New Zealand Mental Health Addiction data and metrics

New Zealand Mental Health & Addiction data and metrics IIMHL, Stockholm, Sweden 29 May 2018 www. matuaraki. org. nz www. tepou. co. nz

Te Pou o te Whakaaro Nui • Our People • Our Purpose • Our Provenience • Our Products www. matuaraki. org. nz www. tepou. co. nz

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People seen in mental health & addiction services, Jan - Dec 2017 DHB only 63% 111, 053 DHB Mental health only Alcohol and other drug only Both Total Forensic DHB & NGO 19% 32, 977 % 79% 15% 6% 100% 5% Note: People with any type of activity excluding do not attends and leave. www. matuaraki. org. nz Source: Ministry of Health, PRIMHD extract 9 April 2018, analysed and formatted by Te Pou. NGO only 18% 30, 781 NGO Mental health only Alcohol and other drug only Both Total Forensic % 60% 34% 6% 100% 1% www. tepou. co. nz

Current Drivers 1)New Coalition Government As a result a number of policy frameworks are being revised as the new Government’s priorities are implemented 2) National Mental Health and Addiction inquiry Independent Inquiry with broad terms of reference. The inquiry covers the breadth of current New Zealand policies, services, programmes, and interventions in the mental health and addiction area 3) Mental Health Commission The NZ government has asked the Independent Mental Health and Addiction Inquiry to include recommendations on the roles and responsibilities of a re-established Mental Health Commission for NZ. 4)Health Workforce New Zealand Developed the Mental Health and Addiction Workforce Action Plan 2017– 2021 (the Action Plan) is to identify the priority areas and actions required to develop an integrated, competent, capable, high-quality and motivated workforce focused on improving health and wellbeing www. matuaraki. org. nz www. tepou. co. nz

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Future directions Stronger emphasis on: • Improving Equity of outcomes, • a life course approach to prevention of mental illness and distress alongside support for those who experience mental illness • multi sector and agency co-ordination www. matuaraki. org. nz www. tepou. co. nz

www. matuaraki. org. nz www. tepou. co. nz

www. matuaraki. org. nz www. tepou. co. nz

Statistics NZ - Integrated Data Infrastructure (IDI) www. matuaraki. org. nz www. tepou. co. nz

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Mental health and addiction quality improvement programme: HQSC • Five year programme • Designed to focus on five themes across the MH&A sector 1. 2. 3. 4. 5. Eliminate seclusion by 2021 client transitions, prescribing and medication management serious adverse event responses physical health • Building on the work of Te Pou and National KPI Programme • National collaborative- 20 DHBs • The programme is based on the successful Scottish Patient Safety Programme: Mental Health www. matuaraki. org. nz www. tepou. co. nz

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Measuring Users of Services Experience www. matuaraki. org. nz www. tepou. co. nz

www. matuaraki. org. nz www. tepou. co. nz

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“…some of this work is about system development, most of it is about culture and attitude change. Only by asking and using the information we receive, do we create an environment of continuous improvement. ” www. matuaraki. org. nz www. tepou. co. nz

Referrals with seclusion as a percentage of all referrals for non-forensic tāngata whai ora aged 18 to 64 years, all DHBs, year ending December, 2010 to 2017 Note: Data may not represent full seclusion data for some DHBs. Only data that is captured electronically is included. Referrals have a bed night activity in the period. Exclude team type codes: 03, 05, 16. Source: Ministry of Health, PRIMHD extract 9 April 2018, extracted and formatted by Te Pou. www. matuaraki. org. nz www. tepou. co. nz

Referrals with seclusion as a percentage of all referrals for nonforensic tāngata whai ora aged 18 to 64 years, by ethnicity, all DHBs, year ending December, 2010 to 2017 Note: Data may not represent full seclusion data for some DHBs. Only data that is captured electronically is included. Referrals have a bed night activity in the period. Exclude team type codes: 03, 05, 16. Source: Ministry of Health, PRIMHD extract 9 April 2018, extracted and formatted by Te Pou. www. matuaraki. org. nz www. tepou. co. nz

DHB variation in seclusion rates 22. 20% 11. 40% Median = 7. 8% 6. 70% 2. 60% Group 1 (<3%, 1599) www. matuaraki. org. nz Group 2 (3 -<9%, 5916) Group 3 (9 -<13%, 2352) Group 4 (13%+, 504) www. tepou. co. nz

Odds ratio Likelihood of seclusion 11. 1 2. 65 1 1=Low 3. 84 2 3 4=High DHB Group www. matuaraki. org. nz www. tepou. co. nz

Number of seclusion events per shift by day of week, nonforensic tāngata whai ora 18 to 64 years, all DHBs, Jan to Dec 2017 Number of seclusion events Events per day Weekdays Weekends morning 683 291 137 146 afternoon 660 232 116 night 237 86 47 43 Shift 1 (1) Morning shift 7 am to 3 pm, Afternoon shift 3 pm to 11 pm, Night 11 pm to 7 am. Source: Ministry of Health, PRIMHD extract 9 April 2018, extracted and formatted by Te Pou. www. matuaraki. org. nz www. tepou. co. nz

Percentage of people admitted who are secluded within 24 hours, non-forensic tāngata whai ora 18 to 64 years, by ethnicity, all DHBs, Jan to Dec 2017 Note: For admissions which start in the period and have seclusion, check to see time from the beginning of bednights to time of seclusion is less than 24 hours. Source: Ministry of Health, PRIMHD extract 9 April 2018, extracted and formatted by Te Pou. www. matuaraki. org. nz www. tepou. co. nz

Percentage of people secluded, once admitted to inpatient units, previous admissions and first inpatient admission comparison, all DHBs, Jan to Dec 2017 Note: Previous admission is defined as any previous inpatient non-forensic admissions. These admissions could be either a short or long period before admission from July 2008 onwards. Source: Ministry of Health, PRIMHD extract 9 April 2018, extracted and formatted by Te Pou. www. matuaraki. org. nz www. tepou. co. nz

Percentage of collections in the clinical range for Ho. NOS items at inpatient admission, secluded versus not secluded, all DHBs, Jan to Dec 2017 Note: Percentage of collections in the clinical range (2, 3 or 4) for each Ho. NOS items. Referrals have a bed night activity in the period. Exclude team type codes: 03, 05, 16. Source: Ministry of Health, PRIMHD extract 9 April 2018 extracted and formatted by Te Pou. www. matuaraki. org. nz www. tepou. co. nz

Percentage of collections in clinical range on each Ho. NOS item, at admission, New Zealand, Jan - Dec 2017 Note: Percentage of service users in the clinical range (2, 3 or 4) for each Ho. NOS item. Source: Ministry of Health, PRIMHD extract 9 April 2018, analysed and formatted by Te Pou. www. matuaraki. org. nz www. tepou. co. nz

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Help • Currently working on a restraint measure(s) for national collection. What are others doing? • Is anyone collecting family involvement indicators? www. matuaraki. org. nz www. tepou. co. nz