He Ara Oranga endorses the Equally Well collaborative, citing it as an example of good practice to address physical health inequities (p.6). He Ara Oranga also calls for an increase in collective impact approaches, like Equally Well, as part of a transformed mental health and addiction system. This public acknowledgement is a reflection of all of your commitment and actions collectively, as Equally Well champions. Such great work by everyone, thank you.

Now that the government has formally responded to He Ara Oranga, collectively we need to ensure a focus on physical health is front and centre of a transformed addiction and mental health system.

Over the past five years the Equally Well collaborative has been championing what we need to do to bring physical health into the core of a mental health and addiction system and to make visible the physical health inequities experienced by people with addiction and mental health issues across health. However if we were in any doubt as to what this should and could look like the Lancet Psychiatry Commission’s Blueprint for promoting physical health provides ample evidence on how to bring physical health care into the core of mental health and addiction care and vice-versa.

The Equally Well collaborative continues to express the need to increase choice and reduce the reliance on pharmacological responses, as an important contributor to improving physical health.

He Ara Oranga recommends increasing choice by broadening the types of mental health and addiction services available. The Equally Well collaborative continues to express the need to increase choice and reduce the reliance on pharmacological responses, as an important contributor to improving physical health. A transformed system would include prescribing practice balancing the physical health needs with mental health and addiction needs; medication discontinuation discussed routinely in consults, and active support given to people who would like to consider medication discontinuation. All these strategies are strongly endorsed by the Lancet Commission Blueprint.

He Ara Oranga also recommends increasing choice by broadening service responses. Broadened service responses need to include access to quality housing and employment as core components. Socioeconomic status and housing circumstances are major contributors to the physical health inequities experienced by people with addiction and mental health issues.  A transformed system will need to include access to individually tailored support for people who wish to get and keep work and support for finding and sustaining safe affordable housing.

Whilst we look to implement He Ara Oranga’s recommendations as Equally Well champions we must not forget that Equally Well spans the health and health-related sectors. The Simpson review of the Health and Disability System is still underway and a consultation report is due out in August. The physical health of people experiencing mental health and addiction issues needs to be a priority for the whole of the health system. It needs be a reportable health equity issue which all the health and disability system are accountable for addressing. This would include, for example, monitoring and improving the quality of cancer care for people who experience mental health and addiction issues, ensuring equity of access to cancer screening, and cardiovascular risk assessments, and ensuring trauma-informed approaches are embedded in all health services. 

As Equally Well champions please influence this wider review of the health and disability system whenever you can. Please also continue informing and raising awareness and supporting a transformed addiction and mental health system which improves physical health as well as supporting mental health and addiction needs.