For older people and frail people, the long-term benefit of medicines reduces and the potential for harm from adverse effects increases. When the benefit–risk balance changes in this way, medicine review and optimisation are important to simplify the therapeutic regimen, reduce inappropriate medicines and minimise risks. In this article, pharmacist prescriber Linda Bryant uses two case studies to illustrate important considerations during medicine reviews
Budget must prioritise child mental health after abysmal New Zealand OECD ranking
Budget must prioritise child mental health after abysmal New Zealand OECD ranking

The findings of UNICEF’s Report Card 19 paint a devastating picture of a country failing its youngest, the New Zealand Association of Counsellors (NZAC) says.
Titled Fragile Gains – Child Wellbeing at Risk in an Unpredictable World, it ranks New Zealand last out of 36 OECD and EU countries for child and youth mental health.
NZAC President Sarah Maindonald says this isn’t a first; Unicef’s Report Card 16 also ranked New Zealand's youth suicide rate as the second worst in the world.
“Why does our youth suicide rate remain one of the highest in the OECD? And why do we keep featuring at the bottom of the table for youth mental health?
“Because we keep tinkering around the edges rather than confronting this crisis head-on.”
Maindonald urges the Government to use the upcoming Budget to deliver targeted funding to increase the number of school guidance counsellors, aiming to reduce the current student-to-counsellor ratio to 1:400 over the next two years.
Currently, estimates suggest there are only around 300 school counsellors nationally, a figure that falls far short of meeting student needs.
“Too many young people are falling through the cracks because they simply don’t have anyone to talk to,” Maindonald says.
“Counselling in schools is not a luxury, it is essential.”
The Education Review Office’s 2023 report, Someone to Talk To: Evaluation of Counselling in Schools, confirms that effective school counselling improves students’ mental health, learning, and general wellbeing.
The report also found that students accessing school-based counselling had better attendance and felt safer and more connected at school.
“We know what works. What we lack is political will and sustained investment,” says Maindonald.
“It’s time for this Government to make children’s mental health a real priority. Put counsellors where they’re most needed: in schools, early, and consistently.”
Mental health intervention needs to start much earlier in life, Maindonald says, and the Budget is the Government’s clearest opportunity to show it is listening to the evidence.
“We’ve been advocating for increased counselling for children and teens in schools for over 10 years. And the Awhi Atu Awhi Mai pilot was a brilliant step towards realising an ambulance at the top of the cliff.
“But we’ve got to stop being shocked by these rankings and start taking responsibility for them. The wellbeing of our children depends on it.”