2016 has begun in New Zealand with both concern and optimism. Concern arising out of a increasingly shared acceptance that the status quo is no longer sustainable (neither financially nor structurally). Optimism, arising out of a national service development plan developed by the Ministry of Health (“Rising to the challenge...”), and subsequent discussion document (On Track), articulating quite transformative change, developed by the NGO sector.
While the physical structures of large psychatric asylums are long gone (the last being closed in the early 1990s), the residue of attitudes, thinking and culture from those times remain embedded in our system.
This is why the triumvirate of strategies proposed by the IMHCN – change the thinking, change the system, change the practice – are so intuitively relevent to us in 2016.
“Rising to the challenge...” prescribes change within 4 hours overarching themes:
- actively using current resources more effectively
- building infrastructure between primary and specialist services
- cemeting and builindngin gains in resilience and recovery
- delivering increased access
On Track complements and robustly represents the kinds of changes we need to anticipate:
Big challenges; great opportunities – and encouraging activities! Some health authorities are undertaking capacity and capabilty development programmes to determine the extent to which non goverment organisations are prepared to deliver more specialist services.
Co-design initiatives are underway, grappling with issues such as access, employment, housing, integration or services and service design.
Rather than continued discussion around the on-going process of deinstitionalisation, we have overtly begun discussion about the devolution of mental health support services, from hospital campuses to community agencies and non government organisations. Service designs which are relevent to people living lives in 2016 are essential; service designs that enhance the well-being and capacity of communities are a priority.