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Video transcript: Improving Together - Tamaki Mental Health

English, 6 min 40 seconds.

Sue Copas, Community participation manager at Auckland District Health Board

My name is Sue Copas and I'm the community participation manager at Auckland District Health Board.

The main aim of the project is the Tamaki Mental Health and Wellbeing Initiative, and it's a broad initiative and there are a number of different subprojects under that banner name.

The driving force behind the project is about equity and health outcomes, sort of better health outcomes for everybody in the particular locality and it's about working together to achieve it.

So all the stakeholders are working together to achieve really good local outcomes that matter to the people in this area.

[Shots of the Tamaki community]

So we're working in Tamaki, which is a really cool, vibrant, and very ethnically diverse community in East Auckland.

It's got a population of about 17,000 people.

Quite a large percentage receive the government benefits, so there are some issues
in this particular community.

These are high prevalence of health and social issues for people here, but it's really, a community that's got lots of community leaders and people that are working together, so it was a great place to come and work together.

So co-design was the methodology that we chose right from the very beginning in this project.

And it's actually, what's Co-design is?

[Shots of the Co-design workshop]

It means starting with the experiences and the understandings of the people, and that guides and leads all the way along.

So it's not an event and it's not a phase, it's something that you do, entirely in this project.

So and you work alongside together, so it's developing those trusting elationships, working together and designing together, solutions that work, in the locality, for the people, and with the people in that locality.

And that was a really important decision that we made because it's kind of flipping the system. We normally, service providers, design services and do it to people.

Co-design is all about working with, and it's absolutely premised on the experiences, as we said, of the people, it's the heart of co-design and the heart of person centered healthcare.

So from that process, we created a shared vision and it was a big permission giving vision, and it was an experience in mental health and wellbeing, that's focused onĀ  the wellness of the whole person and their family, whanau and community for the whole of their life supported by integrated services that are relevant to Tamaki.

Oliver Campbell, Project Manager, Auckland DHB

My name is Oliver Campbell and I'm a project manager working for Auckland district health board.

So we wanted to enable people in Tamaki who were experiencing more than just a health issue, to access appropriate and timely NGO support.

[Animation showing the variety of peoples feedback]

And their community were really keen for any door to be the right door for access to that support.

But initially we wanted to focus on creating access to that support through primary care.

OK, we worked with a small and willing cohort of three NGOs, three general practices, people who experience this support service and people from community-
based organizations, such as the Citizens Advice Group Bureau.

The core business of the NGOs was to provide mental health and wellbeing support to people with mental health issues, but traditionally they'd worked exclusively with secondary or specialist mental health services.

GP's were used to responding to mental health issues, but hadn't traditionally had access to NGO support.

[Shots of the action learning group work shopping ideas]

So from the stakeholders we brought together an action learning group, who initially prototyped a walk alongside community-based support service, and then over a six-month period they trialed and developed that prototype.

The action learning group held fortnightly facilitated conversations and this was supported by data, including real-time experience of the people who are using that support service.

This was fed back into the group and helped the group and gain reflection on the way the support service was experienced, and then that led to greater learning and
the development of that service.

Sue Copas

So an area where we found we needed to make a lot of change was in the language that we used, and that language actually informed the practice.

So we found a lot of people were not happy with the idea of referral, that doctors normally refer and it's a really transactional way of practicing, it's kinda like we refer, and it's out of sight, out of mind.

[Shot of a patient speaking to a doctor in a clinic]

So in the co-design process, people see based on this idea of building good relationships, they wanted to be introduced to a relationship with somebody.

So the idea of introduction to a person rather than referral to a service was a key part of the feedback that we got.

[Shot of the doctor completing the referral form]

And we started with a referral form that the NGOs use, that said at the top of it, referral to an NGO mental health service.

We found the idea of mental health was a problem in the community, there's a lot of stigma around that word 'mental health'.

People said they wanted to work on wellness and wellbeing, and so as we prototyped and we change that form.

[Shots of the action learning group work shopping ideas]

It started off with a referral to an NGO in the mental health space, and that turned into an introduction to a wellness support team.

So the language completely changed, and the practice behind it completely changed.

[Graphic showing the person-centred support model]

So it was about introducing people into a relationship with a support person, rather than referring to a service provider, which was quite a different frame.

And that all came from what people were telling us, as we prototyped and learned from that process.

Oliver Campbell

So with the prototype experience completed successfully, we have the twin aims of wanting to share our learnings more widely, and also wanting to expand the support service to more NGOs, and more GP practices.

Someone from the Tamaki community who had experienced the support service, came up with and developed a name for the support service, which is AWHI ORA Supporting Wellbeing.

We will be going through a gifting, and blessing ceremony at the local Marae later in the year.