In the recent "Wellbeing Budget", Finance Minister Grant Robertson stated that mental health is no longer on the periphery of the health system. Unless the ACC system is reformed, however, his statement will not ring true.
The horrors of the March 15 Christchurch mosque attacks highlighted the inequitable treatment of mental injury compared to physical injury. Those victims who were shot are eligible for ACC-funded cover for both their physical and any associated mental damage.
In contrast, victims who witnessed the traumatic violence but sustained no physical injury are not covered by ACC and must find alternate ways of paying for treatment.
Under current ACC legislation psychological treatment for mental injury is covered only if sustained at work, is associated with a physical or treatment injury, or related to sexual abuse. In addition, the mental injury must be clearly linked to the physical injury. ACC devotes an entire 27-page document advising clinicians how to go about establishing a mental injury.
This complex process stands in sharp contrast to the experience of many of us who may sprain an ankle during a sports game or cut ourselves whilst cooking, visit our GP or ED, complete an ACC form and are, almost automatically, covered for the costs of treatment.
Our ACC system is something of which we should be rightly proud and was visionary when introduced in 1974. As New Zealanders we don't have to take out costly health insurance in case we get hit by a bus. Nor are we reduced to lengthy legal battles with the owner or driver of the bus to make them pay for our treatment.
But the ACC definition of injury is specifically linked to physical damage to your body. It may have been that when the legislation was drafted lawmakers didn't even consider the possibility that someone could sustain a mental injury. But our understanding of mental health has improved vastly since the 1970s and we now know that people can suffer immense distress regardless of whether there has been bodily damage.
The current ACC process continues the marginalisation of mental health problems, shrouding it in a complex bureaucratic process, and prolonging the view that mental distress should be treated differently, and less, than physical distress.
Those victims of the mosque attacks who did not sustain physical injury may still be suffering intolerable and life-long pain if they cannot afford psychological treatment. Mental pain and distress are no less real than physical pain, but it is heightened by shame and implicit judgments that society makes about sufferers.
Yes, changing the ACC system would be complex and likely result in greatly increased treatment costs. But if we truly believe in holistic, compassionate, all-of-person healthcare then it shouldn't be a barrier to change.
Without change the ACC system will continue to fix broken bones but not broken minds, and the Government's claim to bring mental health out of the dark will not be fully realised.
Read the original piece on Stuff.