Midland MH&A Projects 20/21

At the March 2020 Clinical Governance meeting it was agreed that several regional projects will be undertaken that target specific specialist services.  Four projects were identified:

  1. Emotional Intensity Disorders
  2. Infant Child Adolescent MH&A
  3. Infant Perinatal
  4. Eating Disorders

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Emotional Intensity Disorders (EID)

Kate Stewart(Completed)

The Midland MH&A Clinical Governance network commissioned the EID project in early 2020 - Kate Stewart was appointed to lead the project.

A diagnosis of borderline personality disorder (BPD) attracts considerable stigma and discrimination within healthcare services.  In the literature contact and engagement with health services for people with BPD is noted to be often difficult, typified by negative attitudes and sometimes punitive behaviour.  Studies suggest that BPD whaiora generate an uncomfortable personal response from clinicians.  Individuals with BPD have been described as “untreatable”, “attention seeking”, “difficult”, “manipulative” and “time-consuming”.

Project objectives included:

  • Identification of gaps and solutions in the current Midland EID continuum
  • Identification of effective support and treatment modalities
  • Development of a continuum of care and support that is culturally safe, supports consistent application and is equitable access across the Midland region
  • Identification of education and training required to support provision of effective care and support across the continuum

EID ProjectProject Recommendations:

The EID project steering group recommends the Midland Clinical Governance group:

  • accepts all components of the proposed Midland EID service framework
  • endorses proposals developed under the Access and Choice funding to enable  implementation and ongoing functionality of the proposed EID service framework
  • supports the establishment of a Midland EID working group to implement and maintain oversight of  Midland regional EID service provision
  • supports changing the language and attitudes associated with the diagnostic term BPD and endorse socialisation of the term EID across MH&A services

Please click here to read the full report or click here for the Project Scope.

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Infant Child Adolescent Mental Health (iCAMHS)

Kate Stewart

(Completed)

The Midland MH&A Clinical Governance network commissioned the iCAMHS project in early 2020 - Kate Stewart was appointed to lead the project.

The Midland DHB Clinical Governance group is seeking to improve its response to Midland whaiora and whānau who access ICAMHs services.

Drivers for change include the He Ara Oranga report and the current Midland MH&A inpatient rebuild cases.  Both have furnished the region with an opportunity and obligations to review what is being provided.  Furthermore, longstanding concerns regarding the quality of treatment provided to Midland whaiora by Auckland District Health Board (ADHB) Starship Child & Family Unit (CFU) have also been a catalyst for change.  

Project Objectives Included:
  • identification of gaps and associated solutions within the existing Midland ICAMHs service continuum
  • exploration of the feasibility and sustainability of returning the Midland funded CFU beds to the region
  • identification of workforce issues and solutions
  • development of a co-designed service framework that utilises local and regional solutions and supports improved outcomes for Māori

iCAMHS ProjectProject Recommendations:

  • Accepts all components of the proposed Midland ICAMHs service framework
  • Endorse proposals developed under the Access and Choices funding to enable implementation of the proposed Midland ICAMHs acute care service framework
  • Support the establishment of a Midland ICAMHs working group to lead the implementation of the Midland ICAMHs acute care service framework and maintain oversight of  ongoing functionality
  • Support a second Midland ICAMHs project phase to further develop the community and primary care components of the ICAMHs treatment and support continuum

Please click here to read the full report or click here for the Project Scope.

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Eating Disorders

Project Statement

Given that Eating Disorders have the highest mortality rate of any disorder, EDS clients throughout the region need to have access to high quality care, appropriate treatment options that meets their level of need that is close to home as possible. Develop stepped care that establishes local services through to intensive service requirements and explicitly recognise the importance of a whānau centred approach. 

Click here for the Project Scope.

Objective

The project will:

  1. Explore what the continuum would look like if the funding for the Northern region bed is returned to Midland
  2. Identify gaps and solutions at local and regional level and provide recommendations
  3. Examine the critical mass issues around clinical need referral / risk fluctuations
  4. Implement an agreed level of stepped care including day programmes and re-feeding strategies that include co-morbidities and trauma informed best practice
  5. Develop pathways of care that are agreed regionally that leads people into the right level of care
  6. Future proofing the services going forward to meet the diverse needs of Maori
  7. Identify workforce development / staff requirements and supervision needs

deirdre-mulligan.jpgThe Project Steering Group are representatives across the Midland region and led by Deirdre Mulligan

  • Amber Fletcher (Bay of Plenty)
  • Emma Thomas-Redward (Bay of Plenty)
  • Helen Mc Petrie-Tarei (Lakes)
  • Gemma Dymond (Taranaki)
  • Jo Miller (Taranaki)
  • Julia McLean (Taranaki)
  • Maureen Macann (Tairawhiti)
  • Alesta Stephan (Waikato
  • Amanda Shanley (Waikato)
  • Glenn Bradburn (Waikato)
  • Lynne Blake (Waikato)
  • Marie Sievwright (Waikato)
  • Jolene Proffit (Waikato)
  • Stacey Porter (Werry Whāraurau)

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Infant Perinatal

Project Statement

  • To develop a consistent equitable stepped model of care for caregivers who use infant perinatal mental health and addiction of services across the region to ensure:
  • Effective level of provision with regionally agreed pathways of care that are culturally appropriate, safe and address’s intergenerational trauma
  • Experience of the whole whānau is valued
  • All services involved are coordinated and seamless
  • Ensure primary health pathways for caregiver and baby are developed

Click here for the Project Scope.

Objectives 

The project will provide:

  1. A regional model of care that includes local and regional options
  2. Regionally agreed and consistent pathways
  3. Include services for all mothers including teen mothers / care givers and infant
  4. A regional model of care that is culturally adept and deliberately aligned to Maori aspirations and objectives, as described in the regional strategic accountability documents

 The Project Steering Group are representatives across the Midland region and led by Deirdre Mulligan

  • Sandra Patton (Bay of Plenty)
  • Tim Gutteridge (Lakes)
  • Hine Moeke-Murray (Tairawhiti)
  • Wendy Tyghe (Tairawhiti)
  • Nicky Askew (Taranaki)
  • Jacque Coates-Harris (Waikato)
  • Belinda Walker (Midland Regional Network)