Another day of sabbatical wonder!

This is Dr. Andrew 'Andy'  Horrigan, psychiatrist for CATT. He is one of several psychiatrist who work for CATT (and not the only American), which is the crisis assessment team that covers 24/7, the area covered by Capital & Coast Board of Health, the government entity that would be the equivalent of our DBH for the state. Andy grew up in Maine and completed his medical studies at Dartmouth College, after graduate studies in Ohio. He then worked for three years at Manchester Mental Health as a team psychiatrist. Andy just started here two weeks ago. He acts as a consultant within the crisis response team that meets with clients in the various community settings where they are struggling at the time of contact. He was quick to identify his role as 'consultant', reaffirming that his role on the CATT crisis response team is just as another equally valued member of this team, a difference from his role in the states. Andy also made a point to illustrate with example that many of the other team members are more skilled interviewers than himself and he is glad to observe and learn from the nurses, both male and female who make up most of the crisis response team that he goes with into the community for crisis assessments.
Lately I have been slack at the picture part of documenting my sabbatical work, in part due to the challenges of meeting many new people and staying focused in my listening role. I have some other photos but am awaiting formal permission to use them.
Waka Saba is the director of CATT, a female nurse of Maori heritage, an easy to talk to guide and highly skilled facilitator, who has been my primary support and contact these past four days on the Kenepuru Hospital grounds where CATT is based.
Waka introduced me to Vicki who is the director of Te Haika, which loosely translates to 'the anchor'. It is the foundation and keystone to the new system of coordinated mental health services here. Capital & Coast has twenty-six discrete treatment teams, who in fact do most of what we do in community mental health. They were faced with significant challenges of service communication and coordination between all of these teams. They determined that the core problem was the fact that incoming calls for initial contact and service were responded to with significant inconsistencies, in part due to a wide range of first point of contacts, and that if they could route all calls through one central service, with skilled clinical-medical staff to assess and refer, then they could establish the consistency needed and gain many efficiencies in being able to coordinate all 26 teams to match the need of the service call at the time of first contact. Vicki and her team has achieved this with their high tech system that records all calls and tracks many details of every contact in order to better measure the full scope of response to all mental health needs in their service region. Quantifying these calls has also revealed certain gaps in service accommodation, allowing for a more informed service design that better meets those needs. A couple of years ago Vicki, with a strong aptitude in IT and a significant background in mental health services, began Te Haika as the sole point of initial contact and appointment coordination and assignment, for the whole service area. This has resulted in many new efficiencies, like a 58% improvement in reduced wait times for first appointments. They are just beginning to see the significance of many of these new efficiencies, and the staff report a much better sense of effectiveness in their roles. My interview with Vicki and Waka amazed me and I wished I had video taped it. I said as much to them and they agreed we may be able to repeat this discussion down the road and record it.
Waka drove me out to visit one of the four respite houses that is part of the community support services. This one in an upscale urban community called Whitby just east of Porirua. The home is very bright with lots of glass and great views. It's purpose is to provide brief respite for up to four adults at the same time. I was introduced to Jean, whose shift spans the afternoon and evening. She said she finds her role at the respite house very satisfying, in part because she feels her work is purposeful. Since Te Haika has been implemented the respite program has gone from a utilization that ranged at the 60 to 70 percent level to a more consistent 90% range. Similar improvements in efficiencies of system resource utilization have resulted across the service spectrum here since Te Haika and CAPA have been implemented.
Well, today things have begun to settle more into a routine of sorts. I left my home base in Otaki at 7:45am and biked for 45 minutes to reach the train station in Waikanae, then its a 40 minute train ride down to Kenepuru, and a 5 minute walk from the train and up the hill to CATT. Then of course the reverse to get home. Thankfully it did not rain much while I biked the hour and a half today. I am glad for the exercise and a closer look at the communities I pass through. Tomorrow it's back to learn more while I shadow a nurse named Ian on the CATT team.

First Day Of Sabbatical

 This is the seat of central government, and perhaps Wellington's most iconic landmark, the 'beehive'. I took a short walk from the Capital and Coast Board of Health office where I spent most of my first day on sabbatical and ate my lunch in the sun.

 In the caption below you can see the modest four story grey building where the C&C offices are on the top floor. They all access the office space climbing the stairs. They are a short walk from the train station where I caught the train back up the coast to Otaki at the end of the day. These offices are scheduled to move a short time after I return home as this building must be refitted for higher earthquake standards. They will move next to the Wellington Regional Hospital and the new-yet-to-open APS section of the hospital.

 Below is the largest wooden structure, with the red roof, that now exists in the southern hemisphere. It sits just a block from the Beehive. In the foreground is a Maori tribal landmark called a 'po', spelling is uncertain.

 This is the plaque seen when entering the C&C office space for Tony Littlejohns, Operations manager, who shares the top floor with an interior designer, and about eight other staff. I was introduced to eight others who came for a regional planning meeting that I sat in on for the implementation of CAPA. For those curious about CAPA, The Choice and Partnership Approach, see www.camhsnetwork.co.uk   This system is a new approach that has proven to eliminate waiting lists for intakes and 2nd session follow ups,  it appears to pose significant advantages and efficiencies.

 Tony Littlejohns drove me across town to the Wellington Regional Hospital so I could get my official badge. The security staff at the hospital did not pay attention to the "Special Staff" status that was listed on the form or the expiration date that was for this May, oh well.