1. What do we want? - An Integrated System
When do we want it?
- NOW!
Jane Kinsey (GM) & Dr Heather McPherson (CD)
NMH – March 2018

2. Ages & Stages MH&A (Ref: On track)
Past
Current
Future
Disease focus
Illness
Wellbeing
Hospitals
Community-based care
Health and social systems
Volume
Outputs and outcomes
Value
Fragmented
Coordinated
Integrated
Singular response
Joined-up actions
Collective impact
Command and control
Collaboration
Co-production
Simple
Complicated
Complex
Low adaptability
Innovative
Agile and adaptive
Patients
Service users
People
Medical model
Recovery
Social determinants model
14 contracted NGOs
17 individual services in MH&A – separate management, referral criteria

3. Current pressures Demand for PMHI outstrips supply
PMHI focus is mild to moderate – What about capacity for moderate to severe?
Addictions and other co-morbidities
Distress / stress increased presentations
Disconnect with specialist services – D/C
Physical health outcomes
Social pressures - Housing and employment

4. Integration Framework Leadership and culture
Building Trust
Maori models of care
Leadership and culture
Model of care – getting the basics right
Improvement

5. Integration – what does it mean?
What is the challenge?
Meeting people’s Physical, Mental and Social Needs
What does it mean?
Integration of health and social care, primary and specialist care, and physical and mental health care

6. Integration for us:
Within and across specialist MH&A services
Across service continuum – NGO, primary, secondary and tertiary
Holistic care – mental and physical health
Across sectors – social and education

7. Ages & Stages of health care

8. Challenges to MH&A integration Workforce
Ageing workforce
Training and education
Population diversity
Recruitment and retention
Collaboration and integration
One team across continuum and sectors
Shared care / Info sharing
Top of scope / Role clarity
Increasing Demand on services
Complexity
Co-existing

9. Current initiatives Psychiatry liaison in primary care
Nurse Practitioner in primary care
Primary care – credentialing programme
GP CD for Mental health
SPOE and Joint primary/secondary triage and MDT discussion complex cases.
Equally Well / wellness focus
Health improvement practitioners
Supported discharge to primary care
PMHI – counselling / psych
Locality focused teams (iLoc teams)
IPS employment support
Group intervention e.g. refugee population
Targeted programmes e.g. corrections
Peer & community support workforce
MH Pharmacist
IT tool for primary and secondary metabolic monitoring