Other Information - Mental Health Services Strategy Documents
Q. What is the national mental health strategy and where can I obtain a copy?
The current National Mental Health Strategy is detailed in Te Tāhuhu: Improving Mental Health 2005-2015: The Second New Zealand Mental Health and Addiction Plan (Te Tāhuhu). Te Kōkiri: The Mental Health and Addiction Action Plan 2006-2015 (Te Kōkiri) is the associated action plan. Both are published by the Ministry of Health. Contact details for the Ministry are:
P.O. Box 5013
Wellington
New Zealand
+64 4 496 2000
http://www.moh.govt.nz
Te Tāhuhu sets out the ten leading challenges and outcomes that Government expects the mental health and addiction sector, state services and other agencies to pursue in the period up to 2015. These outcomes include all New Zealanders making informed decisions to promote their mental health and well-being. Outcomes also include people with experience of mental illness and/or addiction having the same opportunities as everyone else to participate in the everyday life of their family/whānau, communities and society.
The second Ministry document, Te Kōkiri, sets out the specific actions that will be taken by the sector during the period up to 2015 to progress the ten leading challenges in Te Tāhuhu. For example, actions to build mental health and/or addiction services include strengthening the linkages between services and primary health care, and continuing to develop and contribute to intersectoral activities that support recovery. Actions to increase responsiveness include implementing initiatives that recognise the importance of family and increasing their participation.
Te Kōkiri does not set out actions for agencies outside the mental health and addiction sector. However, it recognises that a wide range of government agencies (for example, housing, labour and education) can contribute to the Government's overall aim for mental health and well-being. Hence the emphasis on intersectoral activities.
Q. What is Te Hononga?
Te Hononga provides a single, unifying picture of the sector in 2015 from the perspective of the Mental Health Commission. This picture is derived from Te Tāhuhu and Te Kōkiri. Te Hononga complements, supports and builds on both Ministry documents. It has the twin aims of promoting mental health and well-being for all New Zealanders and reducing the prevalence of mental illness and/or addiction.
Te Hononga's focus on values and the kind of society we share reminds us how and why we need to keep moving towards well-being for all New Zealanders.
In 2004, the Commission consulted with service users and produced Our Lives in 2014: A Recovery Vision from People with Experience of Mental Illness (Our Lives) to inform the development of Te Tāhuhu. Te Hononga builds on the vision and aspirations of service users detailed in Our Lives, looking beyond the mental health and addiction sector to include the wider social and health sectors and New Zealand society.
The picture that the Commission portrays in Te Hononga for 2015 is not just about how a strengthened mental health and addiction sector (both government and non-government) will look. It's also about better lives for everyone, and the types of systems and society there will be to support this.
Te Tāhuhu, Te Kōkiri and Te Hononga
The Commission considers that it is important to help ensure that everyone arrives at the same place (a state of well-being) at the same time (2015). By way of analogy, it is helpful to have an illustration of the finished product, along with the instructions, when building a model. Te Hononga provides this picture for 2015.
Q. What is the Blueprint for Mental Health Services?
The Commission's Blueprint for Mental Health Services in New Zealand: How things need to be (PDF, 407kb), provides a practical basis for strategy implementation. It was developed over 1997 and 1998 to help planners, funders and providers of mental health services to implement the national mental health strategy for more and better mental health services. Subsequently, the Blueprint was adopted as a national policy and planning document. It has been endorsed and supported by successive Ministers of Health.
The Blueprint describes the broad groupings of people who need mental health services - age groupings, ethnicity groupings, high needs groups etc - and the range of services that need to be available to meet the needs of these people. It also describes the philosophy of recovery that should underpin these services, that is the assumption that most people will get better and can live well even if their symptoms recur or persist. It is about more and better mental health services.
It strongly emphasises the need for a recovery approach in the provision of services, the importance of respect for individual rights and recognition of equality in recovery from mental illness. There is an expanded section on meeting the needs of Māori; specific sections on the needs of Pacific people; and the needs of the families and whānau of people with mental illness are also given greater recognition.
It assumes that three percent of the population have severe mental health disorders, and another five percent moderate to severe disorders.
Q. What are the National Mental Health Standards and how do they relate to DHB mental health services provision?
The National Mental Health Standards were first developed in 1997 to help address issues of quality performance in service delivery. They provide clear guidance to service providers, services users, family and whānau of what they can expect from mental health services in New Zealand.
The standards were updated in 2001 and became the Mental Health Sector Standard. This is a dynamic document that reflects the ongoing changes and challenges of the mental health sector. To facilitate this process a review form is included at the front of the standard to help people to contribute to the review process. A copy of the National Mental Health Sector Standard can be purchased from Standards New Zealand at Private Bag Box 2439, Wellington or by phoning 04 498 5990. This current standard, NZS 8143:2001, replaces NMHS 1997.
The Standard is referred to in Objective 3.4 of the National Mental Health Strategy, which is to implement, throughout mental health services, best practice and continuous quality improvement consistent with the National Mental Health Sector Standard. There are 18 standards, each of which relates to a particular area of service delivery. These are commonly identified by number, for example, people will speak of Standard 9, which relates to consumer participation. The areas covered by the 18 standards are:
- Tangata Whenua
- Pacific People
- Cultural safety
- Children and young people (note: this standard should be read in conjunction with other mental health sector standards)
- Rights of people receiving services
- Safety
- Records and confidentiality
- Privacy
- Consumer participation
- Family, whānau participation
- Minimising the impact of mental illness
- Leadership and management
- Access
- Entry
- Assessment
- Quality treatment and support
- Community support options
- Reducing discrimination and promoting community acceptance.
By July 2000, providers were required to provide evidence of achieving these standards. Contracts for provision of mental health services now routinely require achievement of the National Mental Health Sector Standard. However, during 2000/2001 there was limited national monitoring of DHB services against the standards, and none for non-government organisations (NGO).
The National Mental Health Sector Standard is being reviewed in 2007/2008.
Peer Support
The Commission recognises that peer-support services can play a key role in recovery and well-being. Previous work has advocated for the development of peer supports in New Zealand and Te Hononga describes 2015 as a time when peer supports are "integrated across the sector and complement other services available". It also states:
Peer support builds on the connections between people with similar experiences. It values the insights and knowledge gained from having ‘been there' and involves the mutual giving and receiving of support. In 2015, people with experience of mental illness and/or addiction will deliver a diverse range of peer supports available to all service users and their family/whānau. (Commission, 2007, p 68)
A previous review undertaken on behalf of the Commission concluded that the international research on service-user led services reported very positive outcomes for those using the services. However, it was also found that there were a wide range of models or service types covered by the literature and that it was not possible to identify any specific model(s) that would be better than others for use in the New Zealand mental health and addiction sector.
The Commission's work programme for the 2007/08 financial year aligns to the goals set out in Te Hononga and the Mental Health Commission Amendment Act 2007. The 2007/08 Peer Support Project focuses on promoting the building of peer-support services through increasing knowledge of the most appropriate model(s) for further development in New Zealand.
In particular the 2007/08 project aims to:
- provide a review of recent research on peer supports - not to duplicate those included in the review released in 2005
- outline various models of peer support
- identify critical components of effective peer supports.