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Local Specialist MHA FAQs

These will be updated as we receive more questions. If you would like to ask a question that is not covered by the below, please email mhachange@ccdhb.org.nz. Last updated 17.03.23

On this page:

  • The concept proposal
  • The process
  • How will this affect me?
  • How will this affect tāngata whaiora?
  • Intersection with other services

The concept proposal

This paper seems to focus on people with mild to moderate needs. Can we ask about people who have intense/complex needs? 

We recognise that people who present to our services have a range of mental health and addiction concerns. The local concept paper focuses on people with intensive support needs who have traditionally been seen at a secondary care level by our adult community mental health teams and require a more tailored response.    

As noted in the local concept paper, people who require a less intensive response will be able to access support in their communities through a range of primary care and community-based services, and/or via community mental health and wellbeing hubs, if that is where their needs will be appropriately met. This is why the Community Mental Health and Addiction workstream includes projects focused on the development of Primary Care Liaison, Peer Support and Community Mental Health and Wellbeing Hubs. These projects are interdependent and work towards change across the mental health and addiction sector, to achieve our vision of "Mental health and wellbeing for everyone, in our communities - individuals, whānau and communities supported by trusted health services that respect people’s unique sense of culture, spirituality and wellbeing." 

I noticed you have removed the word 'Adult’ - will the service also work with people who are under the age of 18 years old? 

No, services for this age group are out of scope for this proposed concept and delivery model. 

How is this different from what we are already doing? 

The vision for the Mental Health and Addiction Change Programme is mental health and wellbeing for everyone, in our communities - individuals, whānau and communities supported by trusted health services that respect people’s unique sense of culture, spirituality and wellbeing.  

We acknowledge the excellent work already happening to deliver equitable care to people in their communities. We want to take this a step further by increasing our equity focus with the aim of creating greater service consistency across our district.  

We also want to invest in services that we know from data and evaluation produce positive outcomes for the people we look after, more specifically kaupapa Mäori and Pacific NGO services, and interagency partnerships.   

This is also consistent with the direction in Te Pae Tata, the Interim Health Plan (Te Whatu Ora, 2022). 

Previously you have referred to an Integrated Locality Mental Health and Addiction Team. What is the difference between that and what is proposed in the paper (i.e., Local Specialist Mental Health and Addiction Service)? 

Integrated Locality Mental Health and Addiction Team was the first proposed name to describe the bringing together of a core set of mental health functions, which are currently siloed, into a single integrated team. That is, community mental health, crisis responses, and access and triage functions working together as an integrated team. 

This type of approach is still in the concept stage, but we received feedback that the name we chose didn’t accurately reflect what we were trying to describe. Therefore, we have changed the language slightly to acknowledge the specialist nature of the mental health and addiction functions we provide. The proposed name for the project and the service is Local Specialist Mental Health and Addiction Services. We are not completely fixed with this name so will be open to feedback on this as we progress.  

The process

Can you give some more detail about the next steps? 

We have reviewed the feedback on the local concept paper and a summary document can be found here.  

During March 2023 we are conducting a series of three design workshops, with attendees from across the Mental Health and Addiction sector. These will help define service user pathways, refine the proposed functions and operating model, and incorporate evaluation and service user feedback as success indicators. The resulting proposal will be shared for consultation in April. We will continue to seek kaimahi and stakeholder feedback at each step of the process. 

I missed the deadline for giving feedback, is it too late?  

No, you are not too late! This is a concept paper only, and there will be more opportunities to contribute to the next stage, which is the more detailed implementation plan. In the meantime, please continue to send your feedback to mhachange@ccdhb.org.nz

I don’t think this concept goes far enough, what can I do? 

We have taken what you have said so far and tried to capture this in the concept design.  As we are only in the concept phase, there is time to tell us what you think. This is your opportunity to give feedback and offer ideas about things that we might have missed. 

Email feedback to mhachange@ccdhb.org.nz

How will this affect me?

Will the changes require me to change the focus of my role? 

For some kaimahi, yes there are likely to be changes to your focus. Any changes will be explored with you once the proposal moves from concept to proposal.  We are committed to working with staff who are identified as being affected/impacted once the proposal is finalised.  

Are any jobs at risk as part of these changes? 

No, it is not envisioned that staff will lose their jobs. The changes being implemented aim to increase the capacity of our system by using the available resources of people and funding in better ways. We also want to provide the opportunity for staff to specialise in certain areas (e.g., advanced therapies) and work at the top of their scope. 

Will I need to reapply for my job? 

At this stage no, however we will be working closely with staff, the unions and HR to support staff identified as affected or whose roles are significantly changed to ensure that we follow a clear and supportive process. We are acutely aware of the significant workforce shortages and do not want to add to this. 

Will I need to re-locate? 

For some staff there may be changes in where your work base is located. For many this may be a positive change, and for others the highly mobile nature of the proposed new service delivery model will have some appeal. Throughout the process we will work with all stakeholders to minimise any impacts on you and your role, but at the same time ensuring we improve the system for people with mental health and addiction needs. 

How will this impact sector staff? Will I have to work in a different location? 

At this stage, the proposed changes are conceptual only. We will be consulting on a more detailed plan next year, which will take into account feedback gathered in this round. This includes details such as changes to jobs.  

Throughout the process we will work with all stakeholders to minimise any impacts on you and your role, but at the same time ensuring we improve the system for people with mental health and addiction needs. 

I don't understand how this relates to my job.  

For the majority of kaimahi working across the mental health and addiction sector, this will not directly affect your job, especially at this conceptual stage. It reflects a move towards a more integrated mental health and addiction system, and how different organisations across the sector will work together. You will start to see how this looks for you more clearly over the coming months. 

Are you proposing staff work longer hours?  

We are looking at all options to meet the needs of people using services across the district. Although we are not currently proposing any specific changes to operating hours, increasing the availability of specific services outside of usual business hours is something that has been raised in the past. Any potential extension to operating hours would not necessarily mean individual staff working longer hours.  

We are interested in what staff and stakeholders think about the option to change the operating hours of our services. Specifically, how this might look, and the benefits and risks the project needs to consider before a decision is made. These discussions will be completed in full consultation with key stakeholders as part of the design process and an outcome will be outlined in the proposal released in April. 

Trust needs to be rebuilt within our organisation, so that our workforce can feel secure and supported. Will future iterations of the plan contain a plan for rebuilding this relationship? 

During the initial work on shaping the concept, we had several discussions about our internal organisational culture and how this will need to align with the concepts we propose. Strengthening our organisational culture has been an ongoing theme in the feedback, and we plan to pick this up in the more detailed implementation planning so that it is incorporated into the final design of our services. More detail on this will be released in due course.  

How will this affect tāngata whaiora?

How will my care change? Will I be able to access services in different locations?  

At this stage, the proposed changes are conceptual only. We will be consulting on a more detailed plan next year, which will take into account feedback gathered in this round. This level of detail has therefore not yet been worked through. 

However, in general, we aim to offer people more flexibility about care they receive, and so there will likely be more location options for people around where care is delivered. 

How will you ensure any developments are client/person-focused? 

In drafting the local concept paper, we sought feedback from community lived experience stakeholders, the MHAIDS Lived Experience team, and the Lived Experience Advisory Group who reviewed the paper and fed back specifically around ensuring that the views of people with lived experience were strengthened in the proposed model of care.   

We are clear that people with lived experience will continue to be involved in service design and workshops/workstreams while we work to refine and develop the model of care and service configuration.   

An important part of the MHAIDS change programme is the development of peer support services, which has its own separate workstream. Peer support will be embedded into the future Local Specialist Mental Health and Addiction Service.   

Currently, we receive feedback on our services using the Mārama RealTime system. We will continue to use this tool to get feedback on how the changes are progressing and whether they are making a meaningful difference for people and whānau who use our services. 

We acknowledge that there are significant changes ahead for the service, and we want to make sure that any transition is managed for people in a safe and sensitive way. Ongoing engagement with people who use our services is key to ensuring this happens. 

Intersection with other services

Can we have some more information about how the Hubs will work in practice? 

While the Community Mental Health and Wellbeing Hubs represent a separate project within the Community Mental Health and Addiction workstream, we acknowledge the interdependencies of the different workstreams. See FAQ ‘What is the difference between the Local Specialist Mental Health and Addiction Service and the Hubs?’ for more information about the differences between these two projects. 

Like the Local Specialist Adult Mental Health and Addiction Service, detail about how the Hubs may work is yet to be determined. It is crucial that any Hub model is community-led with mana whenua and co-designed with peers, which will make sure each Hub is tailored to the needs of its community.  

While it is not the initial intent for specialist mental health and addiction services to be based within the hub, there is still room for each community to consider the possibility of co-locating workers from various services in the same building, including specialist mental health and addiction services. 

Irrespective of the final model, there will need to be an integrated response for people presenting in mental distress, whereby the primary and community workforce (including those located in the Hub) and the local specialist mental health service come together to provide seamless support.  

Defining the functions and different services across the system clearly will avoid the risk that we provide ‘everything to all’; rather, people will be able to access the right care at the right time from the right service. 

What is the difference between the Local Specialist Mental Health and Addiction Service and the Hubs? 

The hub will be a physical place in the community, from which many different services and supports will operate, including peer support and leadership. Potentially this will include community cultural services, primary care, mental health and addiction NGO providers, and in some cases and at some times, secondary mental health and addiction staff. It is envisioned that each community will understand its unique needs and therefore determine what is needed in its hub: by the community, for the community. 

While the local specialist mental health and addiction services will work closely with the hubs, it is not expected that they will be based within the hubs full time. Further work needs to be completed on linkages and pathways across these systems. 

 

Last updated 14 April 2023.