Urgent change is needed to the organisation of mental health services in the South which builds on the strengths of all those involved, the Otago and Southland district health boards community and public health committee has heard.
In a recent presentation to the committee on behalf of two groups of mental health service providers, Donald Shand said there was a need to remove actual and perceived conflicts of interest from the way the boards provided services.
The boards' planning and funding team, which organises community contracts, needed to have a distance from the services provided by the boards themselves.
The groups, Future Directions Network Southland and Otago Mental Health Non Government Organisation Group, recommended increased partnerships with the 61 community providers and redistributing services from the board to the community.
One of the group, Kerry Hand, also made reference to the recent Deloitte review of the planning and funding of mental health services by the boards, which he said showed community services had been penalised financially over time, something which had not been addressed.
He acknowledged that providers now had good relationships with planning and funding personnel.
Mr Shand emphasised the group was not suggesting spending more money, but "getting a bigger bang for your buck".
This could be done by building on the capability of the community services, and this was needed before their future capability was undermined.
The group suggested widening access to mental health services, called for needs assessors to be community-based and independent of providers, and sought a shift in the emphasis of audits from box-ticking to evaluations which sought improvement and encouraged development.
Community providers should be invested in as safe alternatives to acute hospital-based care.
Mr Shand said the community sector needed to be involved in the process of developing the services plan, not taking over the planning, but contributing in a way which was meaningful and transparent.
Regional general manager of funding and planning David Chrisp said the group's thinking was not out of line with that of his team, although moves were not occurring as fast as the group might have liked.
• The Otago board and the Ministry of Health have not yet officially commented on the findings of the Deloitte report, which was released in July.
It was critical of the way the board allocated money to its own services, saying the pricing lacked justification and describing it as not sustainable.
Recommendations for change included improvements in contract administration and communication with community services and for an emphasis to be put on the integration of the boards' services with those in the community.
In his recent letter approving the Otago board's district annual plan, Health Minister Tony Ryall referred to the board and the ministry jointly exploring models of care to ensure services were delivered at a lower cost, while maintaining at least the existing level of access and quality.
Some redesigning of service would be likely and there were examples of innovation with good outcomes for patients which Otago could learn from, he said.
