Engage Aotearoa

Category Archives: News

Taking part in the Mental Health and Addictions Inquiry

The Government Inquiry into Mental Health and Addiction has been established by the New Zealand Government in response to widespread concern about mental health and addiction services in the mental health sector and the broader community. It’s time to have your say about what works, what doesn’t work, and what else is needed. Submissions are due by 5pm, 5 June 2018.

Anyone can make a submission to the Inquiry. Service-users, family members, and mental-health professionals have especially valuable perspectives to share. There are a number of different ways you can make your voice count.

  • Fill out the Inquiry Panel’s consultation document. You can do this online or on a downloaded form. The consultation document is like a short survey that asks the following questions…
    1. What is currently working well? Why do you think it is working well? Who is it working well for?
    2. What isn’t working well at the moment? What mental health and addiction needs are not currently being met? Who isn’t receiving the support they need and why? What is not being done now that should be?
    3. What could be done better?
    4. From your point of view, what sort of society would be best for the mental health of all our people?
    5. Anything else you want to tell us? 
  • Write your own submission and email this to the Inquiry Panel. They will consider all submissions received. You can use the questions in the consultation document or not, the choice is yours.
  • You can also provide your submission over the phone by calling 0800 644 678 between 9:30am and 5:30pm Monday to Friday. Someone will be able to talk to you and write down your ideas about how to improve mental health and addiction in New Zealand.
  • Finally, you can attend a regional community meeting to share your ideas directly with the panel. You can complete their Expression of Interest form so they can keep in touch with you when they have updates to share.

Contact the Mental Health and Addictions Inquiry

Website: www.mentalhealth.inquiry.govt.nz

Email: mentalhealth@inquiry.govt.nz

Phone:  0800 644 678

The Latest from the British Psychological Society

In case you missed it, on the 1st of February the Division of Clinical Psychology at the British Psychological Society published a new report that presents a different way of looking at mental-health problems,  The Power Threat Meaning Framework.

The announcement explains, “A group of senior psychologists (Lucy Johnstone, Mary Boyle, John Cromby, David Harper, Peter Kinderman, David Pilgrim and John Read) and high profile service user campaigners (Jacqui Dillon and Eleanor Longden) spent five years developing the Power Threat Meaning Framework as an alternative to more traditional models based on psychiatric diagnosis. They were supported by researcher Kate Allsopp, by a consultancy group of service users/carers, and by many people who supplied examples of good practice that is not based on diagnosis.”

You can read the full Power Threat Meaning Framework or a shorter overview.

Find the original announcement here.

People’s Review of the Mental Health System

Share your story and help create a better mental-health system.

The people at Action Station have teamed up with Kyle MacDonald to create a People’s Review of the Mental-Health System. They want to gather together as many personal stories as possible, to convince our politicians of the need for improvements.

Their question to you is simple: what has your experience of the public mental health system been?

The public invitation goes on to say “Everyone has a story about mental health in New Zealand. Whether you work as a mental health professional, have experienced the mental health system directly yourself or someone in your family has, your story matters. We don’t need more statistics, the numbers already add up to make it clear that we have a crisis and need urgent action, and still nothing has been done. But personal stories can do what numbers cannot – they can move Ministers to action. Stories create empathy, and empathy creates change.

Find out more here.

GP referrals allow for free attendance to Raeburn House courses and groups

Raeburn House are now able to accept referrals from doctors to Raeburn House courses / groups and people who are referred to Raeburn House by their GP’s can attend the courses for FREE.  This includes all of the courses in their Building Resilience programme.

Contact: Kimberly Lamb, Programme Co-ordinator
Raeburn House, Northcote, Auckland 0627
T:            09 441 8989
F:            09 441 8988

Five x $10K Media Grants up for Grabs

MEDIA RELEASE: 8 July 2015
Mental Health Foundation of NZ

Are you a journalist or a creative artist who wants to change attitudes towards mental distress?

Five grants worth up to $10,000 each are now available for three journalism and two creative projects focusing on mental health issues.

The Mental Health Foundation (MHF) welcomes project proposals from journalists, photojournalists and those freelancing in print, radio or TV media; as well as artists, creative writers, musicians, and performers. Journalism, photojournalism and creative students may also apply.

“A new survey shows New Zealanders are less accepting of mental illness than they are of sexuality and religion, so in 2015 we have up to $50,000 available thanks to ongoing sponsorship from the Frozen Funds Charitable Trust and support from the Like Minds, Like Mine national programme,” MHF chief executive Judi Clements says.

Read the full media release here.

The deadline for applications is the 2nd of September 2015.

Read this flyer to find out more.

To receive an application pack or for more information:
Contact Cate Hennessy, Media Grants Co-ordinator
Ph 021 687 426 or email info@mediagrants.org.nz

US Supreme Court Rules Same Sex Marriage a Constitutional Right

The US Supreme Court ruled on June 26th that marriage is a constitutional right that extends to couples of the same sex, effectively legalising same-sex marriage across the United States and making it unconstitutional for any State to ban same-sex marriage.

In his ruling, Justice Anthony Kennedy declared, “No union is more profound than marriage, for it embodies the highest ideals of love, fidelity, devotion, sacrifice, and family. In forming a marital union, two people become something greater than once they were. As some of the petitioners in these cases demonstrate, marriage embodies a love that may endure even past death. It would misunderstand these men and women to say they disrespect the idea of marriage. Their plea is that they do respect it, respect it so deeply that they seek to find its fulfillment for themselves. Their hope is not to be condemned to live in loneliness, excluded from one of civilization’s oldest institutions. They ask for equal dignity in the eyes of the law. The Constitution grants them that right.

Read more here.

Research Evidence on Peer Support Work

In light of the recent media attention on Peer Support Work, the team at Engage Aotearoa thought it timely to share some research on peer support, should members of the community want to get some more information on the topic.

In a review published last year researchers cite a meta-analysis of 11 studies evaluating peer support against case management and clinical professionals in support roles, which concluded “No significant differences in symptoms, hospital admissions, service use, psychosocial functioning or client satisfaction were found. In a second category, six trials compared usual care with services with PSWs in adjunct roles, four with PSWs in mentoring or advocacy roles. There were no significant differences in quality of life, social relations, client satisfaction, hospital admissions, but a small reduction in emergency service use and a larger number of met needs. With these small benefits and no adverse effects found for PSW, Pitt et al. conclude in their review that PSW’s support was noninferior to support by mental health professionals” (emphasis added).

Reference: Mahlke C, Krämer UM, Becker T, Bock T, (2014). Peer support in mental health services. Current Opinion in Psychiatry, 27/4, 276-81. doi: 10.1097/YCO.0000000000000074

In a 2011 review researchers noted that “it seems prudent to mention that a result of no difference demonstrates that people in recovery are able to offer support that maintains admission rates (relapse rates) at a comparable level to professionally trained staff” (emphasis added). They also point to several studies that reported improvements in empowerment, sense of independence,  self-esteem,  hope and community integration along with reduced internalised stigma.  Authors outline several challenges that face peer support workers in the execution of their roles, which require training and organisational support and go on to conclude that peer support workers “have the potential to drive through recovery-focused changes in mental-health services.”

Reference: Repper, J., & Carter, C., (2011). A review of the literature on peer support in mental health services. Journal of Mental Health, 20/4, 392-411.

A 2012 study of peer support worker perspectives of their work, showed that peer support workers are aware of the many challenges they face and highlight the value of their training in enabling them to deal with such challenging issues as self-disclosure and managing boundaries.

Reference: Kemp, V., & Henderson, A.R., (2012). Challenges faced by mental health peer support workers: peer support from the peer supporter’s point of view. Psychiatric rehabilitation journal, 35/4, 337-40.

There is a notable lack of evidence to suggest that peer support work carries risks that are not inherent to any work in the mental-health field and which cannot be overcome without adequate training and supervision. In 2014, Te Pou launched a set of core competencies for peer support workers in New Zealand, to help define the role and help regulate who is able to practice as a peer support worker in mental-health and addictions services. Importantly, in Mary O’Hagan’s 2010 paper, we hear service-users’ own answers to the question “What are the benefits of peer support to you?
  • Knowing you are not alone. Seeing that you are able to live with a mental health diagnosis and still go to school, get degrees, have a job, have a relationship and family. Feeling you are more ‘normal’ or ‘okay’.
  • If it were not for peer support, I wouldn’t be alive.
  • My life was turned around.
  • It was my passage way to getting better, pretty much the only one.
Reference: O’Hagan, M., Cyr, C., McKee, H., & Priest, R. (2010). Making the Case for Peer Support. Mental Health Commission of Canada. Cited in O’Hagan (2011). Peer Support in Mental Health and Addictions: A Background Paper Prepared for Kites Trust.

Find out more about Peer Support in NZ at Kites Trust, the Peer Workers Association or Mind and Body Learning and Development.

Guest Blog: Robert Miller on the Social Bonds Pilot for NZ Mental-Health Services

Commentary on Latest Move of New Zealand Government Over Mental Health Care

UntitledLike many Kiwi’s, Robert Miller from the NZ Schizophrenia Research Group recently received a message from Annette King, health spokesperson for the Labour Party, asking him to sign a petition against the government proposal to trial funding mental-health services with Social Bonds. Here, Robert shares a few of his thoughts on this controversial new move to fund mental-healthcare. Social Bonds involves using a private investment model where companies put up their own funds and are reimbursed (with interest) only if certain outcomes are met. The process of ‘procurement’ is now well under way. By March 2015, seven potential partnerships were being assessed, with a view to ‘moving to implementation in the second half of 2015.’ The Government document mentions ‘NGOs, retail banks, and specially created partnerships’, but provides no details of which organisations are to be involved. The first four Social Bonds contracts have been announced and they all have work targets as the defined outcomes.

Greetings from Masterton!

Yesterday, I received two messages on the same topic – the government’s latest initiative for funding mental health care in New Zealand by what it calls ‘Social Bonds.’ One came from Annette King asking me to sign a petition, which I did. The other came from my good friend Julie Leibrich (former Mental Health Commissioner) expressing her serious concern about the government move. Here is her message –

‘National is planning to use Social bonds to fund mental health services.  Social bonds allow Government to contract out services and funding to non-government or private organisations, with agreed targets and timeframes. If the targets are met, Government pays back the investors, and also pays a return on their investment. The return depended on the level of results, up to an agreed maximum. Labour says that the risks of the policy are huge, because in order to meet targets providers are likely to focus on “easier-to-help” clients and not difficult and expensive ones. The Department of Internal Affairs warned that New Zealand should not “engage in trials or implementation of a social impact bond”. There is a good article about the dangers. I think that people with mental illness struggle enough as it is to get good care, and the idea of them becoming Guinea pigs in a social experiment is appalling. So I would be grateful if you would consider the petition, and if you want to, then sign it.’
~ Julie Leibrich, former Mental Health Commissioner

Since the pilot was announced, there has been much comment on the Social Bond scheme for mental health funding, in newspapers, generally highly critical. Let me make a few of my own comments, briefly, because there is urgency here.

(i) Mental health is probably one of the hardest areas of health policy to get right, and this government seems to think it is just about money. It IS about money, of course, but just as important (perhaps more important), it is about organisational culture, sensitive responsiveness to needs of clients, and morale in mental health services. It is quite possible for dedicated, highly trained and skilled staff to deliver a first class service when physical aspects of the service (buildings etc,) are distinctly below par. It is the ‘human capital’ as much as the funding available which matters. These aspects of a good service cannot be measured in the usual way in which profit and loss are computed.

Nowhere, it seems, does one sense that actual persons with their own hopes and dreams are involved. Collectively, they are just ‘a problem’ to be reduced

(ii) The nature of funding streams IS an important factor in delivery of mental health care. In something as complex as setting up an effective mental health service, with its community outreach, it would help if funding (especially of NGOs for mental health care) were not administered in such a way that different agencies who should collaborate, are forced to compete for funds.

(iii) Earlier this year I learned of someone writing a report about mental health for Treasury, found her e-mail address, wrote to her, but never received a reply. Maybe this government move is related to that report, although it has clearly been under development already for some years. In this case the government seems to be moving to get this inconvenient burden off its shoulders. The un-named banks and financial institutions are likely to have their bases outside New Zealand, have no responsibility to the New Zealand electorate, only to their shareholders. Apart from maximizing profits, mental health is an area which is not a money-making business, is not, and never has been capable of really generating a profit, except in a highly distorted sense of market discipline. In addition, I ask: What would be the ‘quid pro quo’ demanded by those private investors? If it seems that targets are not being met, and the return on investment therefore not likely to be forthcoming, what pressures will be put on services to meet the targets? What corners will be cut on ethical aspects of service delivery? What style of healthcare delivery would they require? Would delivery of mental health services become hostage to multinational enterprises, with agenda quite out of line with our own philosophy of healthcare?

(iv) There may be some merits in the social bond scheme as a way to bring about public/private partnership. However, if so, it would be better to test this particular model of such partnership in an easier area than mental health care. It seems as if this is being tried out in the mental health area first because ‘no one really cares too much about this anyway’. Government policy makers should reconsider the choice of mental health as the first place to try out this approach.

(v) In terms of ‘meeting targets’, the devil is in the detail. The main target appears to be getting people with mental health problems into paid employment; but this depends on many factors beyond control of any mental health service. In addition, for many service users, obtaining employment is the end of a long journey. It might be better to emphasize earlier stages of that journey, namely helping to rebuild personal resources of people whose normal development has been undermined by mental disorders. This might include entering and succeeding in higher education. Entry into paid employment would be a natural flow-on from this, which is a more fundamental form of assistance.

Immense flexibility is needed to cope with the individuality and idiosyncrasies of each client… Target-driven systems are unlikely to achieve this

(vi) In any case, this appears to be setting up a ‘pseudo-market’, possibly a subterfuge for covert administrative and government control. It also seems to imply that the government admits that devising a good mental health system is beyond its capability; and somehow, by offering financial incentives, the market in mental health care will somehow magic up a level of intelligence in this area, which is superior to the government’s own. This stretches credibility.

(vii) Administrators do like to set targets, as if the matter of concern is one where commands can be given, and outcomes/outputs delivered according to plan (but, in today’s world, using the ‘invisible hand’ of market forces as an intermediary). Those at the front line of any human services, especially mental health services, know better. In their practice, immense flexibility is needed to cope with the individuality and idiosyncrasies of each client, for instance in matching each client to the most suitable practitioner of counselor. Target-driven systems are unlikely to achieve this. Such flexibility is one of the features that make for a good organizational culture and good morale in those services.

(viii) The government’s plan is one more move – perhaps more dangerous than others so far – to move small aspects of our social services to enterprises based offshore. Others we know about include setting up private prisons, or catering services in hospitals, to name a couple. Who are the movers of this international trend? What are their real objectives? Early in 2014, as part of a resignation document I wrote, when I left committees of RANZCP, I shared a paragraph expressing my concerns, which contained hints of answers to those questions:

“…that entrusting mental health issues to untrained community people has encouraged re-uniting two policy areas which had been painfully separated in the second half of last century. The two areas are mental health and justice. In the nineteenth century in Western countries (and in many other countries still today), the two were not separated. Authorities who could put you away in an asylum were either medical people or JPs. Since 1950, there has been steady progress in prizing these two apart, so that the area where, inevitably, the two overlap, becomes a difficult and highly specialized discipline of its own – forensic psychiatry. I fear there are now accelerating moves to bring these two back together again. With international consortiums now running both private prisons in many countries, and some mental health NGOs, I fear that merging of the two policy areas is gaining momentum internationally, led by those whose ethical perceptions are quite different from most of those who will be reading this document.”

(ix) I have just sent in an abstract to the New Zealand branch of RANZCP for their forthcoming meeting in Hamilton in September. Basically this is about the history of psychiatry. Sadly I conclude that, over the last century a specialty, which, in the 1890s, had the promise to become a respected branch of personal health care, at least on the continent of Europe, was largely taken over by those who sought the most efficient way to administer a ‘social problem’. This emphasis is quite explicit in the Government document: Under the section titled “What is the Government looking for the Pilot to do? we read in its first bullet point “test the concept within the New Zealand context to see whether this is an effective and efficient way for government to reduce social problems” [emphasis added]. Nowhere, it seems, does one sense that actual persons with their own hopes and dreams are involved. Collectively, they are just ‘a problem’ to be reduced. Mental health care has insidiously become linked in the public mind to other ‘nasties’ of social policy, including (from 1834), workhouses and asylums, and then prisons, together with legal sanctions on prostitution, suicide, sexual orientation, street drugs, ‘welfare dependents’ and so on, all those areas that ‘nice people’ do not want to know about. The battle between these two has been raging for the last century, and more. I fear that parts of that battle are now being waged by international corporations, unaccountable to any electorate, probably in denial about the personal aspects of healthcare, or the person-centred ethical precepts, which should guide healthcare.

(x) Now is the time to challenge this outrageous government move.

Robert Miller

Learn More

About the author: Robert Miller was educated in Britain, originally a medical student, until he was overwhelmed by a psychotic disorder. Later he retrained as a neuroscientist and came to New Zealand in 1977 to a position in the Department of Anatomy at Otago Medical School. His research objectives have been to explore the theory of brain function and its relation to mental disorders. He founded and continues to lead the NZ Schizophrenia Research Group in 1994. From 2009-2014 he served as community representative on committees of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) where he learned that one of the biggest problems in mental health is to get different players to listen to one another. Robert tries to stay independent of all organisations, so as best to encourage them to work together. He is not a member of the Labour Party.

IIMHL New Zealand Special Update

The following links are a summary of the IIMHL AND IIDL UPDATE – 15 NOVEMBER 2014

If you want further information on the IIMHL organisation go here. To sign up for their mailing list go here.

For general enquiries about these links or for other IIMHL information please contact Erin Geaney at erin@iimhl.com.

  1. The Physical Health of People with a Serious Mental Illness and/or Addiction: An evidence review
  2. Stories of Success
  3. Tihei Mauri Ora: Supporting whānau through suicidal distress
  4. New ‘wellbeing bank’ for baby boomers
  5. “There is always someone worse off…” (regarding the earthquakes in Christchurch)
  6. Debriefing following seclusion and restraint: A summary of relevant literature
  7. Families and whānau status report 2014: Towards measuring the wellbeing of families and whānau
  8. Growing Up in New Zealand: Vulnerability Report 1: Exploring the Definition of Vulnerability for Children in their First 1000 Days (July 2014)
  9. Parents or caregivers of children with a disability have a voice in New Zealand (video playlist)

Also recommended in the update are:

Effective parenting programmes: A review of the effectiveness of parenting programmes for parents of vulnerable children
(2014, April 14). Wellington: Families Commission

New Zealand practice guidelines for opioid substitution treatment
(2014, April). Wellington: Ministry of Health

 

 

Questionnaire: Performance of Nonprofit Healthcare Organisations

Ishani Soysa, a doctoral student (PhD) from Massey University, aims to develop and test a performance measurement framework that can be easily adopted by nonprofit healthcare organisations, given their missions, strategic goals and objectives. The questionnaire is a major component of the PhD as it collects data to test performance measurement frameworks empirically.

Ishani is collecting data from directors and senior executives in Australia and New Zealand, who are responsible for the governance of nonprofit healthcare organisations. If this is you, please complete the questionnaire.

Please visit the following link to respond to the questionnaire. Please do so within the next two weeks.

Or contact Ishani Soysa
Doctoral Researcher, School Of Engineering & Advanced Technology, Massey University