National Evaluation in New Zealand
Prior to implementing CAPA, CAMHS in NZ faced the following problems – in our experience common all around the world:
- Relentless demands
- Assessment rather than treatment focused
- Target pressures
- Lack of time
- Staff recruitment, retention/turnover issues
- Shortage of Supervisors/supervision
- Insufficient resources – cars, car parks, computers, cold leaky buildings
- Insufficient psychiatric cover
- Lack of cultural support
- Access issues – poor access to in-patient facilities
- Reduced funding
- Rising referral rates
- Managing Waiting lists
- Trial and error approach to problems
In 2006/7 we visited for the first time, initially at the invitation of the Canterbury District Health Board. Subsequently, the Ministry of Health and Werry Centre visited the UK. In 2007 The Werry Centre received funding to support Services to implement CAPA/7HH.
- By 2008 there were 3 services using CAPA
- By 2009 there were 6 services
- By 2012 there are 16 District Health Boards using CAPA
- By 2012, 14 CAMH services used CAPA, 2 CAMH are using aspects of CAPA, 1 DHB with adult services uses CAPA and 5 DHBs are considering how CAPA could work for their adult services.
Evaluation
CAPA implementation in New Zealand has shown:
- waiting lists have gone
- reduced waits for entry to the service
- reduced Do Not Show rates
- client satisfaction
- team morale improvements.
- enjoying the Choice appointment process
- working in the spirit of partnership
- more focused clinical practice
- clearer outcomes agreed with young people and families.
Families and young people really like the services and feel listened to and helped. They love the re- reduced waiting time, choices for time and place of the first appointment, that it gives them the chance to hear about other services that could help them, and a clear idea of the journey through a service. Consumers said that CAPA fits well with consumer participation.
Cultural value
Whānau Ora is an inclusive interagency approach to providing health and social services to build the capacity of all New Zealand families in need. It is about welcoming and empowering the whānau, the family / systemic unit, as a whole rather than focusing separately on individual family members and their problems (http://www.tpk.govt.nz/en/in-focus/whanau-ora/).
CAPA implementation and adaptation for Mauri people is exemplified by this saying:
“You do not go on the waka, alone; It takes many paddlers to make the waters shift.”