Abstract:
This report provides information about mental health services in New Zealand that have successfully adjusted service provision to meet "high and complex needs‟ of some service users. Some people with mental health and addiction problems appear unable to have their needs met through mental health and addiction services. They continue to cycle in and out of care, and for various reasons, they prove a challenge to services. Rather than exploring the perceived failings of services, the Mental Health Advocacy Coalition (MHAC) wanted to discover what happened in services that stepped up to the challenge and changed what they did for the benefit of this group of service users. This project aimed to identify and analyse examples of such services. The researchers conducted interviews with 16 service managers and key workers and 23 service users. Participating services included three District Health Board (DHB) providers and five non-governmental organisations (NGOs) across the middle and upper North Island. In answer to the question: "What has made your care successful?‟, the participants – whether managers, key workers or service users – universally identified „relationships‟. This answer applied to broad intrasectoral relationships between the mental health sector and social agencies such as Work and Income, Housing New Zealand and workplaces; intrasectoral relationships between specialist and community services, DHB provider arm services and NGOs; and DHB funders and planners and all contract holders. This answer also applied to the close, committed, "give a damn‟ relationships between service users and their carers – regardless of the background and qualifications of the carer. These relationships formed the springboard for meeting needs such as having a settled and safe place to live, working, reconnecting with whānau and communities and making friends. Clinical expertise was not considered the foundation of these successful services; rather, it was the services‟ ability to negotiate the need for clinical care within those relationships and in support of meeting those human needs.