Development of an Action Plan to implement Te Tahuhu – Improving Mental Health 2005-2015: The Second New Zealand Mental Health and Addiction Plan.

Development of an Action Plan to implement Te Tāhuhu – Improving Mental Health 2005-2015:
The Second New Zealand Mental Health and Addiction Plan

Information update - December 2005

The Advisory Group established to develop an action plan for Te Tahuhu – Improving Mental Health has met five times since 25 August 2005 and has now completed an initial draft.

During November and December the Ministry of Health has undertaken a three step process of gaining initial feedback on a draft before going to Cabinet for their approval to release the draft for consultation.

The draft action plan has been reviewed by senior peer reviewers from across the mental health and addiction sector, and has also been reviewed by a number of key sector stakeholder groups.

The Ministry of Health has also provided presentations to a number of key groups, updating them on the process that has been undertaken.

The draft action plan uses a template similar to that used in the Cancer Control Action Plan. The action plan has been drafted to predominately be a ‘high-level’ document. It is built around actions to meet the ten leading challenges in Te Tahuhu – Improving Mental Health. The leading challenges were a mix of both high level strategic statements and operationally specific statements – the actions in the action plan are the same.

Where to from here:
The draft action plan is being revised in response to the feedback that has been received to date and once completed will be sent to Cabinet in early March 2006 for their agreement to begin the consultation process.

Question and Answer series

Introduction
This Question and Answer series has been developed to provide information for the mental health sector, and other interested groups, on the development of an Action Plan to implement Te Tāhuhu: Improving Mental Health 2005–2015: The Second New Zealand Mental Health and Addiction Plan (Te Tähuhu – Improving Mental Health).

Key information on Te Tähuhu – Improving Mental Health is also provided.

Enquiries

If you have any enquiries about this information or the development of the Action Plan please contact:

Ezrai Fae
Project Manager
Mental Health Directorate
Ministry of Health
Email Ezrai_fae@moh.govt.nz
DDI: (04) 496 2250
Cellphone: 027 231 8024

Why is an Action Plan being developed?

When Government agreed to Te Tähuhu – Improving Mental Health 2005-2015:The Second New Zealand Mental Health and Addiction Plan (Te Tähuhu – Improving Mental Health) in June 2005, it directed that an Action Plan to implement Te Tähuhu – Improving Mental Health be reported to Cabinet Social Development Committee by 31 March 2006.

Government also directed that the Action Plan be jointly developed by the Ministry of Health and District Health Boards (DHBs) working with stakeholder representatives.

How will the Action Plan be developed?

Structure

An Advisory Group has been formed reporting directly to the Director-General of Health, who along with the Chair and Deputy Chair of the Advisory Group, will jointly report to the Minister of Health on the development of the Action Plan.

The Ministry of Health is responsible and accountable to Government for the development of the Action Plan.

The Mental Health Commission, as an independent body, will continue to provide independent advice to the Minister of Health.

A working group with representatives from both the Ministry of Health and District Health Board members on the Advisory Group will undertake the detailed work on the Action Plan.

How were Advisory Group members chosen?

Individuals were invited to join the Advisory group on the basis of their individual expertise, rather than as representatives of any particular organisation or section of the mental health sector.

Who are the members of the Advisory Group?

Chair – Memo Musa, Chief Executive Officer Whanganui District Health Board
Deputy-Chair – Janice Wilson, Deputy Director-General Mental Health Directorate, Ministry of Health.

Advisory group members

Karleen Edwards
Sue Hallwright
Julie Nelson
Helen Rodenburg
Rees Tapsell
Francis Agnew
Joy Cooper
Mary Smith
Judi Clements
Anne Helm
Maxine Gay
Kaye Carncross
Ana Sokratov
Mary O’Hagan
Jenny Wolf

Working Group Membership

4 Ministry of Health staff

Manager Policy and Service Development, Mental Health Directorate
Project Manager
Analyst
Admin support

4 DHB representatives

Karleen Edwards
Joy Cooper
Sue Hallwright
Mary Smith

What is the process for the Action Plan’s development?

The Advisory Group will meet four times between August and December 2005 and two times between February and April 2006.

What is the objective, and key tasks of the Advisory Group?

The Advisory Group was set up to develop the action plan to implement Te Tähuhu - Improving Mental Health, and to report the Action Plan to Cabinet Social Development Committee by 31 March 2006.

The Advisory Group will advise the Director General of Health on the:

development of prioritised actions to address the ten leading challenges identified in Te Tähuhu – Improving Mental Health.
determination of timeframes, responsibilities and accountability measures for the prioritised actions.

Will there be consultation on the Action Plan?

Yes, there will be a consultation process on the Action plan during November/ December 2005.

Who is responsible for the Consultation process?

The Ministry of Health is responsible for organising the consultation process, which will take place through established channels such as the Regional Mental Health Networks, Consumer Networks, NGO networks, DHB CEOs.

Are there boundaries within which the Action Plan is being developed?

Yes. The following parameters are being applied:

The Action plan is being developed within current policy, funding and performance management criteria.
The purpose of the action plan is to implement Te Tähuhu – Improving Mental Health.
Te Tähuhu – Improving Mental Health continues to implement the Blueprint and continues to place an emphasis on services for people who are most severely affected by mental illness.
Te Tähuhu – Improving Mental Health covers the spectrum of interventions from prevention/promotion to primary care to specialist services.
Te Tähuhu – Improving Mental Health is funded within current baselines across public health, primary care and the agreed future funding path for the Blueprint. Any actions arising from the action plans development that require funding outside of baselines will require separate budget bids to be made.
Te Tähuhu – Improving Mental Health is aware of and places the plan in the context of intersectoral approaches but does not set policy positions or actions for other government departments

When will the Advisory Group begin its work?

The Advisory Group had its first meeting on 25 August 2005.

The Advisory Group has agreed to use the same framework for the action plan as that used in the Cancer Control Strategy Action Plan.

What is the focus of Te Tähuhu – Improving Mental Health?

Government released Te Tähuhu - Improving Mental Health 2005-2015: The Second New Zealand Mental Health and Addiction Plan in June 2005. This plan builds on the national mental health strategy, draws together Government interests in mental health and addiction, and provides a clear statement on government priorities for investment in mental health and addiction for the next ten years.

Te Tähuhu – Improving Mental Health is based on an outcomes framework. It has a set of outcome statements for funders and providers to pursue and gives clear signals to service users about what they can expect from publicly funded services.

All New Zealanders in their communities	People make informed decisions to promote their mental health and wellbeing value diversity and support and enable people with experience of mental illness and addiction to fully participate in society and in the everyday life of their communities and family/whanau Service see a trusted and high-performing mental health and addiction sector, and have confidence that if they need them, they can access high-quality mental health and addiction services
People with experience of mental illness and addiction	Person have the same opportunities as everyone else to fully participate in society and in the everyday life of their communities and family/whanau Service experience trustworthy agencies that work across boundaries and enable service users to lead their own recovery experience recovery-focused mental health services that provide choice, promote independence, and are effective, efficient, responsive and timely
Family/whanau and friends who support and who are affected by people with experience of mental illness and addiction	Person maintain their own wellbeing and participate in society and in the everyday life of their communities and family/whanau Service experience agencies that operate in a way which enables them to support their family members’ recovery and maintain their own wellbeing

Te Tähuhu – Improving Mental Health also sets out ten leading challenges that the mental health sector must address if Government outcomes are to be achieved

Promotion and prevention	Promote mental health and well-being and prevent mental illness and addiction
Building Mental Health Services	Build and broaden the range and choice of services and supports, which are funded for people who are severely affected by mental illness
Responsiveness	Build responsive services for people who are severely affected by mental illness and/or addiction
Workforce and Culture for Recovery	Build a mental health and addiction workforce - and foster a culture amongst providers - that supports recovery, is person centred, culturally capable, and delivers an on-going commitment to assure and improve the quality of services for people
Maori Mental Health	Continue to broaden the range, quality and choice of mental health and addiction services for Maori
Primary Care	Build and strengthen the capability of the primary health care sector to promote mental health and well-being and to respond to the needs of people with mental illness and addiction
Addiction	Improve the availability of and access to quality addiction services, and strengthen the alignment between addiction services and services for people with mental illness
Funding Mechanisms for Recovery	Develop and implement funding mechanisms for mental health and addiction that support recovery, advance best practice and enable collaboration
Transparency and trust	Strengthen trust in services and accountability and information systems
Working together	Strengthen cross-agency working together

What are the key messages from Te Tähuhu – Improving Mental Health 2005-2015: The Second New Zealand Mental Health and Addiction Plan?
The key messages are that Te Tähuhu – Improving Mental Health:

marks a new era for mental health and addiction in New Zealand
builds on the current mental health strategy and past successes, and draws together Government interests in mental health and addiction
continues to implement the Blueprint
continues to place an emphasis on people who have the highest needs, ensuring they have access to specialist services
covers the spectrum of interventions from promotion and prevention to primary care and specialist services
has for the first time, Government defined outcomes for mental health and addiction in New Zealand through describing a set of outcome statements – general outcome statements describe what people should be able to do, and service oriented outcome statements describe the expectations that people should have of mental health and addiction services
identifies ten leading challenges that face the sector and that must be addressed in order for Government outcomes to be achieved.

What are the key issues for each of the ten leading challenges?
Prevention and promotion

Mental health is more than the absence of mental illness
A focus on promoting mental health and well-being and preventing mental illness and addiction
Increasing awareness of how to maintain mental health and wellbeing
Addressing stigma and discrimination
Addressing suicide and depression

Building Mental Health Services

Continuing to develop specialist services for people most severely affected by mental illness and addiction, especially those with enduring severe illness
Continuing to implement the Blueprint
Increasing services for children and young people and older people
Broadening the range of services and supports for adults, e.g. quality crisis services, psychological therapies, peer support services, service user led services

Responsiveness
Pacific peoples and people from Ethnic communities

A focus on developing cultural capability so that services can respond to the unique needs of specific population groups
Improving the responsiveness of services
Increasing the use of culturally specific models of care

Services users

A recovery approach is at the centre of Te Tähuhu – Improving Mental Health
Service users must lead their own recovery, have personal power and a valued place in their whanau and communities
Services must be built around the needs of the people who use them
Continuing development and increasing emphasis on
- service user workforce
- service user led services
- service user leadership and governance roles in the sector

Family/whanau

The importance of family and whanau is recognised in the development of an outcome statement for whanau and friends who support people with, and who are affected by mental illness
Increased recognition that service users live in whanau and communities and that mental illness and addiction impacts on whanau
Inclusion of family/whanau in treatment

Workforce and culture for recovery

A knowledgeable and skilled workforce is critical in achieving Te Tähuhu – Improving Mental Health’s outcomes
It is important to strengthen work environments so that people - regardless of the level they work - can exercise leadership and drive service-level improvements
A future focus will be on:
- building a workforce to deliver services for children and young people, Maori, Pacific and Asian people, and people with addiction
- developing a responsive workforce and culture for recovery
- fostering a culture amongst providers that supports recovery, is person centered, is culturally capable
There will be opportunities for new disciplines to emerge and for professional roles to evolve

Maori Mental Health

Continuing to build on the significant gains that have occurred for Mäori mental health in the past ten years in particular the:
- number and diverse range of mental health and addiction services for Mäori
- significant workforce development
- development of Mäori models of care
- developments in Mäori research and evaluation
Te Tähuhu – Improving Mental Health looks to enable Mäori to present earlier to services
Supporting kaupapa Mäori models of practice
Increasing Mäori participation in the planning and delivery of services for Mäori

Primary Care

With the changes in the structure and funding of the primary health care sector brought about by the implementation of the primary care strategy, opportunities exist for improved responsiveness to mental health needs as an integral part of Primary Health Organisations (PHOs) and primary health care
A focus on building and strengthening the capability of the primary health care sector to promote mental health and wellbeing and respond to the needs of people with mental illness and addiction
The Government is funding demonstrations of innovative ways for PHOs to work with people with mild to moderate mental illness in primary care

Addiction

Continue to improve the availability of, and access to, addiction services
Strengthen the alignment between addiction services and services for people with mental illness
Build the expertise of both the addiction and mental health services workforce

Funding Mechanisms for recovery

Funding mechanisms are fundamental in shaping public services that are purchased by State agencies
Funding models, contracting processes and service frameworks need to balance demands and allow for seamless delivery of services

Transparency and Trust

The public must see a trusted and high-performing mental health and addiction sector
Transparency and value for money of publicly funded services is important
Increasing the availability and use of information to support the sector and recovery

Working Together

Effective partnerships across health and other government funded social services is critical
Different parts of the mental health system need to work well together to ensure continuity of care
The broad range of social and economic factors such as housing, employment and education all impact on people with a mental illness or addiction
Strong partnerships and networks can give more coordinated support
Regional and national collaboration across DHBs can promote optimal use of resources