As a mental health client, I take a range of medications, but the two most effective are the expensive ones. I really do fear the measures that Pharmac will have to take in order to keep their budget under control. After all, there are similar drugs in the same class as the ones I take, and many of them are off-patent. De-funding these expensive ones in order to provide more access to more drugs for more people is understandable - and it would be catastrophic for me and many others who have played medication roulette for a long time and finally found something that works.

I know my perspective on this rather large topic is very narrow and personal. The bigger issues matter too, and I know they will affect me in different ways, but this is the way that would do the most damage to my family and I.

I’ve known people to totally reject counselling as an appropriate treatment for their issues, but accept that SSRIs treat a chemical imbalance, which is less stigmatised than being mentally unwell.

Being on antidepressants is much easier to hide than having to take time off for lengthy counselling appointments, so it can appeal to people who don't want other to know they're unwell.

I wish people didn't feel like they have to hide these things, but then, it took me a good ten years or so to 'come out' fully. Our culture has some way to come on this.

it’s just that when I’m low it feels as if being dead is a much better option

And it's ridiculous that because you passively don't want to live, instead of actively wanting to die, you don't get adequate treatment. It's like they take on the actively suicidal because it looks bad if you turn away a suicide risk and they kill themselves, but they don't adequately treat people who, with the right help, can actually have a decent quality of life. Because quality of life doesn't matter in the wildly overstretched system we have - they can barely cope with the most ill of the mentally ill - what resources do they have for those that are just very unwell instead of extremely unwell?

Fortunately that was an error, their is no drop from 16 to four

Well, that's bloody good news!

This is not, of course, just about depression. There is no drug that could even theoretically replace relationship counselling.

And then there's also ACC counselling. Debriefing for victims of sexual abuse and trauma. Down from 16 sessions to four. How on earth is that anywhere near enough time to work through what horrors they have been through? These people are traumatised, and they've had to relive their horrors for a stranger in order to access the funded counselling. How can anyone in good faith say that these victims can realistically be helped properly in four bloody sessions?

When I mentioned prominent thoughts about dying – and being as low as I’ve ever been – it was pretty much ignored.

If this is how you are feeling, then you need to go back and keep asking for help. You can't go on with a treatment plan that is not working and suicidal ideation. That's just a recipe for disaster. Go back to your doc. Tell them again that you're suicidal. If that doesn't work, or if you can't, call your hospital and ask for the mental health crisis team, and tell them. Don't leave it until it's completely too late. I've lost people who never got help. It's an aching void in my life. And I have been so close to being that loss, saved by the power of modern medicine and an unusually hardworking liver.
Doing what you need to do in order to get help can involve a lot of banging your head against the wall. But it's worth it, for the sake of your life.

Thank you all for your comments so far. The range of experiences underlines that both talk therapies and medications have their places, and their use depends entirely on the individual's needs. The service in Christchurch sounds like something that should be available everywhere, and I'm disappointed that it's not.

“How do we even know that talk therapy works anyway”

How did they manage to miss the piles of research that is behind the recommendations of groups like the NHS? Mild to moderate depression = talk therapy. It's the standard of treatment, and antidepressants aren't supposed to be initiated unless the depression does not resolve or it is severe. How do they not know this?

It gives me a little bit of hope that at least somewhere in the country, people are being offered that option. My experience, and the experience of several people I know, has not been so positive. I wish it had been, and I wish therapy was more widely available. As you point out, it makes a difference for people.

And how I wish that they would factor that in to their calculators