Minimising harm to people who need mental health and addiction services, and ensuring that health care funding is used in the most effective way, is the aim of the national Mental Health and Addiction Quality Improvement Programme. The programme is being led by the Health, Quality and Safety Commission (HQSC).
To get the Tairāwhiti perspective on the programme, HQSC were in town last week to facilitate a very well attended workshop.
Pictured are HQSC Programme Manager Roz Sorensen and Clinical Lead Clive Bensemann, presenters Cilla Allen and Maraea Craft, HQSC Chief Executive Janice Wilson, presenter Rachel Malone and HQSC Kaumatua Wi Keelan.
Māori on Community Treatment Orders
An average number of people on a given day subject to a Community Treatment Order (CTO) is 133 per 100,000 in Tairāwhiti compared to 83 per 100,000 nationally. The ratio of Māori to non-Māori is 4:1 in Tairāwhiti compared to 3.6:1 nationally.
Maraea and Cilla presented a project to reduce the rate of Māori on Community Treatment Orders. Maori are excessively affected by the Mental Health Act and they said it is time to challenge the status quo and achieve equity for whānau. The project started in March, they have reviewed CTO data to look for possible reasons why our rates are so high here in Te Tairāwhiti, completed a literature review looking at the evidence to help understand reasons for our high rates, and engaged with staff on why our use is high and ideas on how to reduce.
Their findings that showed institutional racism and unconscious bias were contributing factors to our high rates were presented and the next steps outlined.
Quality improvement in Te Whare Awhiora
As the recipient of the HQSC’s emerging leader award, Rachel talked about her experience of initiating quality improvement projects in Te Whare Awhiora. This included nurse-led activities on the ward during evenings and weekends and reestablishing a designated room for sensory modulation.
Rachel recommended that:
- Health providers should work together to provide ongoing education for mental health nurses.
- Ongoing recognition of unit successes and individual staff initiatives is important is.
- Redevelopment of acute care units must recognise the need for more intensive care to cope with the rising acuity of people's needs. The reality is that in most cases wards are becoming more compact, overcrowded with less space for people and much, much noisier.