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To: The House of Representatives; and the Cross-Party Mental Health and Addiction Wellbeing Group

Ensure access to ERP therapy for people living with OCD

Over 50,000 New Zealanders live with the mental distress of Obsessive Compulsive Disorder (OCD). Exposure Response Prevention (ERP) therapy provides the skills needed to break free from OCD, whereas other kinds of therapy are ineffective. It is frustrating and wrong that ERP therapy is very difficult to access in the public health system (1).

Those who can afford to do so turn to the private sector. Many people living with OCD can’t afford private therapy. The Disability Allowance is nowhere near enough to cover the cost of a course of weekly treatment. Those who do manage to gather enough money will struggle to find a psychologist or psychotherapist who has expertise in ERP and is accepting new clients.

People remain trapped in an exhausting cycle of unwanted scary thoughts (obsessions), fear, doubt and anxiety, and time-consuming routines (compulsions). Everyday activities such as going to school or work, sharing a meal and driving a car can become impossible. People often get exhausted, and more problems develop - relationship breakdown, unemployment, depression, substance use, self-harm and thoughts of suicide.

We call on the The House of Representatives and on the Cross-Party Mental Health and Addiction Well-being Group to support the 50,000 New Zealanders who live with OCD, by ensuring timely and equitable access to effective therapy via training to expand the workforce capable of delivering ERP therapy, both in primary and secondary care.

Why is this important?

Fixate is an online community for NZers living with OCD or supporting someone living with OCD, with over 800 members. Personal experiences shared within Fixate reveal heart-breaking stories of individuals and families struggling with untreated OCD. Aside from the enormous personal cost, there is a hidden public cost in the “revolving door of care'' where people receive ineffective support for unrecognised, misdiagnosed or untreated OCD.

Early diagnosis and targeted interventions would reduce both suffering and the need for costly support and long-term therapy down the track. When emerging OCD symptoms that could be “nipped in the bud” are left untreated, they become embedded and more resistant to treatment.

The best practice treatment for OCD is ERP therapy (2). Sometimes this can be accompanied by medication that ‘quietens the obsessive thoughts’, making it easier to do the exposure work. Most people who access these treatments experience substantial improvement and/or recovery (where troublesome unwanted thoughts still occur, but are manageable and no longer disrupt everyday life).

In Aotearoa New Zealand, people experiencing severe OCD are referred to secondary mental health services. However there is a high bar to acceptance of referrals and staff with expertise in ERP therapy are reportedly scarce to non-existent. Even when a referral is accepted, people are added to long waiting lists and don’t access treatment for many months. Those who don’t meet the threshold for referral are left in primary care where health professionals lack training in ERP therapy.

1. https://www.stuff.co.nz/life-style/wellbeing/125409931/obsessive-compulsive-disorder-convinced-woman-she-was-a-dangerous-murderer
2.https://journals.lww.com/intclinpsychopharm/Fulltext/2020/07000/Clinical_advances_in_obsessive_compulsive.1.aspx
To learn more about people living with OCD and ERP therapy, go to
www.ocd.org.nz
https://iocdf.org/blog/2017/03/31/view-the-new-documentary-living-with-me-and-my-ocd/
https://www.lawsociety.org.nz/news/lawtalk/lawtalk-issue-944/obsessive-and-compulsive

How it will be delivered

Update 1 June, 2023: The Health Select Committee report on our petition has been released. The report mainly consists of a summary of the various submissions, with a final section “Our response” which includes recommended actions.

The full report can be read here:

https://selectcommittees.parliament.nz/v/SelectCommitteeReport/ececc3ab-8a59-43e4-ca1d-08db621220f8

Updates

2022-04-25 19:20:41 +1200

1,000 signatures reached

2022-04-21 18:57:34 +1200

500 signatures reached

2022-04-19 23:15:29 +1200

100 signatures reached

2022-04-19 21:13:02 +1200

50 signatures reached

2022-04-19 20:29:05 +1200

25 signatures reached

2022-04-19 20:02:10 +1200

10 signatures reached