Christchurch, New Zealand: 2009

Crhistchurch map

Service description

We are an outpatient service for children aged between 2 and 13 years with moderate to severe problems. The Green Team has 5.5 full time equivalent staff (7 people, including an admin person, psychiatrist, psychologists, social workers, and psychotherapist). We have consults from their Maori health worker (Pukenga Atawhai), speech therapist, ASD team members and OT. In mid 2008 the team was downsized to 4.5 then 3.5. The Green Team covers a population of around 110,000 over an area about 30km wide and long. In 2008 we had 140 referrals.

CAPA experience

Planning took 7 months, which began with a 2-day workshop from Steve and Ann in March 2007 in Christchurch, New Zealand. After this we had lots of team away days! A key part of NZ mental health is how to achieve cultural integration and competence so we ensured the service was accessible to Maori by getting advice from Pukenga Atawhai (Specialist Maori Health Cultural Practitioners). We also discussed vulnerable families as a special group. Finally, a key focus in our CAPA implementation was to monitor goal setting and to have written treatment plans. We began in December 2007.

Impact

Users: Families enjoyed the first Choice meeting and found it useful:

Scores over 5 on a 7 point Likert scale on: How helpful was the Choice appointment? Did you feel listened to? Did you receive enough information about the service? Were you satisfied about the wait? Were you clear about what to do?

DNA rate 6%

What do we like?

‘Feel like a burden has lifted.’ ‘More walking the walk in terms of strength-based practice (focus on how things are working and what is going well rather than focusing on illness and pathologising the problem).’ ‘Efficient use of families and clinicians time.’ ‘Nice focusing on what the family want to do.’ ‘Much more positive focus in that first meeting than before.’ ‘Paperwork feels lighter, more sensible and letter is more readable.’ ‘We really like having our admin person being such a central person in our team. Admin used to be more random and less involved.’ ‘Easier to “let go of families” now.’ ‘Great to see the families as having responsibility for their change, seeing them as being their own case manager. ‘

What helped us?

Attended a 2-day CAPA workshop. Purposeful, easy to comply with paperwork requirements.

Any problems and advice?

Discovered needed more training in psychiatric assessment. Be clear about who holds responsibility after the Choice appointment.

And finally

You will never solve the problem with the mindset that created it (Albert Einstein).

CAPA 11 components

This is the rating scale of the 11 components of CAPA: a green light is fully implemented, amber is partial and red is not implemented.

Team photo
No. Component Score
1 Leadership 2
2 Language 2
3 Handle Demand
4 Choice Framework 2
5 Full Booking 2
6 Selecting by Skill 2
7 Extended Skills 2
8 Job Plans 1
9 Goal Setting 2
10 Peer Group Supervision 1
11 Team Away Days 2

A full implementation of CAPA - 86% (see CAPA-CRS).