The New Zealand Mental Health Strategy: Is it Making Any Difference?

Wilson, Janice

doi:10.3109/10398569709082105

Cited by 2 publications

(4 citation statements)

References 4 publications

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“…Over the last three decades the provision of mental health services in New Zealand, as in most western countries, has changed. Care, even for those with serious mental illness, is now commonly provided in the community, and includes intensive treatment, rehabilitation, and support services (Kemp, 1994;Joseph and Kearns, 1996;and Wilson, 1997). Appropriately managed and funded, community services are widely viewed as effective and preferable to hospital-based services.…”

Section: Community Mental Health Servicesmentioning

confidence: 99%

Negotiating the Network: The Contracting Experiences of Community Mental Health Agencies in New Zealand

Newberry

Barnett

2001

Financ Acc Manag

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Structural options for reforming New Zealand'spublicly funded health services included a hierarchy, a market model, or hybrid arrangements such as quasi‐markets and networks. A survey of 28 community mental health agencies, contracting with the four regional health authorities, found that three structures emerged: a quasi‐market, a coercive network and a beneficent network. Further reforms to the publicly funded health services created a single purchaser and preferred a network structure. Performance assessment of these reformed health services requires assessment of the whole network and not just individual components. The accounting profession, although closely involved in the public sector reforms, appears to have overlooked this task.

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Section: Community Mental Health Servicesmentioning

confidence: 99%

Negotiating the Network: The Contracting Experiences of Community Mental Health Agencies in New Zealand

Newberry

Barnett

2001

Financ Acc Manag

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“…In mental health services unbundling resulted in further separationl3 of the social (e.g. accommodation) and health aspects of mental health (Wilson, 1997). Social needs were conceived of as disability costs whereas health needs were treatment.…”

Section: The Reforms Of the 1990smentioning

confidence: 99%

“…In theory, with the rights reforms and the number of providers available, the mid-1990s should have been a period when consumers would have had considerable choice. However, the Director of Mental Health reported that this was not the case, that the consumers lacked knowledge about their choices and were more confused than they were prior to the major reforms and expansion of service options (Wilson, 1997').…”

Section: Mental Health Consumer Movementmentioning

confidence: 99%

“…In addition, accessibility was compounded by an increase in the demand for mental health services. This was attributed to greater public acceptance of mental illness as well as an increase in the incidence of mental illness (Wilson, 1997). It was widely believed by those in the health services that the demand for ongoing mental health services was compounded because access was free whereas there was the co-payment cost of consulting with the GP.…”

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confidence: 99%

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Innovation in Service Delivery: the Expansion of General Practice Services for People with Serious and Ongoing Mental Illness

Nelson¹

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<p>Over the past 50 years there have been many innovations in New Zealand's mental health services. Using case study methodology this research examined two innovations involving general practice - the Newtown Union Health Service (NUHS) mental health programme and the Hawke's Bay (HB) shared care pilot - targeted at people with serious and ongoing mental illness (SOMI). The intent of the research was to inform service delivery arrangements and to provide new knowledge concerning the development of innovative services. Four sources of data - programme documentation, evaluation reports, utilisation data and stakeholders' experiences acquired through questionnaires and interviews - were used in developing the case studies. While the history of these innovations was traced to specific actions, these innovations emerged because of the national and clinical context. The NUHS programme was a bottom-up development the innovation occurring because NUHS needed to find a way of meeting the needs of the people with SOMI who were registered there. NUHS practitioners in consultation with the community made decisions concerning the programme's development The HB pilot was a top-down development that was purchased because new money became available. Primary and secondary service practitioners, managers, researchers and the purchaser made decisions concerning the pilot's initial development. The factors that shaped the innovations included: funding, staffing, clinical and financial risk management and time. Similarities in the innovations included the range of arrangements for mental health care for individual people (from GPs being the sole providers through to GPs providing only physical health care, with the mental health service providing the mental health care), issues of trust and poor communication between the primary and specialist services and the frequency and length of consultations. Differences included the payment arrangements, access issues, the formalisation of co-ordination arrangements and the role of the nurse. The research found that to be adopted for routine use these innovations needed to develop effective service delivery arrangements. The NUHS programme was more successful than the HB pilot at delivering accessible, acceptable, co-ordinated, comprehensive, efficient and effective services. The findings regarding targeting, funding mechanisms, practitioner roles and the time it takes for trust to develop so that innovative services can become established have implications for Primary Health Organisation development. Research is needed on other innovative services to establish whether evaluating the effectiveness of the service delivery arrangements provides a useful framework to monitor and guide the implementation of an innovation in service delivery.</p>

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The New Zealand Mental Health Strategy: Is it Making Any Difference?

Cited by 2 publications

References 4 publications

Negotiating the Network: The Contracting Experiences of Community Mental Health Agencies in New Zealand

Negotiating the Network: The Contracting Experiences of Community Mental Health Agencies in New Zealand

Innovation in Service Delivery: the Expansion of General Practice Services for People with Serious and Ongoing Mental Illness

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