Wednesday, March 28, 2012

Art Space! And the radio waves with All Access radio NZ!

Some of the creative art space
 I was able to spend significant time with the people at Pablos and Vincents art spaces here in downtown Wellington this week. These are two of the longest running creative art workshop spaces in New Zealand. Pablos is dedicated to providing creative art opportunities  to people who have experience of mental illness, and Vincent's is just celebrating it's 25th year welcomes all community members, but is especially supportive of people with mental illness experience. Vincent's offers a life drawing session two evenings each week, and I am in hopes of sitting in soon. Next week will mark my official welcome and introduction to Vincents, when the director will host my visit.

This is Chris who works as an art tutor at Pablo's Art Workshop and is here pictured in the Roar Gallery
I was impressed with the art piece just behind Chris's right shoulder with "no" brushed in on the black background. It struck me as 'white no'ies', with probably 2000 no's and frequent "X"s.

Galen, who is the director of Pablos. Pablos is a creative art space dedicated to people who have a mental illness.
 Pablos is a great space for exploring creative interests for people who have experience of mental illness. They are dedicated to providing most materials and space use to its members free of charge. I was welcomed without the benefit of an official introduction. Chris opened up the gallery for me and was more than happy to explain the Roar Gallery's role within the Pablos' experience. Above you can see Chris with a few examples of the art produced by Pablos' members. I was lucky enough to get to talk with several of the members, some who have enjoyed and benefitted from Pablos' program for several years. One man was a former graphic design artist who was exploring and developing his skills in the studio space. He had recently challenged himself to "stretch" by painting "outside the lines", an approach very much foreign to his orientation of tight controls in his graphic design background. He was beaming with a smile that had satisfaction running from ear to ear dispute the lack of control his drippy acrylics was confronting him with.  Another fellow was proud to tell me of his partnership with an Australian art dealer who sells some of pieces outside of New Zealand. My visit at Pablos was punctuated with the very gracious welcome by its director, Ms. Galen, who was more than happy to discuss the challenges of keeping a community art space like Pablos in operation for the past twenty years. I am looking forward to returning to the art scene of Pablos and Vincents.
 
The official poster for the half-hour radio show that invited me to sit in. 
click here:  to hear the March 27th show

The studio session in action with Brendon and Dan from The A Team, a Pathways and Social Angels supported program

Two cool guys who entertain weekly on the radio waves of 783am, All Access Radio

 Brendon was keen to meet this New England Yankee from America. One of his big dreams was to have his own radio show and he has done it with the support of New Zealand's Social Angels, and the people at Pathways, like Daniel Crozier, who provides the technical support for Brendon to be able to enjoy and thrive in his radio role each week.
BRENDON: ON the AIR and LIVE! 783am radio New Zealand

Local message at the sustainable and renewable housing fair this past weekend in Paraparaumu

Above is Saba, who recently moved to Wellington with her fiancé from the Canadian Maritimes. In talking with her I learned that her fiancé, Doug, has an art and design background and she thought he would be interested in getting connected with the art spaces I had just visited in the last two days. Doug would like to get involved as a tutor, or otherwise provide some type of support. Doug has now connected with me via email and we will meet early next week so that I can help get him connected to Wellington's creative art spaces that support strengthening the voice and expression of people with experience of mental illness.

Friday, March 23, 2012

Pathways, one of the largest NGOs connected to Capital & Coast

Regional Operations Manager David Hughes of Pathways
Pathways is one of the largest NGOs that provide community based support services for people with mental illness in the Wellington area. Nationally they have 500 employes, and about 100 here in the Wellington and Kapiti Coast area. They are also part of a larger organization called WiseGroup. They are an alliance of over a 1000 employees providing a variety of community based support services in the mental health and wellness field. For those interested they have a terrific website with a very forward thinking mission. They embrace the challenges of change for the potential of innovation and leadership opportunities. Recently they have used incentivized programming for staff and clients to help bring on improvements of wellness, most reentry focused on smoking cessation.
I was invited to sit in on a meeting with a Capital & Coast service co-ordinator, Vikki, for their Needs Assessment and Co-ordination Service, on a project that is transitioning 30 people from long term support services into more independent settings in the community.
I was able to make several site visits with their staff that included an extended care residence, and three different respite houses. They have a strong mobile support program, one that specializes in medication supports in the home.  The residential staff are very motivated to help service users transition while using a recovery based approach to their treatment. A lot of their housing program success is due to the three women pictured below: Dee, Teresa, and Karen, all very committed to supporting a recovery and wellness driven service that is naturally strengths based in its focus of supports. Each housing site has a garden plot, so amongst the many skills based support work is a focus on being able to grow some of the food they eat. Of course many of the residents also like growing some flowers as well.  The Pathways homes are well appointed, bright and comfortable places to stay and visit, with a highly regarded record of effectiveness. One of the respite houses has a room called the 'sensory room' designed to help teach people techniques for deescalation and self soothing skills that has proven to be very effective.
 I hope to be able to return and spend some time with their mobile support teams soon.
Dee, Housing Co-ordinator and Teresa, team leader.

Wet Room for the Extended Care Home

Karen, respite house Team leader

Wednesday, March 21, 2012

Choice and Partnership Approach Training - CAPA


Dr Richard Holt, (American) psychiatrist, and the QA Coordinator, and then Malcolm Robson,
 Operations  Manager for Maori Specialty Mental Health Services and Health Pacifika.

It was another very early start, jumping on my bicycle by 6:30 (still quite dark) so that I would be sure to make one of the early trains that leaves from a station 10 miles down the coast. Once at my train stop, I had a challenging hike for 30 minutes up onto the hospital hill complex. Thankfully I found the site for this days' conference training with a few minutes to spare before the training got underway. A pleasant surprise was to be warmly and traditionally greeted by Te Wera, Consumer Consultant, and an inspiring person for me since I met him a couple of weeks ago. Te Wera is a skilled and very thoughtful listener. He just enrolled ( with what I suspect is a well deserved scholarship) in a three year program at a Maori College based in Otaki.  

Last Friday I spent the day learning more about the CAPA system for service organizational structuring, a system that eliminates waiting lists and provides a high degree of scheduling flexibility in response to known service demands. It also is highly congruent with a recovery based approach that begins with many elements of robust motivational interviewing (first appointment) and then moves quickly into goal specific evidenced based practices that are well matched to the presenting need. This system is highly utilized in many parts of the U.K. in its child and family services. New Zealand is one of the first service systems to put it to use in their adult service system, to help facilitate the recovery oriented evidenced based practices. Three Consumer Consultants were present for this day long presentation and I was glad to be able to sit and talk with two of them. Dr Richard Holt suggested that I give consideration to working abroad. He is an American trained psychiatrist who started his career in mental health as a case manager, did a stint in the Peace Corps in Mali, and returned to school and graduated at the top of his medical class in Florida. His wife, also a psychiatrist here with the APS ward also graduated at the top of her class in Ohio. They have been most recently working here for the past five months. Richard has an impressive command of the Maori language and cultural practices. He is from all reports to me, and several have come from outside his place of service, the most effective psychiatrist I hear spoken of. He is involved in the active cases of approximately 160 patients, all are in some measure of acute care but being treated primarily in the community. I hope to spend more time learning about the Maori services team he works in.
CAPA Conference 

The CAPA creators/ presenters: Dr Anne York and Dr Steve Kingsbury
 Anne and Steve are dynamic speakers, with excellent means of illustrating their systems approach to effective and responsive (flexible) service scheduling. They shared many stories of how they have constructed and fine tuned a systems approach that leaves clinicians and consumers/ families feeling less stressed and more effectively served. Today's workshop was the 102nd for them on CAPA. When the group was wrapping up the morning session they had two senior members of Capital and Coast bring out their guitars and lead some humorous sing alongs with very spirited and inspired playing. It was great fun and added an unexpected twist to the day. I regret not having my camera at the ready to capture this component of the day's experience.

Tony and Sue have been a great help to me in supplying contacts and opportunities for inclusion in service system introductions and exposure,  like here at the CAPA training. Tony is a member of the International Initiative for Mental Health Leadership, my primary connection here in New Zealand to the mental health services. The IIMHL was founded by a past New Hampshire community mental health center CEO            ( Monadnock Family Services ) Fran Silvestri, who left a legacy as the only CMHC in NH who had incorporated a sabbatical policy and practice from 1975. When Fran decided to leave his post as CEO there, after some 15 years in that position, he started the IIMHL, which currently includes a consortium of seven countries, including the USA. They host an international conference every 18 months, and the next one will take place here in New Zealand in 2013. New Zealand leads New Hampshire in its recovery based services, most notably in the inclusion of Consumer Consultants, NGOs primarily staffed by people with mental illness experience,  and minority culture based services.  
The Key People who have been arranging most of my sabbatical contacts: Tony Littlejohns, Operations Manager for Capital and Coast District Health Board, and Sue Campbell his Administrative Leader

Sunday, March 18, 2012

The Wellink Trust and Take 5 art space

This is Shaun McNeil who came from Scotland 14 months ago to work at Wellink and is now it's acting CEO. He is trained as a psych nurse and for about ten years worked in that role. He is a person with mental illness experience and played a very active role in the Scottish Recovery Movement which lead to his connection and role here in New Zealand. Wellink currently has 72 FTE's, with 60 percent of these employees being people with mental illness experience. They are a dynamic group providing many varied direct service supports within the Wellington/ Lower Hutt City/ Kapiti Coast regions. One of the unique services that they introduced me to is called Key We Way Respite House. The Key We Way Home is very near the seaside, about a two minute walk away from the beach in a very nice neighborhood. The home has plenty of outdoor area as well as a spacious interior where up to four people can reside for brief respite stays. It is the first of its kind in New Zealand, that is a respite program organized and operated by peers. This is managed by Treena Martin. Treena reviewed the program with me and is one of Wellink's Intentional Peer Support instructors. Those who have mental illness experience and have an interest in working at the Key We Way Respite service must undergo the Intentional Peer Support Training Program before they can work at this respite program. Another program they had me visit is where they have a warm line that also requires the Intentional Peer Support training. At the same site is a transitional residential program for older teens and young adults. The teen program is called Headspace. The staff here work with each resident to transition into their own community apartment within 18 months, targeting various skills development for competence at independent living.                                                             
Shaun McNeil, Acting Chief Executive, Wellink Trust

Wellink's base in Lower Hutt City
This group setting is the Wellink office for job development and placement, Worklink. They have some vibrant client art work on the walls here. The woman in black and red is Rani, and it was her first day working for Wellink. Beside her is Liz who heads up this office. She is Maori and Rani identified as 3rd generation from South Africa, but having now lived in New Zealand for the past 8 years and calling NZ home. Alan supports people looking for work. They also help support volunteer placements for people who identify that they are not ready for work but want more structured activities and exposure to working environments.  Many staff/ peers here identify volunteer experiences as valuable to their eventual preparation and transition into payed employment, and that was the case for Shaun McNeil.
Liz "McAlpine" Brown and Rani Moodley, Wellink staff.
Brown
Alan Sutcliffz, Wellink staff talking about employment services

Treena Martin, Wellink -  Key We Way Respite
Recent funding cuts have meant that Wellink now only has a single staff for QA - Donan Nellas, and a single person for IT and service tracking, Ramon Medina, both from the Phillipines but now living in New Zealand. Ramon has a background working for one of the big computer companies but was happy to make the transition into this NGO program. He is challenged by the very limited resources since they had to downsize but feels very valuable in his role, so too does Donan who works to ensure that all services maintain a high level of professional, ethical, and effective service.
Ramon Medina and Donan Nellas, business management IT, and QA
Josh is a very skilled and highly passionate program developer. He is of Maori heritage. He shared many of his projects with me and I was glad to stay late while he took me through several of his past projects. He incorporates many of his artistic/ creative skills as he brings these projects to publication. He is using a highly organized computer system, originally designed for intranet systems development, flow charting, and tasking out development systems that entail many layers of system development. It works in real time and makes keeping track of all the various tasks on point for many different departments simultaneously. I suggested that this system might effectively be applied to tracking a client's personal and professional development and he thought so too but had yet to try and apply it to this task.
Joshua Palmer, IT and creative wizard, Wellink Trust

organizational structure at Wellink
The next set of photos is from my visit with Take 5, a creative art studio space and daytime drop in center. Stephanie Cairns manages this program and was glad to show me through while she was busy getting last minute details looked after for their annual art show that opened that same night. After meeting several of the staff and artists I was taken to the public art gallery where the show had been just hung. They were getting the final details settled and were happy to give me a private showing, explaining a lot of the stories behind the work on display. They have a great depth of talent at Take 5, and one peer is internationally known and shows his work regularly in New York City, where he typically has every piece sold before the show even opens to the public. Gary is a wood and bone carver who provides some instruction at Take 5. He is also very skilled at pyrography (wood burning), and painting portraits. The space to work in at Take 5 for artists is very limited but well organized, and has helped many peers find a creative outlet when otherwise they would have none. Most art materials are supplied by Take 5 and their generous supporters.
Gary at Take 5

Graham at Take 5
Graham is another artist on staff who provides instruction and guidance that focuses mostly in the pottery end of the art studio space where he operates the large kiln and keeps the ceramic supplies well organized.
Shapeshifter sculpture
After my inspiring visit to Take 5 and their annual art show near the city center I went across the street to take in the Shapeshifter outdoor sculpture show, another New Zealand International Arts Festival sponsored public showing. This venue is a well grassed park with stream and meandering walk that includes a glass arboretum with many wonderful plants that are used to compliment the various sculptures. The timing of the Take 5 show worked well with the Shapeshifter show, helping to bring people already interested in the art scene to step across the street for the Take 5's show. 
Stephanie Cairns at Take 5
This Odlin Gallery that is hosting the Annual Art Show for Take 5. It is a wonderful older style New Zealand structure that feels like a converted home. The large gallery space for the show is full of light and provided excellent viewing and a central public location.
Art show venue for Take 5

Take 5 Annual Art Show


Take 5 Art Show with Mr Brown manager of the Take 5 Art Space

Take 5 Art Show, ceramic tea pot

creative pursuits at Take 5 Art Show

Half of the Take 5 Annual Art Show

Saturday, March 10, 2012

Maori and Pasifika, Specialty Mental Health Services

Kasia 
This week has been an exceptional one for sharing and learning, mostly a lopsided proposition where I received the greater gifts for sure. I was fortunate to have been scheduled for a formal welcome, powhiri (pronounced popheree) on Monday, my 55th birthday at the marae, spiritual house, Te Whare Marie which translates to 'The House of Peace', while they were welcoming Kasia Madrzejewska , Masters in Clinical Psychology, and just arrived from Christchurch, New Zealand, as the newest team member.
We were first met by Ms. Jayne Tawhi-Amopiu, acting team leader, who gave us the traditional Maori welcome of grasping your hand and then putting her cheek to yours and kissing. Then Ms. Hinengakau Taurerewa, Dual Diagnosis Therapist, veteran of cultural folk medicine practices, and trained Chinese herbalist, did likewise and oriented us to the process of procession where we would be hailed with song-calling and she would respond in like. This is a slow movement toward the marae. Within a few minutes we were asked to remove our shoes so we could enter the marae, and sacred ground. The entire time there are 30 people inside the marae singing to us a welcome, and the men, about half the group, include a pantomime of hauling in a large rope while they sing/chant, which carries the significance of drawing in the great canoe that we would have traveled in to reach their iwi, literally the bones of their people. It was explained to me later that the area outside of the entrance to the marae is a war zone. In times past this would be where the marae members would attack if your intentions were seen to be untrustworthy. The Maori (a term given to the tribes of New Zealand by the white settlers) are a warrior people and the only tribal group that the British Commonwealth had not defeated in the Pacific. They settled with the historic Treaty of Waitangi in 1840 that is now at the center of many modern discussions for improved supports, consistent with the articles of the treaty. Once inside the marae the welcome would become a bit less formal with introductions and welcoming at length.
Those with the greatest mana, ( ma- to join, and na the sacred breath), or prestige, begin this process of individual introductions and welcome, and everyone speaks in Maori. The men with mana first spoke and then the elder women, and my specific escort was an older man who said that he is trained as a social worker and has worked a long time in the forensic mental health services. He helped make the welcome easier to understand by whispering some english translations to me once in awhile. I felt quite humbled with the high energy, traditional practices such as the communal singing and dance that was incorporated, and the music. Prior to entering the marae I was asked if I had a song, because they would have wanted to sing it in support of my welcome, but I could not think of one as this was unexpected on my part, and of course I was a bit overwhelmed as well. Several women had flowers in their hair as they rose to speak about their heritage and place. Each person in the marae spent a good amount of time addressing everyone in their introduction, telling of what mountain and river they have called home. I was to go last and by then I had enough of an idea as to what needed to be said that I was able to get across who my people are, where I am from, and what my purpose was in visiting. I enjoyed their responses and felt reassured that everyone was comfortable with my presence. So that was the first hour, and then we had to complete this welcome with a lot of food, because this is a sacred process and it is not complete until the food is eaten by all present. They made sure I sat amongst the group with high position while I ate. A lot of the food that was not eaten was packed up to bring out to community members.
I was surprised to see other pakeha, that is people of european descent and non Maori. One was Dr Richard Holt, from Minnisota, who has been serving there for the past several months and had an impressive handle on the language already. He is Consultant Psychiatrist for the adult team. Another is Dr Allister Bush, who is Richard's counterpart on the children's team who hails from the Christchurch area on the south island. Both welcomed me to sit in on clinical sessions and discussed their connections and the value of this service with me. My buddy in the welcoming procession, Kasia, being another pakeha. You might think from her photo above that obviously she would be non Maori, but that would often be a mistake, as many Maori decendents look very 'white' or european, but in fact have significant Maori heritage, and that is enough to claim that you are Maori. Last night I attended a wonderful show called "Walk a Mile In My Shoes" by the Bare Foot Divas: five amazingly gifted women who sang and spoke in turn to the issues of their heritage and the struggles they share with their people, one from Papua New Guinea, and one from aboriginal Australia, three from the Maori community. Two of the Divas shared examples of pakeha who for various reasons grew up with Maori families and became inculturated with Maori tradition and spiritual orientation, and spoke Maori as their first language, and then as adults had no desire to leave their Maori ways when sought out by their biological families. They had connected to mauri - the spark of life, that imbues the Maori people with their strength and connection to all spirits. So it was during my incredible welcome and embrace within this marae and the Maori Specialty Mental Health Services at Te Whare Marie. Oh! and the men in greeting also embrace your hand and engage you in the hongi, the sacred sharing of breath, where they put their forehead and nose up against yours and stay their to share the breath of life. I was impressed beyond words with this experience of welcome, the depth of connection right from the start, and was able then to engage each person as someone I knew and felt comfortable with, no longer a stranger. All through the week people here sought me out and welcomed my interest in their role, work, heritage, and future. If I appeared to be disengaged at any time someone would come over and ask if I needed anything. I can not remember a time when I felt more cared for in a work environment.
Moana Kaio, med student, and Kara Mihaere, team psychologist 
Above is Moana and Kara, both are Maori, they shared many stories with me of their experiences with the mental health service. Moana had recently returned for her final few months as a medical student. She elected to return to further study the work done here at Te Whare Marie before she makes her final decision on the specialty she will pursue as a doctor. Kara is a team psychologist, and she gave me a book on Maori Health studies in which she is featured in one study showing the disproportionately high percentage of sleep disorders in the Maori people. In overview, the Maori represent a higher percentage in many categories of health issues that in part reflect the history of the discrimination practiced against them as a people. I met with several Maori, like Wakaiti Saba who grew up not being allowed to use her language in school, and in fact punishment was strictly used when they were caught using Maori words. She is part of an entire generation that were not allowed to use their Maori language. For many it was only through the elders that they were able to carry on the language and teach the children. Today Maori immersion schools are growing and it is a great point of recovery and renaissance for the Maori to have schools that use only their language and teach their world view about spiritual connection and relationship.
Below is a caption of my visit with the sister organization to the Maori Specialty Mental Health Services: Health Pasifika. This organization is headed up by the same leader, Malcolm Robson, and shares other staff from the Maori Services like Dr Allister Bush, and Consumer Consultant Te Wera Kotua. Health Pasifika is comprised of seven prime cultures, but Samoan is the predominant. The day I visited included Cultural Supervision for the staff. Some representatives from the Forensic Mental Health Services were present. They sang several songs accompanied by guitar and ukilalee. The elder woman playing the ukilalee began her service in 1969. She is a vibrant member of the team. I was fortunate to sit in on a conversation the group was busy with, focused on how to include traditional health practitioners, and one was present. It was a very constructive discussion of the issues confronting the western medical model. Dr Bush and Mal Robson were clear to endorse the value of additional options that improve the chances for recovery and see traditional healers as one more of these positive options, especially in light of families asking for access to these traditional healers. Then the discussion moved to how to enable better access to traditional healers who primarily are only known through word of mouth.


Carvings near the entrance of the Te Whare Marie marae
In the day, the wood carvings that adorned the marae were powerful statements of the mana of the iwi, hence the woodcarvers were highly esteemed and their skills used in many areas such as building the great canoes, the pou, pilasters to signify sacred grounds, and of course the iwi marae. I came to understand that there are many layers of significance to these artistic elements within all factors of the Maori culture and language. Everyday my conversations with staff brought up more significance of these greater depths of meaning and value in their language, art, and relationship, and how core these elements are in mental health recovery and wellness for Maori, and Pasifika peoples.
Health Pasifika conducting Cultural Supervision





Tua Hekenui, Cultural Therapist
This is Tua, Cultural Therapist, who works to bring Maori cultural connections/ opportunities into the lives of Maori who come into services. Many who come into these Maori services do not have much connection to their culture, and those that do have, often benefitted from the affirmation that these staff give in their traditional cultural practices like the offering of something like prayer at the beginning of each session, invoking renewed connection with their heritage, community, and spiritual relationships. He was very generous with sharing examples of his approach and work. Tua often takes a client for a walk to help the process of spiritual connection, usually beginning with the spiritual energy of the environment to invoke a new/ renewed connection, for the person with experience of illness. He is then able to steer the discussion toward the connection and spiritual significance to whanau, family, and the issues of recovery and its meaning for their family, iwi.  He is an artist who carves wood, a traditional role in his life's work. He also runs a free school, along with his wife, teaching traditional ways of the warrior skills and ethos, pointing out that Maori warriors had to be skilled fighters but even more skilled as healers (expected). He is currently enrolled in his second year in the Bicultural Social Worker School. Tua imparts an improved sense of belonging with his sharing of Maori world view. He showed me many examples of the creative expression and identity that is Maori in language, art, and philosophy. Many people here spoke of their spiritual connections, and it was a week of spiritual awakening for me. The connectivity we all need, a sense of belonging, relationship, I had only understood from a very limited perspective prior to my encounters with Jayne, Hinengakau, Tua, Te Wera, Richard, Allister, Karen, Kara, Moana, and all the others who spoke of their spiritual lives through their culture and work. Karen took me out and I met with several of the consumers she works with in the community, as well as at the recycling center and organic garden where many consumers spend a good part of their day.
Many here gave me materials to take home with me and took the time to show me examples of their work, and how their culture informs their work of supporting recovery. Tua extended an invitation for me to meet him at Te Ahurewa Topu Ma Taiaha, his School of Maori Weaponry. I feel honored for this and so many other welcoming acts made by the staff here. I hope one day to be able to host anyone from this service who can make it to my home and place of work.
   While listening to Tua, Te Wera, and Hinengakau, I was able to improve my appreciation and depth of understanding for the value and significance of language in its role of recovery. Our language enables us to reconnect and heal dis-ease, hence our talking therapies. Language is the vehicle for the discovery/ recovery of meaning in our community, our relationships, our wellbeing. Many of my discussions came across as analogous to the value of poetry and visual art with its layered meanings and overlay of dimensions that reveal different but complimenting elements of universal beauty. This is primarily done through connecting to the sacred spirits of the environment we hold relationship in. Perhaps none is greater than the sacred sharing of breath, na. The act of dissolving the distance between people and joining our communal spirits. These are universal themes and principles that transcend culture and religion, supersede programming, funding, and the many barriers that we often get sidetracked in. The Maori culture and its participants, especially at Te Whare Marie, showed me how crucial it is to grow these spiritual connections in order for services to be effective, and for people to recover their wellness. The high degree of welcome I experienced here and the ample generosity to share, teach, and touch, made it possible for me to gain heaps of new insight into the recovery process for people with mental illness, and for providers to grow a sense of purpose and pleasure in their work of helping people reconnect to their roots of culture and whanau, family, in a wider sense of the term.
 "Flo" ( "to be kind to your tongue" ) below, heads up Health Pacifika. She explained many of the details of their service and the challenges she faces trying to meet the needs of many cultures in her program. Mal Robson is in hopes of being able to improve the program by scheduling regular visits for staff here so they can operate 'off the same page', coming in from their various island locations and get grounded in the same philosophical/ values driven approach.
Below you can see a caption of Te Wera, Consumer Consultant, who allowed me to video record a presentation he does about the power of language in his culture, delivered via a simple telling of how parents typically teach their very young children to count to ten, and often unknowingly are also teaching them the Maori creation myth, which is a great example of the layering of meaning in language. I look forward to sharing this when I return home.
  
Folole laeli Esera, Team Leader for Health Pasifika  

Mr. Te Wera Kotua, Consumer Consultant, and spiritual mentor. 

Ms. Jayne Tawhi-Amopiu and Richard, a psychiatric nursing student from England
Nine greetings in each of the principle Pasifika  languages

Friday, March 2, 2012

Continued work in the field



 Getting ready for the ride to the train station, a 45 minute trip when the weather is favorable and a lot longer when the wind is against me. Unfortunately the ride is mostly along the main highway route 1 with big tandem trucks passing at my elbow at high speed. Most days I bike to Waikanae, as far north as the electric train system runs, and board the train to Kenepuru (south) and the hospital grounds, which is a 40 minute train ride, but if I go all the way into Wellington then it takes about 75 minutes on the train. The scenery is striking most days and quite varied as the weather changes quickly along the coast.
Wakaiti Saba, Director of Crisis Assessment and Treatment Team - CATT

 At the end of the first week of my sabbatical I climbed Colonial Knob that sits in the far background, left most knob. Each day I check in with Wakaiti Saba (fondly called Waka which means canoe or vessel and she was named Wakaiti as she is the sixth consecutive generation in her family of women to be given this name and Wakaiti is significant as it is the smallest of the great canoes that were used when her people first migrated across the sea to Aotearoa, land of the long white cloud - New Zealand), she is the director of the CATT services team, I then got along with the listening and interviewing.
 Te Taha Manaaki ( loosely, House of Health) is the unlocked in-patient ward above CATT. It houses ten patients at a time and adjacent to CATT is the Acute Day Program run by Ms. Rose. I spent a day and a half with consumers and their nurses attending this program. The average length of stay in the in-patient hospital is 14 days and they average 90 percent occupancy. Capital and Coast maintains the lowest per capita hospital stays in New Zealand, and the second lowest seclusion rates for in-patients, with obviously quick turn arounds. One way this is possible is that the HBT services are offered as an alternative to APS. If the consumer in crisis opts for Home Based Treatment they must agree to stringent supports that are provided in their home in order to stay out of the hospital, and it apparently works well. HBT services are titrated as appropriate but usually they are able to conclude these intensive home services within four weeks.

lunch at Kites

Above is a caption of three of the six people I met at Kites Trust: www.kites.org.nz  in Wellington where I spent a day. Kites is an organization that promotes the valuing, respecting and utilization of people's mental health experience. It is a private non profit NGO that has contracts with the government for various services that support improved services for evidenced based and recovery oriented services. A large focus for their work is also outcome measures and service effectiveness. They created an on-line survey tool used by consumers to help gauge the service support outcomes. They have eleven staff members, and several of them were away the day I spent there. They do not provide direct services but provide training, and advocate in many arenas for client rights and the struggle against stigma and discrimination. Kites uses many approaches to combating discrimination and stigma. They have several discrete programs that facilitate this mission well. They do a good deal of research to help inform policy made by the government. They are distinguished by having most of their staff being 'people with mental illness experience'. After a two hour interview with Marge Jackson, director, who provided a very welcoming orientation ( she can be seen sitting on the left in the upper photo of three people during the lunch they sported me to ) I then got busy with listening to individual stories. I had nearly hour long interviews with each staff person individually. This was not planned, it just happened to click well.
James,  researcher at Kites
To the left is Mr James, he is a key researcher with Kites. He spoke well of the Early Intervention Services made available by Capital & Coast as another valuable service that helps to de-stigmatize the mental illness experience, especially for young people/ adults, and their families.

Darcy of Like Minds, Like Mine.
Above is Ms. Darcy, she oversees  Like Minds:   www.likeminds.org.nz   at Kites. This websites offers a lot of helpful material on issues of discrimination, the largest barrier to recovery. A lot of her work involves coordination of programming and training for Like Minds, Like Mine  regionally and nationally.
Kim with Buddies, and Kites
Here is a poster they came up with for evidencing the value in peer support programs: TOKA TU - stand strong. Buddies  is principally what Ms. Kim began, and oversees at Kites. Buddies is a peer support program that trains people, providing them with 40 hours of specialized training to go to the APS in-patient sites and provide social support and hope. Each of the Buddies volunteers has had the experience of mental illness and recovery. Kim is Maori, very motivated, and key to this program's successful impact and continuation. Below and to the left is Ms. Sara.

Sara, Coordinator of PeerZone
Sara is the coordinator for PeerZone at Kites:  www.wellbeingrecovery.com  She is a trained actress and film maker, having trained in England. She has written and directed original plays, and one was done with youth about self harm that was well received here in New Zealand just a couple of years ago. I was impressed with her level of organization (she had a lot of good leads for me at her finger tips) and the creative use of her work space. Working in the same office with Sara, is Mary, who was not in when I visited but she is a leader in the promotion of recovery in New Zealand and abroad. Mary is a past Commissioner of New Zealand Mental Health.  Central to the message Mary delivers is what recovery means for societal health and wellbeing. www.maryohagan.com/speeches.php This link offers a speech she gave at the Scottish Recovery Conference in 2009 and I recommend listening to it for anyone searching for more meaning in what recovery can be and mean for a community.
Several of the current staff at Kites had been working with Case Consulting, a separate NGO from Kites but recently merged with Kites. Kites had four staff prior to the merge but now has eleven. Case Consulting developed a consumer evaluation tool that has since been improved and the Capital and Coast Board of Health has been using the third generation of this tool. It is called Taku Reo, Taku Mauri Ora, which translates to:  My Voice, My Life. It is used for self assessment and service user outcome measures;  as both a self reflection tool and a feedback instrument for service providers. They provided me with copies, reports, and related books.

Diana, APS Occupational Therapist
Here to the right is a caption of my commute along the coast the same route taken when I went with  Ms. Diana pictured on the left and her crew of OT's, a student intern from the south island, and five in-patients from the Acute Psychiatric Services hospital. This APS team is led by Derek Challenor. Derek has a background in social work and he pointed out that people in his position are typically nurses or other medically trained staff. He has been able to broaden the view of mission for APS to take in the greater community context of what they do and who they serve. Derek gave me the tour of the in-patient program and explained that their current facility is temporary, as they will be moving by early June this year into a new building, a wing of the Wellington Regional Hospital, with very up to date space planning and a lot of care put into the feel of the space for the patients and staff.  They have committed to keeping their total in-patient beds to only 30 with a catchment service area population of 289,000.
Diana, John, and Cristina (who is new to the program just this week), the OT team, filled me in while we rode along as to how they work, and the various program features they are able to incorporate into the treatment course for the in-patient care and recovery process. This includes bringing in programs such as the SPCA coming in weekly with an animal for the therapeutic benefits; Vincents Art Workshop comes up also once weekly to conduct art and craft sessions;  and they have recently instituted a fortnightly BBQ, as a few examples of how they promote recovery while in the hospital setting. Our van trip up the coast for chocolate and ice cream being an example of a less structured OT activity that helps patients recover and move back into the community. A couple of the patients were glad to talk with me about their experiences and their hopes for the near future. Diana was scheduled the next day to accompany and elder patient to her home so an assessment could be made to see how ready she is to cope with the ADLs she will need to do once back in her home and the community. So the OT's are involved with discharge planning in a very active sense, making recommendations for any additional supports that are appropriate, to help make stays at the in-patient facility as brief as is reasonable and allow consumers to return to their homes, family, and community.