A Whole of System MH&A Integration Transformation Agenda in Counties Manukau District Health Board

Abstract

People in our communities with mental health and addiction needs have poorer health outcomes than the rest of the population. We also know that not everyone with mental health and addiction needs experience the best service possible when they need help with their physical and mental health. We believe that with mental health and addictions providers working together better, and working more effectively with primary care professionals, we can improve our communities’ health and well-being. To achieve this, we need to transform our system to one of integrated, seamless service delivery that puts the person and their needs at the centre of everything that we do – and how we do it. At Counties Manukau we have begun a whole of system Integrated Mental Health and Addictions service development journey. We are engaged in co-design, improvement science and cultural capability to inform and support the transformative process across our system. Aligned with the district wide locality integration approach in Counties Manukau core specialist mental and addiction health will be devolved into locality teams. Clinicians in these locality teams will be embedded within primary care and community care providers. The integration focuses on supporting people with a serious mental illness (SMI) being well engaged in primary care including monitoring and addressing their physical health issues. The mental health and addictions workers will also support easier access to non-urgent clinical consultation and ensure support to primary care for the routine screening of people with chronic care conditions for mental health and addictions issues. Key to the integration agenda is the re-design of core support services provided by the NGO sector. This work has a focus on having a suite of locality services that matches the diverse community profiles of our localities. A Maori-led integration initiative is being supported to best address the issues for Maori in Counties Manukau. Self management and recovery play important places in this agenda. Led by primary care and NGOs, experience and learnings to date indicate the successes of this approach can be rolled out across the district. Finally the development of a Department of Psychological Medicine has led integration of the hospital-based divisions of Mental Health and Medicine with enhanced access of Physicians to mental health inpatients and greater access of psychologists, psychiatrists and mental health nurses to the general hospital patients with promising outcomes.