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