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Category Archives: Social Change

Auckland Pride Festival on now

Auckland’s annual Pride Festival kicked off this week with a dawn ceremony at Maungawhau on the 3rd of February and runs right through to February 28th. You can check out the full 2021 calendar of events on the Pride Festival website at https://aucklandpride.org.nz/category/events/.

There are hundreds of events and heaps of them are free. You’ll find things like a Spoken Word Showcase on Feb 17th and 25th, the ICON exhibition from Same Same but Black from Feb 3rd – 28th, a workshop on Accessing Trans Healthcare on Feb 10th, lunchtime yoga at Ellen Mellville Centre on Wednesdays, and the Pride March from Mt Albert Park on Feb 27th.

Alyssa’s Autism Acceptance Project

I recently discovered Alyssa’s Autism Acceptance Project online in a blog post by the project creator herself, Alyssa Bolger and her brother Lachlan, two teenagers on the autism spectrum on a mission to change their little corner of the world for the better. They are based in Australia but I found their story really inspiring and think you will too. I love solutions created by the people they are designed to serve. Insider knowledge is a special thing and it always seems a bit like finding treasure when I come across something like this. As a clinician, research is one thing, but it’s never quite as powerful as knowing real life examples of people doing well and what it’s been like for them. There’s a term for this, ‘the power of positive contact’ and it’s a key ingredient for creating accepting communities. This project has that in spades. You can find Alyssa’s Autism Acceptance Project and follow her family’s journey on Facebook at www.facebook.com/TheAAAProject/

Alyssa and Lachlan’s article on Reframing Autism gives us a real life example that totally busts the common myth that people on the autism spectrum aren’t interested in friendship and shines the light on the barriers that get in the way. All humans need friendship including people on the autism spectrum.

Alyssa and Lachlan write, “My name is Alyssa, and my younger brother is called Lachlan. We are both proud autistic teenagers and we are writing this post together (with a little help from our autistic parents), because we want everyone to know how important friendship is to us, as we know there are Neurotypicals out there who think autistic people don’t care about having friends.”

They go on to explain, “Lachlan and I have learned that making friends is all about having something in common. That’s why we started our Lego club called BrickTime a few years ago. It’s a safe place that’s seen lots of friendships, because of a common love of Lego. Some of the Lego builds have been amazing! We were even going to organise an exhibition to show off these builds, but COVID-19 put a stop to that. Hopefully, we’ll get to do it one day.

Along with BrickTime, the other thing we do as the AAA Project is travel to schools to talk to kids about autism. We started doing this because of a message that I received while I was the Telethon kid back in 2015. A young autistic girl (who was so happy to discover that she wasn’t the only autistic girl through seeing me on TV) sent a message to ask if I would be her friend. She said she didn’t have any friends in her small country town, because nobody ‘got her’. I would have loved to have been her friend but, unfortunately, I had no contact details for her (and I didn’t even know her name). So, we set off travelling around WA, in the hope that we might find her. We talked to kids from schools as far south as Albany and as far north as Kununurra. Lachlan and Dad did all the behind-the-scenes tech stuff, and Mum and I did the presentation.”

Read the full story here: Building Friendships Brick by Brick, by Alyssa and Lachlan Bolger on the Reframing Autism website.

UK Doctors trial Arts Prescriptions

We stumbled upon this video from the BBC on Facebook earlier in the week. GP doctors referred people to “link workers” whose job was to know about all the extracurricular activities in the neighbourhood and link people in with them. Anything from gardening to painting groups. Why? Because most of the people presenting to their GP with mild to moderate mental health difficulties also had social difficulties. Well worth a watch. We wish this existed in NZ.

Click here to watch Dr. Daisy Fancourt talk about Arts on Prescription

 

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.

On Track: Knowing where we are going

More than 200 people from across the mental health and addiction sector and the wider health and social sectors have contributed to a report, co-published by Te Pou and Platform Trust, that aims to prepare NGO mental health and AOD services for “the next round of reform”.

“On Track: Knowing where we are going outlines the wide range of issues that need to be considered and addressed to improve health outcomes for people using services, their whānau and local communities, and to ensure the future capability of the mental health and addiction workforce”.

Engage Consideration: Dutch initiative challenges mainstream thinking about psychosis

This post highlights a relatively new Dutch initiative that works to promote a helpful way of thinking about experiences of psychosis. The team at Engage Aotearoa recently stumbled across it on Facebook and thought it was full of information others might like to consider – either in their own recovery or in their efforts to support others seeking recovery.

Jim van Os and others have created a website, manifesto and set of audio-visual ‘explanimations’ to help people understand psychotic experiences in a way that allows for meaning-making and hope for recovery.

Much of the website is in Dutch, but an English-language version of the core resources on the “Schizophrenia Doesn’t Exist” website is available. It’s a provocative title, but the project creators do not mean to say that extreme experiences like hallucinations and delusions do not exist.

If you are not much for reading, you can watch Jim van Os’s TED Talk and get it all in a 15-minute nutshell or explore the 2-minute ‘explanimations‘ about psychosis and recovery on the website.

Visit the Schizophrenia Doesn’t Exist English-language webpage to find everything in one place. 

The Manifesto outlines “14 Principles for Good Care of Psychosis”. The first 7 principles address current thinking that frames psychosis as a brain disorder called schizophrenia and set out evidence for an alternative – Psychosis Spectrum Syndrome or PSS. The final 7 principles set out a vision for recovery-based practice, these state…

“8: To recover from PSS, a person must be offered hope and perspective from the very first moment. Recovery is a psychological process. It is a process of learning to adapt and develop a new perspective. With support from people with lived experience of psychosis and, where necessary, from doctors and therapists who support the process of recovery.

9: Every person with PSS should have access to a person with lived experience of psychosis from the earliest phase of treatment. A person with lived experience is in a unique position to offer perspective and hope (‘I was able to recover as well’).

10: The primary goal of treatment is return to the person’s environment, education and/or work. Education and work are prerequisites for recovery: even if residual symptoms remain, people can start picking up where they left off. The practice to wait for full recovery is counterproductive.

11: Anyone who enters the mental health system with PSS should be encouraged to talk about their psychosis. The content of the psychosis should be seen as meaningful, and may represent the key to underlying issues.

12: Psycho-education should not introduce an unproven biomedical model of brain disease as a central theme.

13: Anyone who suffers from psychosis should have access to psychotherapy by an experienced therapist.

14: Antipsychotics may be necessary to reduce psychosis but do not correct an underlying biological abnormality. Antipsychotics are no cure. Much more attention is required for individual dose optimisation to reach the lowest possible dose and to avoid irrational polypharmacy.

Schizophrenia does not exist, which is a good thing.
Because much can be done about PSS.”

~ Quoted from, Manifesto: 14 Principles for Good Care of Psychosis. Schizophrenia Does Not Exist website, 12 July 2015.

 

 

Have You Seen the Target Zero Documentary Yet? Watch Online

A very special documentary aired on Maori Television on the 15th of June. Target Zero highlights the need for suicide prevention strategies in NZ, Key to Life Charitable Trust‘s grassroots work across NZ, what gets people through and the solutions whanau and youth themselves are enacting in their schools and towns. IMG_0168

 

Engage Aotearoa would like to congratulate Mike King, Jo Methven, Tai Tupou and the rest of the Key to Life team on  the messages they have brought together in Target Zero. This is an inspiring example of what can come about when genuine people, with genuine passion, collaborate with their communities to fill community needs.

Watch Target Zero online here and share it on social media.

These are the kinds of ideas we need to be spreading.

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

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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.

Health Promotion Agency Launches “Don’t Know? Don’t Drink” Campaign

The Health Promotion Agency launched a new campaign called “Don’t Know? Don’t Drink” on the 14th June. The Campaign, which will run until September, aims to raise awareness about the effects of alcohol during early pregnancy and ultimately reduce rates of Foetal Alcohol Spectrum Disorder (FASD) in New Zealand.

“Don’t Know? Don’t Drink” encourages women to stop drinking alcohol if there is any chance they could be pregnant because alcohol can affect a developing baby throughout pregnancy, including before a woman knows she is pregnant. There is no known safe amount and no known safe time to drink alcohol during pregnancy.

Watch the first “Don’t Know? Don’t Drink” video here

Learn more about the signs and symptoms of FASD here