Mental Health and Addiction Services in New Zealand: Current Issues Actions Required Presentation to HDC Conference 13 November 2017 Kevin Allan Mental Health Commissioner
Overview HDC s perspective our monitoring and advocacy role What we see Actions required New Government new priorities
HDC s perspective Unique Perspective Independent watchdog Promote and protect consumer rights Statutory powers: obtain information, make recommendations, report publicly
HDC s Monitoring Framework Based on HQSC quality measures (effectiveness, equity, safety, experience, efficiency and access) 1. Can I get help for my needs? Potential markers: numbers accessing specialist services, wait times, primary care access data 2. Am I helped to be well? Potential markers: improvement in clinical assessment, access to housing and employment, follow up & readmission rates 3. Am I a partner in my care? Potential markers: complaints themes, experience surveys, discharge /relapse prevention plans 4. Do services support me to be safe? Potential markers: serious adverse events, seclusion rates, complaints themes 5. Do services work well together for me? Potential markers: experience surveys, housing and employment status, complaints themes 6. Do services work well for everyone? Potential focus on regions, Maori, prisoners, other population groups And a context section Overview of needs, services, strategy, leadership, workforce etc.
HDC s Perspective Monitoring and advocacy - four pillars: HDC complaints themes and trends Consumer feedback Marama Real Time Feedback, national advisory groups Sector engagement DHBs, MOH, HQSC, NGOs, workforce organisations, professional leadership forums etc. Service performance information PRIMD, KPIs, significant reviews, HQSC information etc. Public report February 2017
Monitoring What We See Complaints 247 last year second highest complaints re DHB services Main issues: Communications consumer and whanau/family Clinical decisions & consent incl. assessment incl. risk assessment treatment Access Coordination of care
Monitoring What We See Need 20% at any one time, 50% during lifetime, 4.5% high need (2006 info), target 3% - achieved in 2010/11 (currently 3.5%) Access increased 75% in the last decade from 96,000 to 168,000 Growing recognition of MHA issues Increased willingness to access services Considerable pressure from increased demand
Monitoring What We See Issues of concern include: Difficulty accessing appropriate community services including primary care services Consumer and whanau engagement Coordination of services CTO rates for Māori higher and increasing (3.9 times higher for Māori males) OAG and other reports (HRC, Ombudsman, People s Report) incl. access, planning, options, workforce etc. Suicide rates
Monitoring What We See Positive clinical outcomes - HONOS, ADOM Marama Real Time Feedback: +14,000 voices, + 80% would recommend their service to others Quality improvement initiatives Seclusion reduction HQSC quality and safety initiative KPI programme
Actions Required Promoting mental well being prevention and early intervention Meeting needs of the 20% - urgent action to develop community/primary care options Better coordination (health, housing, education, justice ) Improving outcomes for Māori Workforce - fit for the future Effective, collaborative sector leadership
New Government Mental health and addictions high priority Review of mental health services 100 day priority Consumer and family/whanau-centred People with lived experience must be fully involved along with others MOH, DHBs, PHOs, NGOs etc. Evidence-based New Mental Health Commission increased focus on monitoring and advocacy role
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