Thursday, March 1, 2012

Reflections on the first week.

 This week was spent learning mostly from CATT, the Crisis and Assessment Treatment Team; HBT, the Home Based Treatment team which is the only alternative other than inpatient admission when someone is in acute crisis; and the Acute Day Program all located in the first floor of the red roofed building in the photo below. These three teams are part of the 26 teams that make up the community based care for Capital & Coast Board of Health, one of 18 District Boards of Health, or DBH that see to the needs of those with a mental illness in New Zealand. Perhaps the most innovative program/ team however is Te Haika, a high tech call center that is about a year old now that has eight clinicians, mostly nurses, taking calls from all over the DBH region. They track and measure all calls that come in for things like time waiting before spoken to, time spoken to, calls dropped, etc. Te Haika or 'the anchor' was the answer to the need for consistency in call response and coordination and appointment scheduling. Wait times for first appointment have been reduced by 58% since Te Haika has been in place. This system utilizes the Choice And Partnership Alliance (CAPA) system for mental health service coordination, started in England for youth services and now used in many places in the U.K.
Waka Saba heads up the CATT program, and she was great at connecting me with various team members and the adjacent teams in the building. She also took me out to visit one of the respite homes in Whitby. The two women below staff the respite home during the day and evening shifts. It is a very well appointed home with lots of glass and great views in an upscale neighborhood. The home can house 4 respite placements at a time. The respite homes are used for brief stays that usually last from 3 to 30 days depending on the individual's need. Most respite homes in this district are run by Non-Governmental Organizations that coordinate with Capital & Coast's CATT.

This is the CATT, HBT, and Acute Day Program base (all on the first floor) with a fully staffed in-patient residence for clients preparing to transition back into the community on the second floor, with stays up to six weeks. These ten beds are part of the 30 beds that APS operates. Behind this building is the main APS facility with 16 beds for locked operations, and another four beds in another adjacent building for elder placements. On the hill behind the building, way in the back, is Colonial Knob. I hiked up to the top, about a 5 mile round trip at the end of the week to take in the views.
This is the entrance to CATT, HBT, the Acute Day Program, and Te Taha Manaaki, the 10 bed unlocked APS program. Virtually all programs here have a Maori name, and the literature makes frequent use of Maori language to promote the inclusion of New Zealands largest group.
Ready to roll off down the road for about ten miles to then catch the train down to Kenepuru Hospital Grounds where CATT is based.
Inside the new train, from Korea, they make accommodation for up to three bikes. I left mine at the train station.
Most of the train cars are elevated, but the one for bikes is designed to be at the boarding platform level.
New Zealand has 130 different ethnic groups, and the mental health services work hard to make all feel welcome. Health Pacifica is one of the two main programs for culturally sensitive and specific services, the other being Maori services.
This is the view looking back down from Colonial Knob. In the upper center is Kenepuru Hospital and the CATT base, where I started my hike from. You do not have to go very far to cross onto grazing land for sheep and cattle. Otaki, where I start my day is at the base of the mountains in the far upper left horizon.
This is one of the panorama views to the north. Below is a panoramic view looking east out over Wellington Bay.

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