Wellington Adult Mental Health, New Zealand

The Wellington map

Service description

CAPA initially began as a pilot in one General Adult Community Mental Health Team, February 2009. It has now expanded to include all four of the general adult community mental health teams as well as other specialist teams including Maori Mental Health, Health Pasifika, Community Alcohol and Drug Services.

We have now amalgamated this approach with the Child and Adolescent Mental Health Services, who were already developing the model themselves.

Facts: 285,000 total population. There are approximately 300 referrals per month that are received by the combination of the above teams. The mental health services are served by multidisciplinary teams.

Prior to CAPA there were multiple entry points with individual teams each having their own systems for processing referrals and allocations. Since CAPA this has been standardised and simplified.

CAPA experience

Prior to CAPA access to service was inconsistent with variable responses leading to confusion and frustration for referrers. The service has now adopted several features of the CAPA model, specifically handling demand and capacity and full allocation booking into Choice Appointments.

The reason why these aspects of the model were introduced first is because access into the service appeared to be the area which was most inefficient, with referrals being inconsistently declined and complaints from referrers.

A hurdle to overcome has been that the CAPA model has been designed very much with services for children in mind. The instigators of CAPA have chosen to focus on parts of the model that might give some early indication of its successful implementation in general adult services. Now that some improvements have been realised, this has given further confidence to adopt aspects of the model further.

What do we like?

  • The service has not been formally evaluated, however we have had compliments from service users and referrers, who say that access to service is easier with the service being more responsive.
  • There has been a decrease in complaints about access to services since CAPA
  • Team Leaders report fairer system for allocation of referrals
  • Workloads are more predictable and peaks in demand easier to manage

What helped us?

  • Dissatisfaction with previous model, both from referrers and staff
  • Champions in different positions in the service, including management, clinical leads, team leaders and clinicians
  • Attendance at CAPA training days, (adult MH staff attending workshops for children’s services)
  • The CAPA work books and web page
  • Local discussion groups and workshops run by local staff
  • Personal visit by founders of CAPA, Ann and Steve a great boost!
  • Early data collection which showed improvement

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.

 
No. Component Score
1 Leadership 2
2 Language 1
3 Handle Demand 2
4 Choice Framework 1
5 Full Booking 0
6 Selecting by Skill 1
7 Extended Skills 1
8 Job Plans 1
9 Goal Setting 1
10 Peer Group Supervision 0
11 Team Away Days 1

Any problems and advice?

Critical to get buy-in of staff who can influence clinicians, in our case we had some great pioneering work by inspirational team leaders.

And finally

We have had some very encouraging results and we are confident we will make even more ground as we further adopt more aspects of the CAPA model in the future. We have been having a series of away-days, we have been determining specialist and core skills and two or our general adult mental health teams aim to implement Partnership early next year.

 

Team Photo

Tony Littlejohns