Community mental health care in Aotearoa New Zealand. Past, present, and the road ahead

Aotearoa New Zealand has a relatively long history of providing community mental health care. Policies and services concerning the mental health and addiction sectors have undergone various reforms; first, during the transition from a hospital-centered to a community-based system, and second, in successive attempts to improve this system. In this article, we discuss the impact of colonization on community mental health, the emergence of community-based mental health and addiction policy and services in Aotearoa New Zealand, and the challenges along the way. We also provide an overview of the current system, which is now entering a significant period of reform. Finally, we identify five key areas requiring special attention during this period of reform. Overall, we believe there is broad support for reducing the emphasis on individualized approaches to mental wellbeing and moving all systems and structures towards models inclusive of social context, including approaches that incorporate family, communities, culture, and the needs of broader society. We look forward to policy and services with a much stronger orientation to the diverse needs of our population.