Family inclusion in Mental Health and Addiction Services

In 2007 the functions of the Commission were reframed to align them with future directions and imperatives in the mental health and addiction sector. Included in these functions is a renewed focus on advocating for the interests of people with mental illness and their families, while taking into account the interests of other stakeholders.

In 2007 the functions of the Commission were reframed to align them with future directions and imperatives in the mental health and addiction sector. Included in these functions is a renewed focus on advocating for the interests of people with mental illness and their families, while taking into account the interests of other stakeholders.

The Commission's twin aims are to improve mental health and well-being, and reduce the prevalence of mental illness. Critical to achieve these goals is looking at how families can be strengthened to make them more resilient to periods of stress, anxiety and trauma and included in the care and decision-making of their loved one's entering the mental health and addiction sector. The Commission's strategic direction is informed by the destination presented in Te Hononga 2015: Connecting for greater well-being. Te Hononga recognises that:

• The family unit has always been, and will continue to be, the foundation of support, strength, security and identity to build and maintain well-being across society.
• To achieve well-being the needs of individuals, their families/whānau and communities must all be supported to flourish.
• Family well-being for all will be supported through practices that incorporate many components of whānau ora.
• Responsiveness will also be evident in family-inclusive services and in the provision of direct services to meet the needs of family/whānau.

Within mental health and addiction services there is always an inherent tension for providers in district health boards and within the community to weigh up the rights of mental health service users, versus the rights of families/ whānau, being involved in the decision-making on treatment and care arrangements for people living with a mental illness. First principle is that service users have the right to determine who is involved in the decision making on services provided. However, long-term it is important that families and whānau are engaged, as in many cases, care of a service user returns back to the family/ whānau.

People with experience of trauma, anxiety, stress, or mental illness do not go through the experience by themselves. Their experiences are shaped by, and impact on those around them; most importantly family/ whānau. The concept of ‘family/ whānau' goes beyond just kinship lines but also chosen support networks for a person with a mental illness. Families/ whānau can play an important role in building strength and resilience and enabling recovery of people facing anxiety, stress and trauma or living with mental illnesses. This point is supported by WHO mental health policy and service guidance notes that stress the needs and rights of families should balanced with the needs and rights of individuals with mental disorders (World Health Organization, 2003).

Mental illnesses can never be separated from the social context; they are shaped by the social and cultural values of communities, including family/ whānau. However, when considering developmental and behavioural influences on a person, family/ whānau are the most important agent of influence. Family members are often identified as being responsible for each other's development, stability, and protection. Members of family and whānau are also linked through shared experiences, and economic, emotional and political bonds.

Current Commission work underway

The current focus for the Commission around family inclusion in mental health and addiction services is focussed on children and youth.

Work expected to be published in 2008 will include:

1. A literature review highlighting
• beneficial role that a family can play in the recovery of child and youth service users (particularly in Pacific and Māori families/ whānau) in the child and adolescent mental health and addiction sector.
• importance of whānau ora.
• the need for families to gain a better understanding of mental illnesses and/or addiction, and resilience and recovery processes for their children and adolescents.
  
2. An accompanying occasional paper that expands upon the ipact of care and the role of family/whānau in mental health and addiction child and youth focussed services.
3. An occasional paper outlining the legal framework for the undertaking of family inclusion in child and youth focused mental health and addiction services and advice on how to resolve issues of conflict for practitioners.

Previous Commission Literature (provide links)

• Recovery Competencies for New Zealand Mental Health Workers (2001)
• Review of Information Sharing Policies and Practices of District Health Board Mental Health Services: Report on Stage 1 (2004)
• Family - A Samoan Perspective: Occasional Paper - No.4 December (2003)
• Four Families of People with Mental Illness Talk About Their Experiences (2000)
• Report of Review of Consumer Opinion and Family Opinion About Mental Health Services (1998)
• Journeys of Despair, Journeys of Hope: Young Adults Talk About Severe Mental Distress, Mental Health Services and Recovery (2006)
  Te Haererenga mo te Whakaōranga (2007) - chapter 8.

References

World Health Organization. (2003). Mental health legislation and human rights (mental health policy and service guidance package). In Department of Mental Health and Substance Abuse (Ed.): WHO Press.