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Future Directions - the Southland mental health network

What:A representative group of mental health service users, families, providers and other stakeholders in Southland.

Why:To coordinate and improve the work of the mental health sector in Southland.

How:By having regular meetings to discuss local and national mental health issues, developing and running projects and getting updates on projects already running.

Target:Mental health providers, stakeholders, service users and families in the region.

Where:Invercargill.

"...a really comprehensive, representative body that is able to coordinate and collaborate mental health activities in Southland."
Richard Harris, coordinator, Future Directions

The profile

Future Directions is a network organisation that brings together mental health care providers, service users and intersectional agencies to ensure an inclusive and coordinated approach to the planning, management and synchronisation of the services in the Southland region. The region has a population of 107,000 and a wide geographical spread.

Future Directions uses a Network Representative Group (NRG) model with the purpose to improve the quality of service provision and continuity of care. The NGR includes nine stakeholder groups: non-government organisations (NGO), public health, provider arm, service users, intersectional (Police and Work and Income), Pacific Island providers, Maori providers, families and primary health care. One or more representatives are elected from their respective groups annually. Key functions are: advisory, consultative, coordinated development, informative, leadership, networking, promoting/marketing, representative and strategic planning.

Future Directions is resourced by the Southland District Health Board (SDHB). At present the network has more than 120 member organisations. They are from mental health, social and disability, other health services, community groups, and government departments. The network employs a full-time coordinator, an IT specialist and a quality improvement specialist. The current Chairperson for the network is Louise Travers.

"The network is all encompassing"
Val Dockerty, consumer representative, Future Directions

The beginnings

Future Directions was the "brainchild" of Chris Nolan, the former general manager of Mental Health Services at Southland District Health Board, to improve networking and collaboration between service providers - be it NGO or DHB. When he entered the position in 2005, Chris recognised there was room for improvement with how the sector worked in Southland, with the key issues being duplication and disjointedness within the various mental health services.

Chris worked towards establishing a highly structured framework for networking, which included the wider sector, from service user groups and families to public health organisations. Creating collective ownership was a key ingredient. Representation was sought from the nine identified stakeholder groups in Southland. Terms of reference, membership and policies and procedures were devised to ensure the network was efficient and transparent.

One of the first priorities was to identify the needs of the wider community and to improve consultation and engagement. In 2005/2006 a series of open forums took place across the region. The outcome of these forums highlighted that some of the services were working in isolation and had limited knowledge of other service developments in the region. Sustainable funding was seen as essential for the network to engage and enable change among service providers.

The network was promoted through advertising, community meetings and public relations. An electronic communication system was set up to enhance stakeholders' interaction. It took about a year of active consultation with community organisations and collaborative work with SDHB Funding and Planning to get the network "off the ground".

By late 2005 the network had about 10 organisation-members, mainly from Invercargill. There was little involvement of the rural communities, smaller towns and centres of Southland district. Richard Harris was appointed as full-time coordinator in late 2005 to support the growth of the network. At present the network has 120 members,

"People actually do feel like those who are coming to the [Future Directions] group are doing a good job of representing their sector and a good job of communicating with them how things are going." Richard Harris, coordinator, Future Directions

The process

Future Directions representatives meet regularly to develop and provide resources, and focus on quality improvement initiatives.

Every twelve months the NRG is re-elected. The process involves the network chair sending letters to each of the nine stakeholder areas requesting them to elect the representative for the next year. Each group decides independently how to select their representative.

Development and provision of resources

  • Future Directions developed a website to inform the sector about their activities. 
  • A services map and directory was created and disseminated across the sector in Southland.
  • IT capacity for the members is continuously building and improving.

Regular meeting

  • The network representatives meet monthly. 
  • The Future Directions coordinator organises the meetings and sets up the agenda, circulating it prior to the meeting. Topics such as NGR membership, representation, service and workforce development, website, quality improvement and new projects are discussed. Recommendations and actions are formulated. The minutes outline the final decisions made at the meeting. 
  • "Hot" topics include funding, especially for NGOs, the state of the national mental health sector, and family perspective on mental health issues. These topics, in turn, lead to development and implementation of specific projects.

Quality improvement initiatives and other projects

  • Quality is a permanent item on the agenda. The Strategic Quality Plan outlines quality initiatives. The network has set up a quality sub-committee.
  • The representatives report on activities within their sector, various projects that are in action, and what new projects are under consideration. 
  • The network Workforce Development Plan includes information regarding recruitment and retention of staff.
  • Some of current projects include:
    • coordinating unified responses for the NGO sector to funders and planners requests
    • negotiating discounts for computers and software for NGO members of the network, under the umbrella of SDHB
    • proposing a policy for emergency team risks, fire arms/shooting, in the rural areas
    • family and service user educational sessions.
"An identified problem of NGOs was they were fragmented and didn't have coherent voice, which led to not having legitimacy of the role... Now it is a very vibrant group that draws from the meetings not only with mental health service but also other services."
Clive McArthur, NGO representative

The unique approach

"It is important to rebuild the trust between the clinicians and the police"
David Raynes, Police representative
  • Bringing together a group of representatives from different sectors, on a regular basis to improve service provision. 
  • Support from the SDHB helps to break down some funding and planning barriers and contributes to financial flexibility and openness between NGOs.
  • The role of the network coordinator is unique. Besides developing and cultivating relationships with the sector and community, the coordinator also provides operational support and contributes to the effective decision making process.
  • IT consultancy service is shared and ranges from giving advice on moving computer equipment to new premises, reorganising networks when they multi-branch, to helping them order and install equipment.
"The network is no ‘window dressing' for consumer representatives."
Val Dockerty, Consumer representative, Future Directions

The results

Having a network like Future Directions contributes to a range of outcomes, increased engagement and involvement of the stakeholders, better coordinated and enhanced service development.

Improved engagement with, and contribution to, the network

  • Growth of membership from less than ten to 120 in three years.
  • Finalised a sector wide quality improvement plan. This involves having a shared vision of what the sector is doing now, and collective agreement on what needs to be done in the future. 
  • A quality improvement award was introduced in 2007 and takes place twice a year. Two recent examples of the award winner include a methadone programme resource and R we CONCTNG project. The methadone programme resource was a small project, involving a practice change. A drug and alcohol service developed a laminated card for methadone clients that spared them the discomfort to say their name in front of others when going for their daily methadone dose. R we CONCTNG involved challenging service providers to illustrate positive changes made to service users and families.

Contributions to service provision

  • The network advocates and negotiates as a collective body, enabling discussions with funding and planning. 
  • The quality and improvement coordinator supported the NGO sector with aligning their internal policies and procedures, making sure they meet their contract obligations when audited, and have the knowledge of how to submit relevant documentation to funding and planning.
  • Identify gaps and support new service development. For example an NGO that joined the network about 18 months ago, now is delivering services in education and employment, a previously identified gap.
"You do wonder ... people who work in mental health always say that they don't like necessarily telling people what they do because they either get a hard time about it or people say to you why would you want to do that? Yet a lot of the people who do work in the sector ... are hugely passionate and it can be a really thankless task and really hard work."
Richard Harris, coordinator, Future Directions

Addressing service users needs

  • A safety plan was developed and implemented to prevent suicide in police cells and during transfer from the police station to the prison. Police statistics show that for the 2003 - 2008 period there have been only two suicide attempts in the police cells, compared to 20 for the period 1995 - 2003. 
  • R we CONCTNG, an initiative developed by SDHB ‘s Val Dockerty (consumer advisor) and Fran Wilhelm (family advisor), challenged service providers. The feedback from the challenge illustrated a good connection between service providers and service users. 
  • There is anecdotal evidence that the network's public forums with the community created trust. It also widened the view of what service provision is, from strictly mental health to more holistic approaches. This includes issues such as employment, immigration, housing, and drug and alcohol.
  • More effective cross collaboration between agencies through information sharing in the NRG meetings. For example, after assessing the statistics regarding the number of referrals from the Police to mental health services for the period 2005 - 2008, discussions with the Police took place which resulted in two security swipe cards being issued to Mental Health Emergency Teams, providing easier access to the police station. 

The lessons learnt

  • Awareness of the differences between the organisations and how different parts of the sector operate. The network is the basis for good intersectional communication. 
  • Southland has a relatively small health care sector and this helped the network to achieve its goal. 
  • Resourcing plays a pivotal role in keeping the network active and the community engaged. Sustainability is warranted by having funding and planning participating in the ongoing work.
  • Collective planning and decision making leads to more effective and efficient application of new initiatives.
"The big deal to me though at the end of the day is just the will of people to want to do it."
Richard Harris, coordinator, Future Directions

More information

Future Directions team members Richard Harris, coordinator (left) and Geoffrey Dembo, system analyst (right).

Contact

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Future Directions

  

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Page last updated: 7 November 2008