Midland MH&A Projects 14/15

Infant Perinatal Mental Health & Addiction Project


In April 2014 a proposal for one off funding was submitted to the Ministry of Health.  Access to high quality training for highly specialised areas is always difficult to access.  This proposal intends to bring facilitators from the Australian Child Centre to provide three regional workshops (the same workshop repeating) for the Midland Perinatal Infant clinicians.  Feedback from the Perinatal Infant Phase II workshops was consistent especially from the LMC’s that there is very little training available around mental health and addictions perinatal and maternal.  An integrated approach to the workshops was fully implemented.

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Infant Perinatal Mental Health & Addiction Faciltator Dr Denise Guy

Dr Denise Guy is a Child Psychiatrist who has worked in Infant Mental Health [IMH] in Australia and New Zealand for almost three decades.  She is President of the NZ IMH Association [IMHAANZ] and was a founder member of the Australian and New Zealand Affiliates of the World Association for Infant Mental Health [WAIMH].

Denise provides IMH supervision to individuals, home visiting and DHB services. She co-ordinates the training and supervision in Australasia of Watch, Wait and Wonder®, an evidence-based relationship intervention for infants from 4 months to 4 years. She is Clinical Advisor to the Counties Manukau DHB “Look at You, Aroha Atu, Aroha Mai” DVD projects for parents, wh?nau and professionals regarding the social and emotional needs of babies in the first 3-4 months of life. Denise is a Trustee of Incredible Families which focuses on the early years with the delivery of Incredible Years parenting programmes, Fostering Changes and Watch, Wait and Wonder.

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Midland Infant Mental Health Workshops with Dr Denise Guy

Three series of Infant Mental Health workshops were held in the Midland region facilitated by Dr Denise Guy in November, Decmeber 2014 and March, May & June 2015, the workshops were:

Workshop 1: Introduction – The First Years

This workshop encompassed:

  • An Introduction to infant mental health
  • The Framework – prevention, promotion, intervention and treatment
  • The Infant’s First Year – relationships and social and emotional development
  • Using the framework to look at the first year in more detail
  • An approach to organising observations of the parent-infant relationship in the first year
  • Clinical discussion and interactional film

Please click here for the Workshop I Evaluation Report

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Workshop 2: Attachment & Caregiving

This workshop encompassed:

  • Attachment – addressing secure, insecure organised and disorganised patterns with particular emphasis on Disorganisation
  • A life span perspective on Attachment including discussion of the Adult Attachment Interview
  • Parenting/Caregiving behaviour and the development of the infant/young child’s attachment relationship
  • An Introduction to Reflective Function

Please click here for the Workshop II Evaluation Report

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Workshop 3: Tailored to DHBs

The 3rd Workshop was run with the DHB staff involved in providing perinatal and infant mental health services. Each DHB is at a different stage in developing services, having dedicated staff, and in the training and skills of these staff.

The following topics were proposed to the DHBs for this workshop:

  1. Training in the Revised Diagnostic Classification System for 0-3 [DC: 0-3R] – Axis I and II. This workshop would require a clinician on site taking responsibility for obtaining interactional film on 2-3 clinical cases.
  2. Working through the Clinical Assessment of an IMH Referral – again it would be necessary to have clinical material from the particular DHB and we would work through the process of completing a full IMH assessment, formulating and planning treatment
  3. Filming in IMH – for assessment and intervention purposes; when, what, how
  4. Intervention and Reflective Supervision – again requiring some clinical material from the particular DHB.

Please click here for the Workshop III Evaluation Report


Building Co-existing Problems Responsive Services


During the months of May and June, workshops were held in the Bay of Plenty, Lakes and Waikato areas for “Building Co-existing Problems Responsive Services”, facilitated by Ashley Konig from Matua Raki & Suzette Poole from Te Pou.

Leaders and managers in mental and addictions services from DHB and NGO were invited to participate.

The content of the workshop was to provide an opportunity to utilise the CEP Service Checklist to identify local systems that are supporting CEP responsiveness and integrated care and areas that need development to inform a district wide action plan to improve services for people with CEP. 

Please click here for the CEP Workshops Evaluation Report.


Northern & Midland Supra-regional Eating Disorders Model of Care Project

 2014 Revision of the EDS Service Delivery Model

The Northern and Midland Regions have collaborated on the development of a sustainable model of care that optimises health outcomes for both regions’ populations (specifically for people with Anorexia Nervosa, Bulimia Nervosa or an Eating Disorder Not Otherwise Specified (EDNOS)) and reduces disparities within the available resources.

This process required collaborative governance, leadership and decision making by stakeholders from across the Northern and Midland regions. The process has provided guidance in the development of a sustainable model of care that optimises health outcomes and reduces disparities within the available resources.

The information gathered during consultation and development has helped define the supra-regional requirements for the full range of eating disorder services (with particular reference to understanding service access, age group requirements and geographical barriers).

Specifically this revision process has:

1.   Provided visibility of current service activities and outcomes

2.   Defined critical success factors and a proposed service configuration with respect to:

  • Service principles
  • Client centredness (in particular consideration of services for Maori and Pacific people)
  • Clinical and service effectiveness
  • Service interfaces and communication approaches
  • Governance and leadership
  • Communication and clinical support
  • Providing equitable access across a broad geographical area
  • Affordability and sustainability
  • Implementation and service provision mechanisms
  • Approaches for measurement and evaluation

The project is being led by the Northern Regional Alliance on behalf of the Northern and Midland DHBs.


Midland Mental Health & Addiction Regional Strategic Plan Re-write



The purpose of this project is to revise the Midland Mental Health and Addiction strategic plan consistent with the national directions. The revision will articulate the strategies and goals that the five Midland District Health Boards (DHBs) agree to approach regionally while acknowledging the importance of individual DHBs strategic and district plans. This includes responsibility for planning, funding and organising the provision of mental health and addiction services at their respective individual district level.

The project is being led by Roz Sorenson

Midland MH&A Regional Strategic Plan Re-write Project Scope 

Midland MH&A Regional Strategic Plan


Midland Mental Health & Addictions Clinical Workstation Project


 A regional MH&A Clinical Workstation Steering Group was established following a presentation from Regional IS (RIS) regarding the issues with the Waikato DHB implementation to the MH&A Clinical Governance Network on the June 2014. Shortly thereafter it was decided by the regional Chief Executive group to defer the Waikato implementation and continue with the other Midland DHBs. The first CWS Steering Group was held in July 2014.

Midland MH&A Clinical Workstation Project Scope

Purpose of the Clinical Workstation Steering Group

The purpose of the Midland Region MH&A Clinical Work Station Steering Group is to:

1. Identify and define a common set of core MH service requirements and processes.

2. Inform the development of a regional IS solution that supports the business needs of the MH&A services across the region.

3. Identify common data requirements for MH&A in the Midland region.

4. Develop a framework and approach for implementing a common MH&A information system solution across the Midland region.

Clinical Workstation Steering Group Terms of Reference

Members of the Clinical Workstation Steering Group:

  • Ross Ekdal, Acute Manager, Taranaki DHB
  • Dr Sharat Shetty, Clinical Director, Taranaki DHB
  • Virginia Enders, Information & Knowledge Manager, Waikato DHB
  • Dr Rees Tapsell, Clinical Director, Waikato DHB
  • Michael O'Connell, Lakes DHB
  • Belinda Walker, Corporate Business Analyst, Lakes DHB
  • Dr Sue Mackersey, Clinical Director, BOP DHB and Chair
  • Eileen Hughes, Business Manager, BOP DHB
  • Debbie Barrow, Acute Manager, Tairawhiti DHB
  • David Stevenson, Data Information Analyst, Tairawhiti DHB
  • John Beveridge, Canterbury DHB
  • Dr Barry Walsh, Ministry of Health
  • Sue Brown, West Coast DHB
  • Darren Douglas, Regional IS, HealthShare
  • Greg Stevens, Regional IS, HealthShare

Project Support:

Support to the project is provided by Kate Stewart (Project Consultant), Eseta Nonu-Reid (Midland MH&A Regional Director) and Ashley Bajaj (Midland Decision Support).


Midland Trauma Informed Care Workshops


Trauma is often normalised or routinized to the point where people are living with it and adapting to it without recognizing its nature as illness.

Trauma in the workplace requires workforce engagement if services are to be improved. Whilst consumer presence is often notable, it is generally tokenistic, yet the experience of trauma is significant and operative at different levels, including historical violence, PTSD, and comorbidity particularly in relation to alcohol and drugs. The changing context and treatment of mental health care requires careful planning for effective engagement.

Workshops were held across the Midland region to provide an introduction to Trauma Infomed Care.  The workshops were facilitated by Anna Elders.  The workshops covered:

What is trauma?


 Simple trauma vs complex trauma

How does trauma impact on our development and life trajectories?

 ACE study

 Biopsychosocial impacts


Re-triggering and re-traumatisation

 How MH settings can trigger and enact trauma

Trauma informed care

 What is it?

 What do we hope to achieve?

An introduction to performing trauma assessments

 What are they?

 Who should be performing them?

 The basics in assessing trauma

 Evaluations were completed at the end of each workshop by the participants and a final Evaluation Report was completed.


Midland Perinatal and Infant Project - Phase II


Following on from Phase I of the Maternal Stocktake of Secondary Services Project the purpose of this project is to undertake a stocktake of primary, maternal, WellChild and community Infant and Maternal mental health and addictions services across the region. The Ministry of Health Service Development Plan: Rising to the Challenge 2012 identifies Infant and Maternal as a priority going forward.

The objectives of this project are to:

  • Meet with the Midland Clinical Governance Group and discuss Healthy Beginnings and what  model of care is envisaged including relationships, linkages and service provision from primary health care and community providers
  • Undertake a stock take of current services within the community and identify how services support mothers and babies at the different levels of acuity and when hospitalisation is required
  • Engage stakeholders in workshops to confirm local stocktake findings and develop a model of care
  • Make recommendation regarding implementation of the proposed model of care at the local DHB level
  • Undertake a gap analysis of the stock take and proposed model of care.

Please click here for the Phase II report.


Perinatal and Infant Project
> Perinatal and Infant Project Scope
> Perinatal and Infant Project Report - April
> Perinatal and Infant Project Report - May


This project will be led by Roz Sorensen


Midland Perinatal & Infant Workshop held during March and April

The Midland Mental Health and Addiction Regional Network are undertaking projects to improve access to service for mothers and infants who experience mental illness during the perinatal period. The Network has already completed the first phase of the project which focused on specialist secondary mental health and addiction services; please click here for a copy of the report.

This workshop is for maternity service providers in primary care and includes primary maternal mental health as well as maternity professionals. It aims to: 

  • Improve knowledge of what services are available in Lakes
  • Improve the referral process to/from mental health services
  • Gather information to inform the work being undertaken on a local pathway for primary maternal mental health services (using Map of Medicine)


Midland Supervision Scholarship - Successful Applicants

At the beginning of the year Midland MH&A offered 10 scholarships to the sector to apply to attend the Supervision Training hosted by Compass Ltd and facilitated by Michael Durrant a psychologist based in Sydney.

The feedback from the successful scholars in 2013 was very positive hence we decided to offer this scholarship to the sector in 2014.  Scholarships closed on the 14 March.

The 10 successful applicants are:

  • Kelly Johnson, Eastern Bay of Plenty
  • Orini Marr, Eastern Bay of Plenty
  • Sela Kingi, Eastern Bay of Plenty
  • Terry Health, Western Bay of Plenty
  • Vicky Hall, Western Bay of Plenty
  • Yvonne McGarvey, Bay of Plenty
  • Noeline Kuru, Lakes
  • Blossom Steward, Tairawhiti
  • Hine Moeke-Murray, Tairawhiti
  • Gwen Taueke Ah-Sin, Waikato