Engage Aotearoa

Category Archives: Human Rights And Legal Issues

Information and updates on human rights and legislation issues related to mental health.

New study highlights stories of successful withdrawal

My latest paper has just been published in the open access journal, Therapeutic Advances in Psychopharmacology, as part of their special collection on discontinuing psychotropic medication.

You can read the full text free here: Service-user efforts to maintain their wellbeing during and after successful withdrawal from antipsychotic medication (Larsen-Barr and Seymour, 2021).

Abstract

Background: It is well-known that attempting antipsychotic withdrawal can be a fraught process, with a high risk of relapse that often leads people to resume the medication. Nonetheless, there is a group of people who appear to be able to discontinue successfully. Relatively little is known about how people do this.

Methods: A convenience sample of adults who had stopped taking antipsychotic medication for more than a year were recruited to participate in semi-structured interviews through an anonymous online survey that investigated antipsychotic medication experiences in New Zealand. Thematic analysis explored participant descriptions of their efforts to maintain their wellbeing during and after the withdrawal process.

Results: Of the seven women who volunteered to participate, six reported bipolar disorder diagnoses and one reported diagnoses of obsessive compulsive disorder and depression. The women reported successfully discontinuing antipsychotics for 1.25–25 years; six followed a gradual withdrawal method and had support to prepare for and manage this. Participants defined wellbeing in terms of their ability to manage the impact of any difficulties faced rather than their ability to prevent them entirely, and saw this as something that evolved over time. They described managing the process and maintaining their wellbeing afterwards by ‘understanding myself and my needs’, ‘finding what works for me’ and ‘connecting with support’. Sub-themes expand on the way in which they did this. For example, ‘finding what works for me’ included using a tool-box of strategies to flexibly meet their needs, practicing acceptance, drawing on persistence and curiosity and creating positive life experiences.

Conclusion: This is a small, qualitative study and results should be interpreted with caution. This sample shows it is possible for people who experience mania and psychosis to successfully discontinue antipsychotics and safely manage the impact of any symptoms that emerge as a result of the withdrawal process or other life stressors that arise afterwards. Findings suggest internal resources and systemic factors play a role in the outcomes observed among people who attempt to stop taking antipsychotics and a preoccupation with avoiding relapse may be counterproductive to these efforts. Professionals can play a valuable role in facilitating 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.

Stuff article puts spotlight on psychologist shortage

On Tuesday, Stuff published an article by Helen Harvey highlighting the ongoing issue of access to psychologists in New Zealand. You can read the whole article here if you missed it.

In a nutshell, there still aren’t enough of us to go around, wait-times are too long, and we have far too few funded options. Dr Malcolm Stewart of the NZ College of Clinical Psychologists hits the nail on the head when he says, “The whole mental health system needs an overhaul. I don’t know if the system has ever really met the need.’’

We went on strike for a whole year trying to advocate for an increase in our workforce numbers so we could create the conditions we need to meet demand, but all we got was a pay-rise and a working group. No real change. None of us are in it for the money of course, so we keep leaving. The official story is always one of moving on to greener pastures, and we usually are. But that’s not usually the whole story. We aren’t allowed to talk in public about what happens in the pastures of DHB-land. It’s a bit like joining Fight Club that way. So it is good to see a journalist taking this up in the media again.

Harvey writes, “Following on from Like Minds Like Mine, a Government funded public awareness campaign, there has been a lot more acceptance of mental health issues and more people seeking out psychological assistance, Stewart says. “And more and more people are seeking non-pharmacological ways of dealing with issues. Good therapy, amongst other things, often helps people to hold onto hope and to believe that change is possible. This can be very protective of life and helps people believe that they can be part of changing their own lives. It is often harder for people to feel this optimism and agency if their treatment is mostly just medication.’’ One in five New Zealanders live with mental illness and/or addiction each year, Health and Disability Commissioner figures reveal. And it is estimated that nearly half of the population will live with mental distress and/or addiction at some point during their lifetime. The system is creaking under the weight and many are blaming years of inaction in the area of mental health.”

Read the full article here:
New Zealand’s Psychological Crisis Putting Lives at Risk
Helen Harvey, Stuff, 26 Jan 2021. https://www.stuff.co.nz/national/health/122695066/new-zealands-psychological-crisis-putting-lives-at-risk

British Psychological Society releases position statement on psychologists with lived experience

The British Psychological Society’s Division of Clinical Psychology released a position statement on clinical psychologists with lived experience of mental health difficulties on the 19th of August.

The document opens by stating, “The Division of Clinical Psychology publicly recognises and supports the unique and valued contribution that lived experience of mental health difficulties brings to individuals working within clinical psychology.”

It goes on to recognise how many therapists with lived experience there are among the profession, the diversity of these experiences, the complexity involved in making decisions to disclose these experiences, the impact of stigma, and the value these experiences bring to the work and the field as a whole.

They close by writing, “Overall, this statement wishes to make clear that lived experience of mental health difficulties does not have to be a barrier to training or practising as a clinical psychologist. On the contrary, people with lived experience are an asset to the profession and make a significant contribution to it”.

As a therapist with lived experience myself, it is a wonderful thing to see these points written down by such a well respected group. I look forward to the day that the professional bodies here in New Zealand take similar steps. I am incredibly grateful to the good folks at In2Gr8 Mental Health for the hand they had in making this a reality.

Read the full position statement here www.bps.org.uk/news-and-policy/statement-clinical-psychologists-lived-experience-mental-health-difficulties


Towards Restraint Free Mental Health Practice

In case you missed it, Te Pou have launched a new resource called Towards restraint free mental health practice: Supporting the reduction and prevention of personal restraint in mental health inpatient settings. This resource is the latest in a suite of work from Te Pou that is aimed at reducing and preventing the use of seclusion and restraint in New Zealand mental-health services. According to the Te Pou website “Every mental health inpatient unit in New Zealand is engaged in some form of practice based activity that promotes least restrictive practice.” This latest resource is intended to assist services to put ‘least restrictive practices’ in place and reduce the use of seclusion and restraint.

Find out more and download the resource here

 

Te Pou: Towards restraint-free mental health practice

Te Pou is pleased to launch Towards restraint free mental health practice: Supporting the reduction and prevention of personal restraint in mental health inpatient settings. This resource is the latest in a suite of work aimed at reducing and preventing the use of seclusion and restraint. Services can use this resource to plan and identify best practices that support a least restrictive approach to service delivery.

Contact:
Te Pou
Level 2, Building B, 8 Nugent Street, Grafton, Auckland 1023.
Telephone: +64 9 373 2125www.tepou.org.nz

New Ministry of Health guidelines for COPMIA

The Ministry of Health will soon release the national COPMIA guideline, currently in draft.

This guideline will outline the responsibilities all mental health and addiction services have to the children of parents with mental illness and or addiction (COPMIA) and their families and whānau. For some, this is going to mean a big shift in the way that services operate. The guideline envisions a mental health and addiction sector that is inclusive of family and whānau, focusses on strengths, and promotes and protects the wellbeing and rights of children. It promotes early intervention in the lives of children to support resilience, offering evidenced based and culturally appropriate ways of working, and across sector partnerships to meet the needs of children and their families and whānau.

For more information click on this link to Te Pou.

Or contact Mark Smith at Te Pou
Phone number: 07 857 1278
Mobile number: 027 687 7127

Synergia Report -Think Differently, Ministry of Social Development

Think Differently, led by the Ministry of Social Development, is a social change campaign that seeks to encourage and support a fundamental shift in attitudes and behaviours towards disabled people.

It works across community and national level activities to mobilise personal and community action, to change social attitudes and beliefs that lead to disabled people being excluded, and to increase people’s knowledge and understanding of disability and the benefits of inclusive communities. To support this work, Think Differently commissioned a review of the published and grey literature to understand the factors that cause disabled people to be socially excluded. The review is designed to inform the further development of the Think Differently Campaign. This summary focuses on understanding social exclusion and its key drivers. The methods and a more detailed analysis of the key concepts are provided in the main body of this report.

 

 

Te Pou: Peer support competencies ‘sandstone to sharpen practice on’

The following is a press release from Te Pou, from their website:

The resource Competencies for the mental health and addiction service user, consumer and peer workforce were launched on November 11 at Te Pou in Auckland.

Dr John Crawshaw, director of mental health, gave an opening address to the mental health and addiction sector people from across the North Island. He acknowledged the pivotal role the service user, consumer and peer workforce has in informing service development and working alongside clinical services, supporting people to self manage and drive their own recovery.

Dr Crawshaw was followed by two peer support workers who spoke about their experience and what peer work meant for them. Elton Hakopa, addiction peer support worker from the drug court, gave a stirring and entertaining outline of his experiences. Elton gave the quote of the day, or even the year when he said “these competencies are the sandstone I will sharpen my practice on”.

Ahmad Al-Ali, mental health peer worker from Mind and Body, also entertained the crowd with his self-deprecating wit and story of courage. Both exemplified the state of gratitude they were in to be able to use their powerful experiences to support other people’s self-determination and wellbeing.

Robyn Shearer, Te Pou chief executive, talked about the power of people from across mental health and addiction co-designing and co-developing the competencies.

Two documents created to support the competency framework were also launched: The Service user, consumer and peer workforce guide for managers and employers and the Service user, consumer and peer workforce guide for planners and funders. These are available to download alongside the competencies. These documents provide information and sound direction for people managing and employing peer workforce members and for planners and funders investing in this exciting growth area in the mental health and addiction workforce.

To contact Te Pou or for further information:

http://www.tepou.co.nz/

Email: info@tepou.co.nz

Te Pou phone numbers online here.

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