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.