Building on Strengths A new approach to promoting mental health in New Zealand/Aotearoa
(online version)
Published in December 2002
HP3591
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Contents
He kupu whakatauki
"whakarongo mai e te tahuhu nui o te tangata,
kua riro mai taku i ahau, huri ake, huri ake,
he kohatu ko tuki"
Tihei Mauri ora
Tena tatou katoa e noho mai nai o tatou marae kainga.
e mihi kau ana ki nga paenga whakairo e moe mai ra.
Koutou kua tiraha, kua okioki, kua whakata,
Ko koutou tenei e tomo atu nei ki te wharepoututerangi,
Ki te putahitanga o Rehua, ki te huihuinga o te kahurangi.
Kua kete pungarehutia koutou e te Ra pakapaka o aitua.
Haere, haere, haere.
e te hunga waiho ake, tena tatou katoa.
Heoi ano, he mihi whakamarama noa iho tenei mo te kaupapa o tenei puka
Hauora Hinengaro, kua oti nei ia matou te pukorukoru.
I roto i nga kohikohinga korero, me nga whakaaro e whakamahi ana
ki tena takiwa, ki tena takiwa, i puta te tono kia tuhituhihia hei papa tauira mo
nga kai mahi e whai ana i enei tu momo mahi, ara, te hauora hinengaro.
Ko tenei pea he ahua momo mahi hauora mo tatou mo te motu,
mo nga tau e rima, kei mua i a tatou aroaro. Ko te hiahia, ma enei tu momo, ka
eke tatou ki nga taumata tiketike o te hauora.
Ko te tumanako, mehemea he hua kei roto i enei kohinga korero mo
tatou te iwi, tikina mai, whakamahia.
Pai Marire
Mita Ted Te Hae
Q.S.o., JP
Cultural advisor, Health Promotion
Acknowledgements
This strategy owes much to the contributions of many people and organisations. While there are too many people to thank individually, The Ministry of Health extends its gratitude to those people who have contributed to this initiative by providing advice, making submissions and carrying out ongoing analysis. Their valuable insights are reflected in the directions presented in this document. We also wish to acknowledge the contribution of the reviewers:
| Professor Mason Durie | Dr Barbara Disley |
| Associate Professor John Raeburn | Fuimaono [Karl] Pulotu-Endemann |
The strategy has benefited a great deal too, from the contributions of various organisations and a dedicated team of professionals who as members of the strategy reference group provided guidance and peer review:
| Dr alison Taylor | Kaylene Katene |
| Suzy Stevens | Sue Dewe |
| Nona Milburn | Materoa Mar |
| Vito Malo | Mita Ted Te Hae |
| Arawhetu Peretini | Maria Cotter |
| Gerard Vaughan | Christopher Carroll |
| Heather Forsythe | Anna Pethig |
| Ministry of Youth affairs | Ministry of Social Development |
| Ministry of Women’s Affairs | Accident Compensation Corporation |
| Te Puni Kokiri | Mental Health Foundation |
| Office of Ethnic Affairs | Housing Corporation of New Zealand |
| Department of Corrections | Human Rights Commission |
| Child Youth and Family Services | Statistics New Zealand |
| District Health Boards | Crown Public Health |
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A debt of gratitude is also owed to those people “behind the scenes” who helped in the preparation of this document:
| Heather Allen – Copy writer | Catherine McPherson – Designer |
| Martine O’Shea - Support | |
Last, but not least, a great deal of credit should go to Monica Briggs and Peter Burton for leading the proposal to establish a case for the development of a mental health promotion strategy and the Ministry of Health executive for picking up the challenge.
Nohopuku Williams
Strategy Writer
Ministry of Health
Foreword
Building on Strengths outlines a national approach for mental health promotion for the coming five years. It seeks to enhance mental wellbeing and to reduce inequalities in mental wellbeing by improving the social, economic, cultural, political and physical environments in which we live. It builds on the good work already being done throughout the country at local, regional and national levels.
Building on Strengths has been written to achieve three things:
- To serve as an education tool for the health sector as well as other sectors. It offers a definition of mental health promotion and advocates for increased effort to enable individuals and communities to take action on their own behalf.
- To outline planned priority actions for the Ministry of Health for mental health promotion.
- To provide guidance to health sector providers and other sectors on what they can do to contribute to positive mental health and wellbeing for New Zealanders.
While Building on Strengths has been developed from a health perspective, it recognises that real progress will be made only through co-operation with other sectors, including local government, other government departments and Maori, Pacific and other community groups. This document calls for the health sector to take a leadership and co-ordination role around mental health promotion.
Building on Strengths is the product of many hands. an earlier draft of Building on Strengths was the subject of consultation. This document is the result of both the consultation process and the contributions of many people.
We believe that through the combined efforts and strengths of many, we have a framework that will serve to promote the mental wellbeing of all New Zealanders.
| Don Matheson | Janice Wilson |
| Deputy Director-General
Public Health | Deputy Director-General
Mental Health |
Building on Strengths: Mental Health Promotion Framework
The Mental Health Promotion Framework (Figure 1) lays down the foundation for sustainable improvements in mental health and wellbeing for all New Zealanders over the next five years. The framework identifies key directions and opportunities (eg, settings, approaches) for improvement that the health sector must support, particularly in
partnership with wider government services (education, housing, employment).
The framework sets out a hierarchy of mental health promotion-focused priorities, which in turn link directly to key Ministry of Health policies outlined in this document (p7). While the framework describes a mental health promotion focus for the long term, more specific explanation of the strategic imperatives, including the vision and goals,
are contained in the strategy management plan section: Towards Health and Wellbeing (p12).
The mental health promotion framework summarises the direction and focus of sector performance against both the strategy goals and five action streams outlined in the Guide for action section (p26). The framework recognises that sector partnerships need to approach the challenges ahead with increasing flexibility and to use mental health and related information in an intelligent and effective way in order to achieve improved mental health outcomes for all New
Zealanders.
Mental health promotion has been defined in this document (p19) as:
"The process of enhancing the capacity of
individuals and communities to take control
over their lives and improve their mental health.
Mental health promotion uses strategies that
foster supportive environments and individual
resilience, while showing respect for culture,
equity, social justice and personal dignity."
(Joubert and Raeburn 1998)
Figure 1: Mental health promotion framework
Executive Summary
The Ministry of Health currently spends several million dollars each year on mental health promotion. Building on Strengths has been developed to provide a national framework for the continued allocation of these funds, against activities that contribute to keeping people mentally well. No additional funding is anticipated or will be withdrawn from other areas of health service delivery to support the priorities of the work outlined in this document.
This strategy is primarily about setting a direction for the next five years and in particular working to create environments that contribute to positive mental health and wellbeing. Sometimes this means understanding the structural root causes of mental illness (often called the determinants of mental illness) and working collaboratively to address those concerns. But, more often, it is less about the prevention of mental illness and more about simply being well. Building on Strengths uses the complementary application of promotion and prevention activities.
This document is the result of a two-year project supported by health service providers, academics, policy analysts, clinicians, mental health consumers and is led by the Public and Mental Health Directorates of the Ministry of Health.
The priority actions outlined by this document focus on:
- strengthening individuals by increasing resiliency through programmes that promote coping skills
- building community cohesiveness through activities that make them safer
- reducing structural barriers to mental health through partnerships to improve access to conditions that promote good mental health, such as education, meaningful employment and suitable housing.
Building on Strengths has three goals:
- To reduce inequalities relating to mental health experienced by some groups.
- To create environments that are supportive of positive mental health.
- To improve individual and community resiliency skills.
To achieve these goals, five priority actions are detailed. They are to:
- Reorient health services to reduce inequalities between socioeconomic groups.
- Strengthen community action in mental health promotion activity.
- Create safe and supportive environments within actions that create cohesive cities, communities, workplaces, schools, homes.
- Develop personal skills by emphasising mental health protective factors such as resiliency, social support and life skill development.
- Build healthy public policy through improved research and evaluation to identify and address mental health promotion needs.
Building on Strengths provides options for the health sector to promote mental health and wellbeing. However, action in the health sector alone is not enough. If the inequalities in mental health experienced by New Zealanders whose personal circumstances bring greater risk of mental illness are to be addressed the health sector will need to work closely with other government agencies, local government and local communities to co-ordinate mental health promotion activities that create supportive environments, strengthen communities and build the capacity of individuals to cope.
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