A panel set up to investigate the state of the country's mental health services has been told there needs to be more focus on community based services.
Labelled as a "once in a generation" review of the mental health system the inquiry was a key plank of Labour's election policy.
There were ham and cheese croissants and candid conversations at the launch of the Mental Health and Addictions Inquiry consultation phase.
The six member inquiry group was welcomed with a pōwhiri at the Palmerston North arena before hearing from police, district health boards, judges, and community groups in Manawatū.
A range of government and non-government organisations from the Manawatū region delivered the first district submission to the inquiry.
Over the next few months the panel will travel the country, hearing from people with lived experience of mental health and addictions, staff, and those in the community. They will be discussing the current problems and possible solutions to improve services.
Inquiry chair Ron Paterson said in the 20 years since the last inquiry there had been a loss in direction.
The terms of this inquiry were far broader than previous inquiries and he had already heard of many issues with the current approach to mental health and addiction services, he said.
"(That) although it's still important that specialist mental health services that are provided from secondary care are there, ultimately the solutions are going to lie in our own communities, in our schools, perhaps in churches and social organisations and also, of course, across other social services, not just the health sector."
Panel member Barbara Disley was the country's first mental health commissioner, a role that was created as a result of the 1996 Mason Report in mental health services.
This inquiry had a different feel than the one in 1996, she said.
"We are now being asked to look more broadly and widely at not only what happens when people are in distress and need the support of services but also to look at how can we stem the tide.
"What are some of the issues in Aotearoa that are actually contributing to poor outcomes for people and what might we do in the future going forward that could generate a much wider, positive focus on mental health wellbeing so that people actually have the opportunity to flourish."
Dr Disley didn't appear keen for an inquiry last year but said she changed her mind when momentum grew.
"What changed my mind was the fact that the voice of people became much louder, particularly with the election, around what people were seeing as an opportunity to really look a bit more deeply at the mental health issues."
"Also the government's stated intentions that they were really keen to have a short, sharp review and then to do something about what the identified issues were. My concern back prior to the election about a review was that we could spend two years or so on a review when actually it was quite evident that some things needed to change a lot more quickly than that.
"I was really keen to make sure that change wasn't stalled while people were thinking about what the problems might be."
The inquiry has already held 50 private meetings, but today marked the start of the consultation phase, which gives communities the chance to have their say.
MidCentral District Health Board was among those who spoke.
Its chief executive Kathryn Cook said the DHB covered an area six times the size of London, including Tararua, Levin, Ōtaki and Feilding.
She would like to see a more coordinated community based approach, one that moves away from the medical model.
"We need everything, we need to just keep trying all the time to do better, whether it's doing better with the money that we have. I talked about unlocking the resources that sit in all the very many agencies that work in this city. We can do much better if we bring those resources together.
"There are many strengths within our system and we'll always need to focus on those elements that are already a part of our system, including our hospital-based services and our community mental health services but we need to do better. There are too many people in this country that are experiencing the reality of living and not living well with mental illness."
Materoa Mar is the chief executive of Te Tihi o Ruahine, the local Whānau Ora Alliance.
There needed to be more community engagement, she said.
Ms Mar wanted more opportunities for community compassion and engagement, as well as amping up the role of the Mental Health Commission.
"Maybe we've lost our way a little bit, so rather than say 'let's take the deficit view of that', I'd rather much look forward to the future.
"Quite a lot of what needs fixing is broken … I do actually think we should start again.
"At a structural level I think we require some sort of body, like a commission. I think the commission should have a broader scope than what it had previously to include aspects that impact on mental wellbeing in other sectors - like Corrections and police and education."
The inquiry is due to report back to the government by October.