mental health - it appears to be particularly important to have meaningful engagements with other people, avoiding loneliness. Material wellbeing and meaningful employment are other key factors. And there is a positive association with physical health and feeling able to be yourself (that is, feeling comfortable with expressing your cultural identity).

Loneliness may seem to be – literally – an individual problem, but it affects the mental health of a significant proportion of the New Zealand community, and has flow-on effects for New Zealanders’ overall wellbeing. 

Finally, the paper looks at which people with low mental health wellbeing were the least likely to have accessed mental health referrals or prescriptions. This included Pacific people and Asians, people aged 15 to 24, people in good physical health, and people with milder mental health issues. These results were in line with the New Zealand Mental Health Survey, and indicated that some population groups are harder to reach for mental health services.

The Government has recognised the importance of mental wellbeing and, in January 2018, commissioned an inquiry into mental health and addiction services in New Zealand. The inquiry came back with a set of recommendations to help transform the current system and ensure everyone can get the support they need, when they need it. One of these recommendations included increasing access and choice of mental health services, particularly to those with mild-to-moderate mental health needs. The Government has made a significant investment of $1.9 billion over four years into mental health in Budget 2019 as a first step to responding to the inquiry and ensuring all people have access to appropriate services. This investment includes a focus on strengthening existing services in place but also rolling out a new universal front line service over the next five years. This new service will place trained mental health workers in doctors’ clinics, iwi health providers and other health services so that when people seek help it is easy to access and immediately available for those suffering mental health issues.

Notes

  1. [1] https://www.loneliness.org.nz/nz/facts/  (Estimates based on figures from the NZ General Social Survey and Population Estimates, Stats NZ)
  2. [2] Mental health wellbeing has been defined using the SF-12 mental health index score in the NZ General Social Survey. See the paper for more details.
  3. [3] The General Social Surveys from 2008-16 have been used, providing a combined sample of over 40,000 people. These wellbeing results have been linked to the Integrated Data Infrastructure (IDI), hosted by Stats NZ.
  4. [4] https://mentalhealth.inquiry.govt.nz
  5. [5] See the paper for a full definition of each wellbeing indicator shown in the chart.
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