Mental Health DHB Toolkit

Mental Health
DHB Toolkit

Date of publication: July 2003

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Summary

The mental health toolkit is part of an initiative to assist with implementation of the New Zealand Health Strategy. Following recognition of inadequate resource levels, and a series of inquiries into inadequate and substandard services, the Government released a national mental health strategy (Looking Forward, Ministry of Health 1994, and Moving Forward, Ministry of Health 1997a) to improve the state of mental health services. The strategies are set in statute and will have attracted more than 100 percent growth in mental health funding in less than a decade.

The intention of the national mental health strategy is to ensure that there are enough dedicated mental health services to meet the needs of the 3% of adults, children and young people who have severe mental health disorders/major mental illness. Early intervention and prevention/promotion approaches have not been widely developed but offer promise for all people who may develop a mental illness, regardless of severity. Research by the World Health Organization (1996) on the global burden of disease shows that mental illness now accounts for 15 percent of the total burden of disease in the developed world, and that depression will be the second leading cause of disability in the world by 2020.

Rapid funding growth has required the development of the workforce and information to provide the necessary infrastructure for service development. The Ministry of Health, including the Clinical Training Agency, is substantially funding the development of the mental health workforce. In partnership with the Ministry of Health, District Health Boards New Zealand (DHBNZ), is providing services to DHBs to aggregate and act on DHB staffing and training needs.

The Mental Health Information National Collection (MHINC) forms the core of the mental health reporting system. MHINC will be fully implemented as non-government organisation (NGO) providers come on line. It is expected to eventually serve as the main source of DHB reporting. It has a number of potential DHB uses such as management of inter-DHB patient flows. In addition a national epidemiology study funded by the Ministry and Health Research Council is expected to produce detailed data by 2006 about the patterns of mental illness in New Zealand.

Extra attention has been needed to meet quality expectations that have at times been strained by the rapid growth rate. Quality improvement initiatives have emphasised best practice, new Mental Health Standards and a programme of audits that are now DHB responsibilities. Continuous quality improvement is the foundation for the long-term effectiveness of mental health service delivery.

The Project to Counter Stigma and Discrimination associated with Mental Illness (Like Minds, Like Mine) was established as a national initiative to destigmatise mental illness and improve the social environment for people with serious mental illness to support their recovery.

Intersectoral linkages are part of mental health policy. The aim of such linkages is to improve access to appropriate and affordable housing, education and employment to assist recovery from mental illness and full participation in society.

The Mental Health Commission (MHC) has a statutory role to monitor implementation of the national mental health strategy. The Commission’s Blueprint for Mental Health Services in New Zealand (1998) describes the service developments needed to support implementation of the national mental health strategy. It includes guidelines as to the resource requirements for providing comprehensive national and regional mental health services. This document has been accepted as Government policy.

Future areas for new investment include further implementation of the Blueprint. Additional resources for 2002/03 and 2003/04 have been provided for child and youth services, implementing recommendations of a Forensic Services Review conducted in 2000, and workforce development. Policy work will focus on the development of output and outcome measures for mental health, and evaluation of the national mental health strategy. The important Māori component of the mental health policy is addressed in Te Puawaitanga: Māori Mental Health National Strategic Framework. The development of effective and responsive mental health services for Pacific peoples, as well as a strengthened Pacific workforce, are also government priorities.

The main expectations on DHBs are continued implementation of the Blueprint targets, improvements and further provider compliance with MHINC, the implementation of routine measures of outcome, quality improvement, participation in workforce development activities and the Like Minds, Like Mine project.

Attention is drawn to the service coverage document (Appendix 2) attached to this toolkit. It sets out the obligations of DHBs with regard to their Funding Agreements with the Crown. These obligations include reference to the Mental Health (Compulsory Assessment and Treatment) Act 1992, which aims to balance human rights with public safety.

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