Midland MH&A Projects 16/17


Midland Substance Addiction Compulsory Assessment Treatment Legislation

From 21 February 2018, the new Substance Addiction (Compulsory Assessment and Treatment) Legislation, SA(CAT)L, will come into effect. The new legislation will replace the earlier Alcoholism and Addiction Act and will have a number of implications for providers within the Mental Health and Addictions field. Over several months, NGOs and DHBs from across the Midland Region have contributed to the development of a Model of Care for services to work with the legislation.

Legislation governing substance use and addiction was last reviewed in 2010 by the New Zealand Law Commission.  The Review confirmed that the Alcoholism and Drug Addiction Act 1966 was no longer relevant for the current context in terms of legal and clinical matters.  The Act was also not aligned to current philosophy and practices.  Subsequently a new framework was recommended resulting in the development of The Substance Addiction Compulsory Assessment and Treatment (SACAT) Bill 2016.

The rights, dignity and health and safety of people who experience substance addiction are central in this new Bill with an expectation that the compulsory components of assessment and treatment will be managed appropriately in the least restrictive way.

The Act “provides for compulsory treatment of persons with severe substance dependence for the purpose of protecting them from harm and restoring their capacity to make their own decisions about their future substance use”.

The Act details threshold criteria and the processes required to achieve a positive outcome for the person experiencing substance addiction.  It also identifies key roles and responsibilities to ensure that processes are implemented (with mana and respect) by personnel with the right skills in the right place.  Processes such as an assessment is facilitated, treatment and treatment planning is applied, informed decision making is supported, and the pathway to voluntary treatment is supported.

SACAT MoC

Midland Sub-Regional has undertaken comprehensive workshops to inform the new model of care for the assessment and treatment of substance addiction.  This model will need to be implemented in order for the Midland Sub-Regional DHBs to meet the legislative requirements of The Substance Abuse Legislation (SAL) 2016.

Click here to read the report.

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Proposed Regional EDSMidland Eating Disorders Change Proposal

The Midland DHBs are seeking formal agreement for the implementation of a new model of care for Eating Disorders Services (EDS) delivered closer to home from a continuum of integrated partnerships that encompass primary, secondary and tertiary level care.  This regionally coordinated model of care is similar to the acclaimed South Island DHBs EDS and will be fully implemented in the 2018-2019 year.

Over the past nine years the Midland region has continued to develop its EDS capacity and capability at individual DHB and regional levels, and consistent with Ministry of Health directions.  It has been reliant on the tertiary service component being provided by the Northern region, Auckland DHB (ADHB).  A recent review showed that the provision of the tertiary component was problematic and recommended that Midland DHBs withdraw from the ADHB arrangements with the exception of access to a Tupu Ora bed, and that other options be explored.

A gap analysis of the Midland DHBs’ EDS confirmed their strengths and areas for development.  Local accessible service user-centric services are in place and are well developed in most DHBs but access to tertiary level consultation, liaison and supervision for more complex cases will be needed when the arrangement with ADHB ceases. Options with Southern, Central regions and Waikato DHB have been explored.  Further to this is the need for a centrally coordinated training and development programme for EDS workforce.  Established networks are to be further strengthened to connect the workforce regionally and nationally enhancing collegial relationships and learning.  EDS Family support groups are to be developed to foster peer support.

Overall the new Midland EDS model will provide opportunities for quality improvement with the development of evidence-informed consistent guidelines, standards, policies and procedures to support its implementation, consistent with the New Zealand Health Strategy’s five strategic themes.

In 2008 The Ministry of Health (MoH) reviewed EDS provision nationwide and developed the document Future Directions for Eating Disorders Services in New Zealand.  At that time the Midland region did not have a robust system for delivering eating disorders services. Additional MoH funding allowed the Midland region to develop and strengthen its Eating Disorder continuum of care recruiting Midland Eating Disorders Liaison roles within each of the Midland DHBs.  Options were explored for managing the more complex cases, and collaborating with the Northern region in a supra-regional arrangement seemed a practical solution in the immediate term.  However over the past years Midland has invested in their own service development including local workforce (in addition to funding the ADHB delivered EDS) to support a more comprehensive continuum of care closer to home for a wider range of Eating Disorders, consistent with the Midland Mental Health and Addiction strategic plan.

Click here to read the report.