A central piece of our community change agenda is the intention to establish locality-focused mental health and wellbeing hubs.
A hub is intended to provide a safe space and a key connection point for people who are in mental distress. It will have the infrastructure to support mental health and addiction service delivery, provide care coordination, and connect people to a wide variety of community supports that help to enhance wellbeing.
There are several evidence-based models that combine primary care and mental health in community hubs. Over the last few months, we have been meeting with a range of stakeholders in both Kāpiti and Porirua to talk about the possible role and function of a community mental health and wellbeing hub in their localities, and how such a model might work in practice.
In reviewing the literature, there are a number of examples of integrated community mental health services that are administered through several evidence-based models - including a community hub. However, it will be up to each local area to decide to what extent their community hub will include one or more aspects of each model, with reference to the following functions:
- provide shared physical space to several mental health, health and social care organisations
- provide support and service coordination
- connect people with other community support organisations in the local ecosystem and;
- provide more intensive wrap-around services for people who want and need it, especially those who are in mental distress.
Who can come to the hub?
The hub will welcome anyone who is in mental distress, whether or not that person is currently registered with a primary health or secondary mental health and addiction service provider.
What will be the leadership and partnership arrangements look like?
The decisions about leadership and partnership arrangements for each geographical area will vary according to local iwi, different local geographies, population needs and existing organisational configurations. As the case studies from place-based initiatives in the NHS England show, there is no ‘one size fits all’ model for collaborative governance, but there are some key features that will need to be considered (Kings Fund, 2022)[1].
Whatever leadership and partnership management arrangements are selected, it is essential that the development of the hub is co-led by the local Māori/Iwi Partnership Board and the local Health District.
The hub’s core functions will be co-designed with tangata whaiora, whānau and participating organisations with room for development, growth and improvement over time. This approach is more likely to result in a constellation of community supports and services that are responsive to people’s needs and continue to be a good fit with one another and with the local community.
What is the timeframe?
A recurring theme in the development of new place-based services is that ‘the culture of collaboration’ is a key enabler of any service change and improvement. Accordingly, the development of the community hubs is contingent on building new partnerships with local leadership and community groups in each geographical area.
The first three localities for consideration include Porirua, Kāpiti and Newtown - based on an initial assessment of their readiness to develop this type of community resource. We will update you about progress in each of these three geographical areas in our monthly newsletter.
Examples from Aotearoa and elsewhere
The community health hub model has been promoted nationally and internationally within various social and health contexts. Here are a few examples:
1.The South Seas Healthcare Community Hub in South Auckland has been operating for two and-a-half years and serves mainly a Pacific and Māori population. The Hub includes a free online pharmacy option called Zoom Pharmacy, which is one of South Seas’ 15 ‘village providers’ – comprised of healthcare, social service agencies and community groups that all take a wraparound approach.
2.Ngāi Tahu -owned health provider Te Kaika is planning to run a large community wellness hub that will be built on its Caversham health campus in Dunedin. The hub aims to provide a range of high-quality health and social services to support whānau, Pacific families and low-income families in Dunedin. The 2500sqm two-storey building will house outpatient services, primary care and social agencies on the ground floor, alongside clinical spaces and private facilities. It will offer access to Dunedin’s mental health and addiction services and will also offer outpatient clinics for a range of other health services including paediatrics, rheumatology, endocrinology, cardiology and diabetes.
3.Southcentral Foundation is a non-profit health care organisation that serves a population of around 60,000 Alaska Native and Native American people in Southcentral Alaska. It supports the community through what is known as the Nuka System of Care. This system incorporates key elements of the person-centred medical home model, with multidisciplinary teams providing integrated health and social care services in primary care centres and the community, co-ordinating with a range of other community services. This is combined with a broader approach to improving family and community wellbeing that extends well beyond the co-ordination of care services and includes things like tackling domestic violence, abuse and neglect across the population.
[1] Kings Fund (2022). Providers in Place-Based Partnerships: Case studies of local collaboration.
