Mental Wellbeing and Local Government

Mental Health Foundation of New Zealand 2012

Introduction

Wellbeing is at the core of local government activities. There is no better time for local government to realise the added value generated from proactively promoting thefull wellbeing potential of its residents. In particular, the Mental Health Foundation believes that if mental or psychologicalwellbeing ispromoted by local government, communities and individuals are more likely as citizens to have higher aspirations, have the optimism that aspirations can be achieved, and the resilience to overcome challenges along the way. This paper sets out the rationale for local government to incorporate mental wellbeing at the core of its planning in the future.

Wellbeing and the Local Government Act

Presently the purpose of local government as laid out in the Local Government Act 20021is to:

  • enable democratic local decision making and action, by and on behalf of, communities;
  • promotethe social, economic, environmental, and cultural well-being of communities, in the present and for the future.

The structure of local government in New Zealand covers regional, city and district councils. Local government provides for democratic local decision-making through elected representativesand promotesthe wellbeing of local communities both urban and rural.

Under the decision-making requirements in the Act, a local authority must be able to demonstrate how their decisions contribute to wellbeing.2However wellbeing itself is not defined in the Act. Most councils have adopted the definitions of wellbeing developed by the relevant government agencies – for example the Ministry of Social Development or the Ministry for the Environment.3Various Councilsthen develop their local strategies, for example, for social wellbeing. Definitions can be broad -‘Social wellbeing includes the health, access to knowledge and skills, safety and security, participation in paid work, human rights, culture and identity, the economic standard of living, social connectedness, and the quality of the environment’4 oreven overlap with promoting mental wellbeing: ‘Social Wellbeing refers to those aspects of life that we care about as a society and which contribute to our individual happiness, quality of life, and welfare’.5This cross-over is reflected in some overseas literature which uses the phrase ‘psycho-social wellbeing’ to cover both psychological and social wellbeing.

Wellbeing as an outcome under the Local Government Act 2002 should follow what the particular community wants to achieve. The important issue here is democratic participation. As part of this, the Community Outcomes process6develops statements of what local communities wish to prioritise, now and in the future. These statements are identified through regular community consultation. Their purpose is to help guide groups and organisations that contribute to community wellbeing, and hence promote better co-ordination of community resources.

Another key issue covered by the Local Government Act 2002 is the need for Councils to plan for sustainability.7 Often sustainability is seen as focused on economic wellbeing and environmental considerations. But for development to be sustainable over the long term,social and cultural well being must be addressed as well. The provision of community infrastructure, developing social and cultural trends, and the wider context both national and global are other aspects that have to be considered.

In line with local government commitment to the Treaty of Waitangi, the status of manawhenua and Maori models promoting wellbeing need to be a part of the decision-making process. For example Te Pae Mahutonga8 asserts the importance of mauriora (cultural identity), waiora (environmental protection), toiora (healthy lifestyles), and teōranga (social participation), which require a context of ngāmanukura (effective leadership) and manawhakahaere (autonomy). The inclusion of kaupapa Maori strategies is vital to ensure true representation of iwi, hapu and whanau.

Wellbeing and local government planning

How is wellbeingcurrently incorporated intolocal government planning? For example, how is the wellbeing of all put first in planning integrated transport systems for current and future needs? Transport affects economic growth, the wellbeing of communities and the environment. The driver for change must be the wellbeing of the community as a whole, guaranteed through effective citizenship, adequate consultation and democratic accountability. Many current commuters have great ideas and strong feelings about transport – how can the atmosphere be created where residents who have never talked before start sharing their valuable ideas? How can it be done well, in a positive and connected way with others in the community?

A current example of environmental wellbeing at a local level is the Conscious Consumers Network.9Being a conscious consumer means thinking about how the purchases made every day can affect other people and the planet.This cafe project received an environmental grant from the Wellington Council in 2008 to establish itself as a Wellington-based not-for-profit organisation.Since then the programme has expanded to Auckland and the Waikato with funding from those councils.Or take the commitment of Kaikoura District Councilwhich is engaged in an exciting, bi-cultural process where their commitment to environmental wellbeing is clearly and publically stated. ‘The Kaikoura community is committed to protecting our environment for residents and visitors, and for our future. Our community is internationally recognised for their actions through independent environmental certification, and the on-going actions of our community show a commitment to sustainability’.10

Another example is a collaborative project involving Auckland Council, Sport and Recreation New Zealand (SPARC), Sport Auckland,Auckland Football Federation, Auckland Badminton Association called Connecting with Diversity.11The project specifically aims to get more people from diverse communities both participating and volunteering in sport.

The Christchurch City ‘Health and Wellbeing Profile’12providesinformation about Christchurch's population and the factors that influence their health and wellbeing. It was largely developed prior to the February 2011 earthquake but now provides up-to-date data about what people value about life in Christchurch. It is part of a collaborative partnership (Healthy Christchurch) which involves the Council, the Canterbury District Health Board, the Police and local health services which enables better decision-making and the ability to align health and wellbeing with other parts of the re- constructive effort, for example, of new houses or places of work.

Proposed Local Government Reforms

In March 2012, Nick Smith (the then minister of local government) announced a planto reform local government with proposals including refocusing the purpose of local government. The ‘four wellbeings’ in the present Act are to be replaced by a narrower purpose for councils of ‘providing good quality local infrastructure, public services and regulatory functions at the least possible cost to households and business’.13 This comes in a climate of concern voiced by government about the ‘enlargement of local government’s role in the decade since the passage of the Local Government Act 2002’.14However the 2002 Act never forced local governments to achieve wellbeing in the four areas noted, only to promote it. If Councilshave an active commitment to community wellbeing now, it appears this might reflect the wishes of the community concerned rather than unsustainable expansion of Council activities.

Local government and mental health

Within the wider context of wellbeing, the impact of mental health at a local population level is significant. Social and economic capital in communities relies on psychologically and physically healthy flourishing individuals and groups who can interrelate positively and contribute. Mental disorder is common in NZ – almost 1 out of 2 people will experience some form of mental illness in a lifetime, with 1 out of 5 in the last twelve months.15People with mental illness are more likely to also have several chronic physical conditions and are at higher risk of suicide, particularly people with depressive or mood disorders. Around 3% of the population reported days when they were completely unable to work or carry out their normal activities due to mental health problems.16The majority of people with mental disorders such as depression and anxiety problems are employed, but struggling with their jobs.16Discrimination can also cause people who are labelled mentally ill of being denied important opportunities and services that are essential to achieving wellbeing.17

While mental illness and associated stigma and discrimination can be a drain on community capacity, positive mental health can strengthen it. Positive mental health and wellbeing is more than the absence of mental illness. The World Health Organisation definition of mental health is: ‘ a state of wellbeing in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community’.18Or put differently ‘ Wellbeing is about how people experience their lives - for example, people must feel able to achieve things or feel they have a sense of purpose to have meaning….Wellbeing is about the personal and the social’.19

Recent analysis on the concept of positive mental health or ‘flourishing’ in people and communities has explored positive subjective states of experience, and functioning, and their personal and social benefits as part of a full spectrum approach to mental health.Population studies from Europe20 and the United States21would suggest that around 80% ofthe population in these countries, and also quite possibly in New Zealand may not be living to their potential because of sub-optimal mental health.

Increasing positive mental health so that more people flourish in life is relevant to the whole populationandneeds to be part of an active policy platform locally, regionally and nationally. Evidence shows that positive mental healthimproves a range of social physical health outcomes22,23,24including:

  • better physical health
  • less mental illness
  • protection from disease
  • increased workplace productivity, decreases absenteeism
  • increased openness and acceptance
  • more participation in community life
  • less crime

Most importantly, mental wellbeing should be seen as a public good in its own right. Mental wellbeing – or the opportunity to flourish - should be considered a basic right and citizens should expect government to facilitate this.

How can mental health be increased in a population?

There are two key approaches to increasing mental well-being or ‘flourishing’. The first is by influencing the social determinants of health which are the conditions in which people are born, grow, live, work and age. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels. The social determinants of health are mostly responsible for health inequities - the unfair and avoidable differences in health status seen within and between countries.25 In New Zealand, influencing these determinants will mean meeting Treaty of Waitangi obligations, reducing inequalities, promoting safety from violence and exploitation, creating community cohesiveness, improving employment and ensuring a good early start in life forall children.

The second approach is by promoting positive personal behavioural change in engaging ways. Just as a healthy lifestyle includes ‘five fruit and vegetables’, a healthy flourishing lifestyle includes the ‘5 ways to wellbeing’. These 5 simple actions were devised as part of the Foresight Report, commissioned by the UK government in 2009 through the Government Office for Science, based on evidence about how to increase positive mental health.26 The 5 ways are - Connect; Take Notice; Be Active; Learn; Give. In the United Kingdom, a number of local Councils have adopted this approach. In New Zealand, the Mental Health Foundation has been using the 5 ways in a range of creative ways for almost three years as part of its contract with the Ministry of Health and is gaining traction in other sectors such as education, policy research and community NGOs.

This approach has a lot in common with present Council activities which address the mental wellbeing needs of communities. The Christchurch recovery has seen the development of the‘Strategic Planning Framework’27which supports individual recovery and community wellbeing, and builds community resilience. Many councils similarly carry out programmes which support community economic development, social cohesion, people-friendly urban design, environmental concerns and healthy relationships (eg family violence strategies).

There are overseas examples of councils taking a similar approach. The Mental Wellbeing Programme run by Lambeth Council in London28 is committed to improving the wellbeing and resilience of its communities. Another example is from the Liverpool City Council, which held a Year of Health and Wellbeing in 2010: ‘There are five ways to Wellbeing and 2020 the Decade of Health and Wellbeing is about encouraging people to build these ways into their daily routines and potentially add 7.5 years to their life expectancy. The underlying message through the five ways is that mental health and wellbeing is as important as physical health; feeling good is an important part of being healthy’.’29

Measuring mental wellbeing

The measurement of wellbeing outcomes and mental health is crucial if local government is to act on and see the benefits from promoting wellbeing. Previously the positive aspects of mental health have been clearly seen as either not measurable, not appropriate for measuring or not worth measuring. Concepts of wellbeing are becoming increasingly accepted as legitimate social outcomes. An increasing number of wellbeing measures have been developed internationally and more recently in New Zealand, for instance genuine progress indicators (GPI’s) in regional councils. The MHF congratulates the Greater Wellington Regional Council for utilising the Genuine Progress Index (GPI)30, a monitoring framework that assesses progress towards wellbeing goals and includes environmental indicators, and subjective measures of life satisfaction, happiness and community strengths. A country as small as New Zealand needs to design a national measurement approach that best fits its remit to improve the lives of local people, works within local context and provides a comprehensive, multi-dimensional picture of local wellbeing.

Another tool that is useful in measuring wellbeing is the Mental Wellbeing Impact Assessment31, a health impact assessment tool that assesses the impact that policies, services, programmes or projects have on the mental wellbeing of a population. This form of assessment can identify ways to strengthen positive impacts and diminish negative impacts and encourages a process to develop measurement.

Suggestions for the future

Local government in New Zealand already has a legislative mandate to promote the wellbeing of its citizens. The Mental Health Foundation asserts that this should remain in place and in fact be widened to include the key issue of mental wellbeing. Action should be taken to create the conditions for all people to fulfil their potential for mental wellbeing as well as to address the factors that undermine their potential. Local government has real power to drive change in the mental wellbeing of communities. This can be done through staff training, policy development, social marketing, community collaborations and building a knowledge base through partnerships with academics and mental health promotion agencies.

Such actions could include:

  • Developing a discussion forum with public health, community representatives, Maori, mental health agencies and elected officials from Council to assess the potential for mental wellbeing strategic actions at a local level
  • Use bi-cultural opportunities to develop and share models and strategies of wellbeing applicable to the local governance level
  • Build strategic leadership to explore the impact of an overarching comprehensive wellbeing framework for Council activity
  • Develop policy to form the basis of an education programme on flourishing for elected and non-elected officials
  • Allocate financial resources to a plan of action that works to promote wellbeing and prevent mental ill health
  • Include direct wellbeing promotion activities in the range of local government provision such as events, newsletters, community awareness campaigns, cultural activity and civic pride
  • Use the present evidence base to build wellbeing into the way services are designed, including population use of the 5 ways to wellbeing
  • Contribute to an annual national survey for local governments to measure the baseline and subsequent changes to the level of flourishing in New Zealand.

Mental wellbeing in practice will increase the input of residents into their local government and lead to greater empowerment and identification with the places they live. A flourishing community would reduce inequalities, encourage diversity and have meaningful participation in Council affairs. An emphasis on how to enhance the positive experience of ordinary people will increase the relevance of Council to their daily lives.

References

  1. Retrieved on 6 July 2012 at
  2. As per clause 77 of the Local Government Act 2002 (above)
  3. As cited under Ministry of Environment : Ministry Outcomes as retrieved on 13 July 2002 from
  4. Ashburton District Council (2008) Ashburton District Social Wellbeing Strategy Retrieved on 3 July 2012from
  5. Queenstown Lakes District Council (2006) Social Wellbeing Strategy for the Queenstown Lakes District Retrieved on 9 July 2012 from
  6. Ministry of Social Development Community Outcomes pg 12,13Retrieved on 3 July 2012 from
  7. Part 6, Section 77, Local Government Act 2002

‘A local authority must in the course of its decision making consider all reasonably practicable options and… consider the benefits and costs of each option in terms of present and future social, economic, environmental and cultural well being of the district…’

  1. Durie, Mason (1999) Te PaeMahutonga: a model for Mäori health promotion Health

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  18. Foresight Mental Capital and Wellbeing Project 2008 Final Project Report – Executive Summary The Government Office for Science, London
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