October 2009

Talofa lava

Many of our colleagues and friends suffered personal loss following the earthquake and tsunami in Samoa.  To all staff and their families who were affected I extend sympathy and aroha on behalf of everyone in Te Korowai-Whāriki.  The stories of resilience and bravery by the Samoan people were an example to all of us.

Thirty five staff attended the Mental Health Directorate orientation this month.  The new programme is getting very positive and constructive feedback.  Many thanks to Kitty Marshall and her team for both the content and the smooth running of the day.  On that note, welcome to Dara Bigwood and Cathy Carroll, registered nurses at Rangipapa, Janice Flood, clinical psychologist for the Youth Forensic Team, Diane Wolters, occupational therapist, Rangipapa and Raymond Morgan MH Support Worker with the ID service.

Emma Dunning, our resident GP, was interviewed for an article in NZ Doctor in September.  Emma reports a huge improvement in access to physical health services, such as influenza vaccinations for TKW inpatients and much better screening for diabetes, breast cancer, cervical cancer and BMI.

Another positive article in the news was the report from the Ministry of Health that placed Capital & Coast Mental Health Service as the DHB with the lowest rates of seclusion.  I know that our nurse leader and Clinical Nurse Specialists have worked very hard to put in place education and support for staff to reduce the use of both restraint and seclusion and it is pleasing to see that this is having an effect.  Our Calming and Restraint Coordinator, Melissa Girvan Grant, is also very active in promoting tools for staff to use  to reduce the numbers even further.

Pukeko, the extension to Saunders House, was opened this month.  It was noticed during the naming ceremony that several pukeko were strolling across the grass.  I wonder who managed to organise that?  This building has four bedrooms, two in each 'wing' and is designed to give residents some choice and privacy within the residence.  We are fortunate that Tuohy Lockwood have a great understanding of our clients' needs and our partnership with them in our projects has been very successful in providing buildings that we can be proud of.

Notes of Interest from Buddle Findlay

Family should have been informed despite consumer’s “adamant” instruction:  The Commissioner found that a DHB should have involved a mental health consumer’s family in his care, despite the consumer’s express wishes.  The Commissioner commented that: “Where there have been several suicide attempts in a short period, and there is no evidence of long-standing family estrangement, there should be a low threshold for notifying family of the risk of self-harm”.  Whilst the DHB stated that the consumer was “absolutely adamant” that he did not want his family to be informed, this was only documented once and there was no documentation to support the DHB’s claim that the benefits of family involvement had been explained to the consumer.  There was also no evidence that disclosure to the family under Rule 11 of the Health Information Privacy Code had been considered.  08HDC08140 (27 February 2009) available at:
http://www.hdc.org.nz/files/hdc/opinions/08hdc08140dhb.pdf

Importance of consultation with family for co-ordination of care:  Following an investigation into the care provided to a long-term mental health client, who had a primary diagnosis of paranoid schizophrenia and polydrug abuse, the Commissioner found a DHB in breach of Rights 4(1) and 4(5) of the Code.  There was no evidence of any meaningful communication with his family, nor any evidence that other DHBs previously involved in his care were notified or that an alert had been placed on the national mental health services network.  Family members knew that the consumer’s irritable and threatening behaviour was a sign of his relapse and, if contacted, could have informed the DHB of the warning signs which would have helped his treatment.  07HDC14286 (27 February 2009) available at:
www.hdc.org.nz/files/hdc/opinions/07hdc14286dhb.pdf

Regards

Nigel Fairley
Operations Director