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PUBLIC HEALTH SERVICES -
MENTAL HEALTH PROMOTION SERVICE
TIER LEVEL TWO
SERVICE SPECIFICATION
Status:
This service specification may be amended for agreements as required to meet local needs. / NON-MANDATORY
Review History / Date
Approved by Nationwide Service Framework Coordinating Group (NCG) / February 2010
Published on NSFL / February 2010
Review: of Public Health Services Handbook. (2003) Amendments: inserted into service specification template, support services service linkages table, quality requirements Purchase Unit Code table and reporting requirements, links to tier one Public health Services service specification.
Change of status to non-mandatory as an interim step before the specification is retired or replaced. / November 2016

Note: Contact the Service Specification Programme Manager, Ministry of Health, to discuss the process and guidance available in developing new or updating and revising existing service specifications. Nationwide Service Framework Library website http://www.nsfl.health.govt.nz/.


PUBLIC HEALTH SERVICES -

MENTAL HEALTH PROMOTION SERVICE

SERVICE SPECIFICATION

TIER LEVEL TWO

This tier two service specification for Public Health Services - Mental Health Promotion Service (the Service) must be used in conjunction with the overarching tier one Public Health Services service specification.

Refer to the Public Health Services tier one service specification under the following headings for generic details on:

·  Service Objectives

·  Service Users

·  Access

·  Service Components

·  Service Linkages

·  Exclusions

·  Quality Requirements

The above heading sections are applicable to all the Service delivery. The Service includes:

·  Mental Health Promotion and Prevention of Mental Illness

·  Suicide Prevention

·  Reducing Stigma and Discrimination

Background

Mental Health Promotion

Building on Strengths: A New Approach to Promoting Mental Health in New Zealand/Aotearoa (Ministry of Health 2002) provides definitions of mental health and mental health promotion. It is aimed at dealing with the root causes and barriers to mental health and wellbeing and proposes actions that can be adopted to further mental health promotion work. Promoting mental health and preventing mental illness is a key component of other documents such as Te Tahuhu: Improving Mental Health 2005-2015, the New Zealand Suicide Prevention Strategy 2006-2016, Te Puawaiwhero: the second Māori mental health and addiction national strategic framework 2008-2015, the National Depression Initiative and the Like Minds, Like Mine programme.

Suicide Prevention

The New Zealand Suicide Prevention Strategy 2006-2016 (Associate Minister of Health 2006) provides a high-level framework for reducing the rates of suicide and suicidal behaviour in New Zealand. The New Zealand Suicide Prevention Action Plan 2008-2012 (Ministry of Health 2008) provides detail about how the seven goals of the Suicide Prevention Strategy will be achieved over five years.

The Action Plan is made up of two companion documents that outline: what the actions are, who will do them and by when and; the evidence and context underlying the Plan.


Reducing Stigma and Discrimination

A six year national plan, Like Minds, Like Mine: National Plan 2007 – 2013 (Ministry of Health 2007) establishes desired outcomes and outlines the actions and approaches to achieve the outcomes. The programme logic is provided in Appendix One:

1. Service Definition

1.1 Mental Health Promotion and Prevention of Mental Illness

Mental health promotion focuses on enhancing the strengths and competencies of individuals and communities, thereby promoting positive emotional and mental wellbeing. Prevention of mental illness aims to prevent specific mental disorders, although in practice promotion and prevention are interrelated. The Service includes promotion of mental health and prevention of mental illness.

1.2 Suicide Prevention

The Services are provided to reduce the rate of suicide and suicidal behaviour, reduce the harmful effect and impact associated with suicide and suicidal behaviour on families, whanau, friends and the wider community, and reduce inequalities in suicide and suicidal behaviour.

1.3 Reducing Stigma and Discrimination

The service is to counter stigma and discrimination associated with mental illness through the Like Minds programme. The Service uses a range of actions and approaches to change discriminatory attitudes and behaviour and to promote social inclusion.

2. Service Objectives

2.1 Mental Health Promotion and Prevention of Mental Illness

Mental health promotion addresses the determinants of health and aims to increase positive mental health, recognising that mental health is more than the absence of mental illness, and using strategies that foster supportive environments and individual resilience.

Mental illness prevention aims to prevent specific mental disorders, although in practice promotion and prevention are interrelated.

Detailed objectives are in the Service Components table below.

2.2 Suicide Prevention

The services will make contribution to the goals of the New Zealand Suicide Prevention Strategy and Action Plan, which are:

·  promote mental health and well-being, and prevent mental health problems

·  improve the care of people who are experiencing mental disorders associated with suicidal behaviour

·  improve the care of people who make non-fatal suicide attempts

·  reduce access to the means of suicide

·  promote the safe reporting and portrayal of suicidal behaviour by the media

·  support families/whānau, friends and others affected by a suicide or suicide attempt

·  expand the evidence about the rates, causes and effective interventions.


2.3 Reducing Stigma and Discrimination

The objective of Like Minds services (described as “actions” in the Like Minds National Plan) is to change discriminatory attitudes and behaviour by:

·  providing opportunities for contact with people with experience of mental illness

·  promoting rights and challenging organisations, communities and individuals not to discriminate

·  delivering evidence-based education and training.

2.4 Māori Health

Refer to the tier one Public Health Services service specification.

Programmes and services to promote mental health, prevent mental illness, prevent suicide and counter stigma and discrimination need to be accessible and effective for Māori, reflect the needs and aspirations of Māori, and aim to improve Māori health and promote whanau ora - Māori families supported to achieve maximum health and wellbeing.

3. Service Users

Service users include the following:

·  community and non-governmental organisations

·  Māori organisations

·  Pacific, Asian, refugee and migrant organisations

·  school students and staff

·  churches, marae, sport and leisure groups

·  central and local government

·  workplaces

·  professional groups

·  media

·  health services (including public health, mental health and primary care)

·  social services

·  family, friends and whanau.

4. Access

This Service is a public health service that is available to the New Zealand population. However specific strategies will be required to meet the needs of different groups.

5. Service Components

5.1 Mental Health Promotion and Prevention of Mental Illness

Service objective /
Service Components
/
Activities
/
Increase adoption of policies in a range of settings to assist the promotion of mental health. / Provide information and advice to inform policies in a range of settings to promote mental health.
Strengthen the efforts of other agencies and sectors whose work impacts on the determinants of mental health. / Assist organisations in a range of settings (for example schools, workplaces and local government) to develop policies that promote mental health
Strengthen efforts to create safe and supportive social and physical environments to promote mental health. / Provide information and support to contribute to the creation of mentally healthy environments. / Work with organisations who have influence over a range of social and physical environments.
Increase knowledge and understanding of mental health and mental illness in the community, including whānau, hapu, iwi and Māori community. / Provide advice and information to the general public on mental health and mental illness.
Develop/implement forums to increase knowledge and understanding of mental health and mental illness.
Support and promote other initiatives which increase knowledge and understanding about mental health and mental illness. / Develop/implement forums or other activities that assist to promote a social climate in which mental health and mental illness are better understood.
Develop/implement forums consistent with He Korowai Oranga: Maori Health Strategy’s overall aim of whānau ora that assist to promote a social climate in which mental health and mental illness are better understood.
Support the development/ implementation of activities that promote mental health by strengthening Māori identity through access to cultural resources, for example te reo Māori, mana whenua, and marae.
Support and promote other initiatives which complement activities to increase knowledge and understanding about mental health and mental illness, such as Mental Health Awareness Week activities and the National Depression Initiative.
Strengthen community action to promote mental health / Foster culturally appropriate community development, community action and other programmes
Develop/support new and existing initiatives/programmes that promote mental health / Develop/implement initiatives to promote the mental health of the general community and those at higher risk of mental illness.
Develop/support new and existing initiatives that promote mental health and wellbeing in communities and settings such as schools, homes, primary health services, marae, churches and workplaces.
Strengthen strategic alliances and inter-sectoral networks to promote mental health / Facilitate inter-sectoral action to promote mental health and wellbeing in communities. / Foster the development and maintenance of networks across a range of sectors (such as Education, Work and Income, Police, and Justice) whose work has an impact on mental health promotion.
Liaise and coordinate at national, regional and local levels with nationally and/or regionally driven mental health promotion programmes/ campaigns.
Develop, maintain and utilise relationships with local media to promote mental health by supporting responsible and accurate reporting of issues concerning mental health and mental illness.
Strengthen skills and knowledge of the health sector to promote mental health / Provide opportunities to strengthen the knowledge, understanding and skills of key health professionals, particularly in primary care, to promote mental health. / Work alongside Primary Health Organisations to strengthen mental health promotion activities to their enrolled populations.
Monitor and assess the quality and effectiveness of mental health promotion initiatives and activities. / Develop mechanisms to monitor and evaluate existing and new initiatives and activities. / Develop robust mechanisms to monitor and evaluate existing and new initiatives and activities that aim to promote mental health.

5.2 Suicide Prevention Service Components

Service Objectives /
Service Components
/
Activities
/
Develop/implement and support a range of initiatives and activities to promote mental health – see 5.1 above. / See 5.1 above. / See 5.1 above.
Strengthen efforts to create safe and supportive environments to reduce the risk of suicide / Work towards the reduction of the availability, accessibility and lethality of suicide methods in the community
Monitor and work with the media, and key media commentators on suicide / Strengthen efforts to reduce the availability of access to lethal substances used in suicide and provide barriers at known suicide jump sites.
Assist and support the media, and key media commentators, to report and portray suicide safely, as outlined in Suicide and the media: The reporting and portrayal of suicide in the media – A Resource (Ministry of Health 1999).
Strengthen community action on suicide prevention / Facilitate and/or assist the development of coordinated regional or district plans that address the continuum of suicide prevention as illustrated by the New Zealand Suicide Prevention Strategy.
Facilitate intersectoral forums to promote coordination and information sharing.
Work with and support Māori communities to establish tikanga Māori suicide prevention initiatives.
Work with and support communities to establish safe and effective initiatives. / Work with key stakeholders and service providers to develop and implement community suicide postvention management plans and responses.
Facilitate intersectoral forums to promote coordination and information sharing between key community organisations involved in suicide prevention and to increase understanding of effective approaches for suicide prevention.
Work with and support Māori communities to establish tikanga Māori initiatives that strengthen whanau, hapu, and iwi and Māori, to promote mental health and wellbeing, and reduce the risk of suicidal behaviour.
Identify opportunities for local and regional activities in support of the National Depression Initiative and other key national initiatives.
Work with and support communities to establish safe and effective initiatives that promote mental health and wellbeing, and reduce the risk of suicidal behaviour.
Develop personal skills about safe and effective ways to prevent suicide. / Implement a range of approaches to assist key community organisations, service providers, and stakeholders to increase their understanding of suicide prevention / Implement initiatives to strengthen the skills of key community personnel to respond to people at risk of suicide.
Provide high quality information and advice to support best practice in suicide prevention.
Reorient health and other services to strengthen capacity and capability to prevent suicide / Work with personal and primary healthcare providers to develop/support new and existing initiatives that promote positive mental health and wellbeing, assist early identification of mental health problems, such as depression, and reduce the risk of suicide. / Support interdisciplinary initiatives in the health sector which improve the interface between health promotion and suicide prevention (including postvention) practice and lead to improved mental health and wellbeing outcomes.
Foster the development and maintenance of intersectoral networks to ensure there is liaison and coordination at the local and regional level with nationally and/or regionally driven mental health promotion and suicide prevention services and initiatives.

5.3  Reducing Stigma and Discrimination Components

Actions

Component / National Service Descriptions/Activities / Regional Service Descriptions/Activities /
Change discriminatory attitudes and behaviour by providing opportunities for contact with people with experience of mental illness. / Provide resource materials and training for community education which includes contact between people with experience of mental illness and others.
Provide ongoing evaluation of Like Minds training and education resources.
Profile people with experience of mental illness in Like Minds advertising and communication resources. / Deliver community education which includes contact between people with experience of mental illness and others.
Use guidelines, resource materials and toolkits developed nationally to ensure opportunities for contact are effective.
Ensure people with experience of mental illness are employed, trained and supported to participate in, and lead, community education.
Change discriminatory attitudes and behaviour by promoting rights and challenging organisations, communities and individuals not to discriminate. / Deliver the Korowai Whaimana programme – a comprehensive human rights and mental illness training package targeted at people with experience of mental illness in a professional role.
Provide human rights training to Like Minds education providers at annual national two-day forum, building on knowledge base from Korowai Whaimana.
Maintain and support a network of competent human rights trainers to share knowledge and understanding of the Human Rights Act 1993 among mental health consumers.
Develop a range of education and training approaches to assist government agencies to better understand the issues of social inclusion and mental health stigma and discrimination.
Work with the Human Rights Commission as part of the Multi-Agency Plan to jointly address discriminatory attitudes and behaviour through the promotion of human rights. / Deliver education and training to organisations to promote rights and challenge discriminatory behaviour.
Promote knowledge and understanding of the Human Rights Act 1993 via human rights trainers working with mental health consumers.
Deliver education and training to a range of agencies (including mental health services) to promote a better understanding of issues relating to stigma, discrimination and social inclusion.
Address instances of discrimination where they occur.
Change discriminatory attitudes and behaviour by delivering evidence-based education and training. / Facilitate regular communication, information sharing and support between the Like Minds providers around the country who are doing Like Minds education and training work.
Provide a centralised Like Minds education and training evaluation system.
Maintain, update and evaluate the Like Minds education and training toolkit.
Produce and distribute a Like Minds education and training ‘supplement’ once every two months, including feedback generated from the centralised evaluation system.
Hold an annual national two-day forum for people involved in Like Minds education and training activities.
Deliver two-day regional workshops on the Like Minds education and training toolkit.
Maintain an education and training strategy ‘governance’ group to monitor and report on progress of education and training work and to provide advice to Like Minds providers and the Like Minds National Programme Leader.
Support national initiatives to address stigma and discrimination in mental health service delivery. / Deliver community education and training using the Like Minds education and training toolkit.
Employ facilitators and trainers who are skilled and well trained.
Provide evaluation data for the centralised Like Minds education and training evaluation system.
Work with mental health services to develop effective strategies to challenge stigma and discrimination within their service.
Work with other health services to develop effective strategies to challenge stigma and discrimination within their service.
Participate in training workshops and national forums organised by national providers.

Approaches