scholarly journals The content of Mental Health Advance Preference statements (MAPs): An assessment of completed advance directives in one New Zealand health board

2020 ◽  
Vol 68 ◽  
pp. 101537
Author(s):  
Jessie Lenagh-Glue ◽  
Katey Thom ◽  
Anthony O'Brien ◽  
Johnnie Potiki ◽  
Heather Casey ◽  
...  
2021 ◽  
pp. 103985622110092
Author(s):  
Lillian Ng ◽  
Alan F. Merry ◽  
Ron Paterson ◽  
Sally N. Merry

Objectives: This aim of this qualitative study was to explore the experiences of clinicians involved with inquiries into the mental health care of patients who were perpetrators of homicide in New Zealand. Methods: Our purposive sample comprised ten clinicians working in New Zealand district health board mental health services. These clinicians were individually interviewed. Interviews were audio-recorded, transcribed and thematically analysed. The coding framework was checked and peer reviewed by an independent researcher. Results: Five themes were identified: the inquiry process; emotional burden; impact on team dynamics; changes to individual clinical practice; and perceptions of inquiries being influenced by organisational culture. Clinicians involved with inquiries reported significant anxiety and disrupted multidisciplinary team dynamics. Some participants found inquiries led to changes to their clinical practice and perceived that a punitive organisational culture limited learning. Conclusions: Clinicians perceived inquiries as threatening, anxiety provoking and primarily concerned with protecting organisational interests. Communication of the inquiry process and ensuring inquiry findings are disseminated may enhance clinicians’ experiences of inquiries and facilitate their participation and their reflection on changes to clinical practice that could contribute to improving services. Support for clinicians and multidisciplinary teams should be emphasised by the commissioning agency.


2005 ◽  
Vol 39 (8) ◽  
pp. 713-718 ◽  
Author(s):  
Kathy Eagar ◽  
Tom Trauer ◽  
Graham Mellsop

Objective: To examine the performance of two widely used outcome measures in public adult mental health services. Method: As part of a larger study, clinical staff in eight New Zealand District Health Board areas collected consumer outcomes data for a period of 6 months. Among other measures, the Health of the Nation Outcome Scales (HoNOS) and Life Skills Profile (LSP-16) were completed at the start and end of episodes of care, as well as at 90-day reviews. Results: The performance of these twomeasures was examined in relation to compliance with the data collection protocol, item completion rates, certain psychometric properties, the relationship between them and the relationship of each instrument to the age, sex, principal psychiatric diagnosis and legal status of the consumer. Compliance with the HoNOS was superior to the LSP-16, but the reverse was true for completion. The two instruments were strongly correlated, but not enough to suggest that one may substitute for the other. A five-subscale structure for the HoNOS was supported. Certain HoNOS subscales were associated with age, but the total score was not, and differences between the sexes were small. Some large diagnostic differences were observed on both instruments. All LSP-16 summary scores and all HoNOS summary scores apart from Depression were higher (worse) in involuntary episodes. Only one LSP-16 item, relating to work potential, was related to age and men generally scored higher (worse) than women. Conclusion: From a technical perspective, the HoNOS and LSP-16 appear suitable for routine collection. New Zealand has adopted the HoNOS for routine use but not the LSP-16 because of local concerns about its appropriateness and acceptability. The clinician-rated measures reported here need to be complemented by both consumer-rated and family/carer measures.


2021 ◽  
Author(s):  
◽  
Jacinta Apelu

<p>As meeting the mental health needs of the Pacific people living in New Zealand has become a major focus for providers and District Health Boards since deinstitulisation, so is the significance of mental health care delivery for the Pacific minority. Pacific community mental health (PCMH) nursing as a means of healthcare delivery is a fairly new and unknown practice domain. The fact that no studies have been carried out to explore nursing in this field makes this an area that requires an understanding. This understanding will, in turn, enhance knowledge embedded in PCMH nursing and helps reduce practice constraints. This study explored the perspectives of Pacific nurses on what it is like for them to work in a PCMH service within a District Health Board. Five Pacific Island nurses who worked in the three Pacific Community Mental Health services based in the Auckland region participated in the project. The study employed narrative inquiry to gather data through focused storytelling method. The results of the study have indicated that PCMH nursing is a unique nursing field as well as highlight significant practice issues for nurses. Complex service infrastructure and language have been found to be the major contributing practice constraints. The findings suggest the need for District Health Board authorities, Pacific Mental Health service management, professional nursing education and development programs to consider addressing these practice issues to prevent further increase in the problem of PCMH nurses shortage and enhance recruitment and retention of these nurses.</p>


2009 ◽  
Vol 21 (4) ◽  
pp. 103-108
Author(s):  
David McNabb

This paper recounts the changes in the New Zealand government-run health services over the past 15 years and the subsequent changes to social work leadership in mental health services. Drawing on two pieces of local research, the article will explore social work mental health leadership in New Zealand. The first piece of research investigates the views of social work professional leaders (PL) about their roles and the prospects for social work in mental health in the future. The second piece of research investigates a new type of professional leadership role in the mental health services of the Auckland District Health Board. Clinical governance is an emerging phenomenon in health services internationally that is aimed at advancing quality improvement. This paper links developments in social work professional leadership with the activities of clinical governance in mental health services. It concludes that there is evidence of an improvement to the leadership infrastructure and of the contribution of leaders to clinical governance in district health boards (DHBs). However, many challenges remain for social work leaders into the future.


2021 ◽  
Author(s):  
◽  
Grace Liang

<p>Psychiatric advance directives (PADs) are an emerging method for adults with serious and persistent mental illness to manage their treatment by documenting treatment preferences in advance of periods of incapacity. However, the application of PADs has largely been neglected by the legal and psychiatric discourse in New Zealand. This paper presents some of the key purposes and unrealised benefits of PADs, and explains why New Zealand’s law and policy surrounding advance directives in the mental health arena is unclear compared to other jurisdictions. Though interviews conducted with New Zealand clinicians and consumer advocates, key practical and legal dilemmas around forming, monitoring, and enforcing PADs were extracted and dissected. Interviews elucidated that, while attitudes were generally positive attitude towards PADs in the mental health system, the lack of a focused PAD strategy stifled its promulgation where it could most benefit service users. This paper proposes that PADs should be promoted, and articulates a normative PAD strategy for New Zealand.</p>


2021 ◽  
Author(s):  
◽  
Grace Liang

<p>Psychiatric advance directives (PADs) are an emerging method for adults with serious and persistent mental illness to manage their treatment by documenting treatment preferences in advance of periods of incapacity. However, the application of PADs has largely been neglected by the legal and psychiatric discourse in New Zealand. This paper presents some of the key purposes and unrealised benefits of PADs, and explains why New Zealand’s law and policy surrounding advance directives in the mental health arena is unclear compared to other jurisdictions. Though interviews conducted with New Zealand clinicians and consumer advocates, key practical and legal dilemmas around forming, monitoring, and enforcing PADs were extracted and dissected. Interviews elucidated that, while attitudes were generally positive attitude towards PADs in the mental health system, the lack of a focused PAD strategy stifled its promulgation where it could most benefit service users. This paper proposes that PADs should be promoted, and articulates a normative PAD strategy for New Zealand.</p>


2021 ◽  
Author(s):  
◽  
Jacinta Apelu

<p>As meeting the mental health needs of the Pacific people living in New Zealand has become a major focus for providers and District Health Boards since deinstitulisation, so is the significance of mental health care delivery for the Pacific minority. Pacific community mental health (PCMH) nursing as a means of healthcare delivery is a fairly new and unknown practice domain. The fact that no studies have been carried out to explore nursing in this field makes this an area that requires an understanding. This understanding will, in turn, enhance knowledge embedded in PCMH nursing and helps reduce practice constraints. This study explored the perspectives of Pacific nurses on what it is like for them to work in a PCMH service within a District Health Board. Five Pacific Island nurses who worked in the three Pacific Community Mental Health services based in the Auckland region participated in the project. The study employed narrative inquiry to gather data through focused storytelling method. The results of the study have indicated that PCMH nursing is a unique nursing field as well as highlight significant practice issues for nurses. Complex service infrastructure and language have been found to be the major contributing practice constraints. The findings suggest the need for District Health Board authorities, Pacific Mental Health service management, professional nursing education and development programs to consider addressing these practice issues to prevent further increase in the problem of PCMH nurses shortage and enhance recruitment and retention of these nurses.</p>


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