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Subject: search.filters.subject.Mental health services, New Zealand

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    Holistic health : the effectiveness of a counselling model in a primary health setting : a thesis presented in partial fulfilment of the requirements for the degree of Master in Social Work at Massey University
    (Massey University, 2005) Gibbs, Cynthia Downing
    The interface between mental health services and primary health care is changing, both internationally and within New Zealand. With the shift toward population health principles and funding formulas, as well as health strategies emphasizing primary health care, the incorporation of mental health services within the primary care domain seems a logical step. In New Zealand, there have been and are currently many variations on this theme of integration, most have arisen in response to the need for service integration and all are locally created and sustained. This study examines one of these initiatives, the incorporation of personal counselling in the primary care setting. This study explores the effectiveness of the counselling model being used by the practitioners providing a primary care counselling service in a provincial town in New Zealand. The counselling model is grounded in social work theory and practice, it incorporates a strengths based perspective with solution focused brief therapy and cognitive interventions. Effectiveness was measured according to whether the participants' initial concerns were met, whether there was global improvement, and the level satisfaction with the therapist. Both quantitative and qualitative measures were used including survey questionnaires, interviews, as well as pre and post intervention measurements. Information was gathered about the experience of participating in counselling in the primary care setting. The results from all these methods indicate that this counselling model addressed the main concerns for participants and there was satisfaction with the therapist. There was not always global improvement for participants, some of whom felt uncomfortable participating in counselling at their General Practitioner's surgery. The interviews reflected these results, and the pre and post measures indicated improvement in symptoms. This model does appear to be effective in this setting with the wide range of issues that present in the primary health domain.
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    We're all a little mental here : creating positive change through mental health advocacy in New Zealand : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Social Anthropology, Massey University, Manawatū, New Zealand
    (Massey University, 2015) Brown, Samuel Gareth
    The following paper explores mental health in New Zealand, and argues for further positive change to occur in this area. This argument is derived from the interviews I undertook with mental health advocates, who seek positive change for consumers through their day-to-day work. My own experiences as a mental health consumer also inform this paper, and position me as both a researcher and advocate. Data analysis takes the form of hermeneutic phenomenology, as this method privileges the advocates narratives, which are typically minimised by mental health specialists. Theoretically, these narratives are analysed through the lens of Foucauldian social constructionism, in order to show how the current dominant biomedical discourse has come into being, and also how this discourse can be challenged, as it represents one of the largest barriers to positive change for mental health in New Zealand.
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    A Tongan talanoa about conceptualisations, constructions and understandings of mental illness : a thesis presented in fulfilment of the requirements for the degree of Doctor of Philosophy in Nursing at Massey University, Albany, Auckland, New Zealand
    (Massey University, 2014) Vaka, Sione Lavenita
    The New Zealand Mental Health Survey, Te Rau Hinengaro (Oakley-Browne, Wells, & Scott, 2006), reported that Tongan people have high prevalence rates of mental illness, do not utilise mental health services, and the risks of mental illnesses were different between Tongan people born in Tonga and those who were born in New Zealand. The risks were higher for those who were born in Aotearoa New Zealand (A/NZ). The overall aim of this research is to explore the meaning of mental illness for Tongan people in A/NZ, and the research question is, what is the meaning of mental illness for Tongan people in A/NZ? The Tongan cultural framework talanoa was used as a conceptual framework to inform this research and also as a method for collecting the data. Using talanoa engaged this research in the circular and collective ideologies of Tongan people. Tongan cultural contexts are used to strengthen this engagement and the collection of data, and Tongan concepts are used to discuss the findings. Thematic analysis was utilised to analyse the data. These Tongan concepts construct (tufunga) mental illness from Tongan perspectives and interpretations. This research found that Tongans in New Zealand perceive and interpret mental illness in three ways: through traditional Tongan interpretations, through Western and biomedical influences, and also through an intersection of Tongan interpretations and Western/ biomedical influences. These interpretations are presented as themes. These themes were tufunga faka-Tonga (Tongan constructions of mental distress); tufunga faka-paiōsaikosōsiolo (biopsychosocial constructions of mental distress), and the tufunga fepaki mo e fetaulaki he vaha‘a ‘o e tufunga faka-paiōsaikosōsiolo mo e tufunga faka-Tonga (intersections between biopsychosocial and Tongan constructions of mental distress). The research findings, therefore, highlight challenges associated with applying a biomedical linear, individually focused Western mental health system to a traditional Tongan, circular, and collective community in A/NZ.
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    Mental disorders and community care : a discourse analysis : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University
    (Massey University, 1995) Danks, Josephine Helen
    Talk about people with mental disorders and community care was examined using Potter and Wetherell's (1987) system of discourse analysis. Participants were ten members of the public, resident in a suburban community. They were interviewed on the topics of community care policy, rights, responsibility and care, the location of community residences, and general knowledge about people with mental disorders. Verbatim transcripts from interviews were analysed, and six interpretive repertoires identified, these being, rights promotion, dual community, patronisation, affiliation, solicitous control and disorder repertoires. While participants' talk often contained content indicating support and concern for people with disorders, the repertoires were constructed in a way which functioned to promote and protect their own interests. Analysis of linguistic devices revealed how participants used language to distance themselves from socially unacceptable talk, and claim consensus for their views. The social consequences of discourse constructed in the form used by participants was discussed. Overall the analysis suggested that the way ordinary members of the public talk about people with mental disorders and their care in the community has a negative influence on the social interaction between the two.
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    Mental health crisis intervention : a discourse analysis involving service users, families, nurses and the police : a thesis presented in fulfilment of requirements for the degree of Doctor of Philosophy in Nursing at Massey University, Palmerston North, New Zealand
    (Massey University, 2014) Wilson, Stacey Caroline
    This research is a Foucault-influenced discourse analysis, which explores the field of Aotearoa New Zealand mental health crisis intervention, with the goal to challenge current practices. The study takes place in the context of changing access to mental health crisis services, following the implementation of the Mental Health Act (1992) and subsequent policy, regulation and practice development strategies. Analysis is centered in converging and competing discourses, strategies and technologies in the field. In order to develop a position to discuss a range of converging and competing discourses, perspectives were sought from 9 people who have accessed crisis services, 8 family members who have supported service users, 9 mental health nurses working in crisis services and 2 senior members of the New Zealand police. Analysis of the published research and grey literature took place in between interviews, data analysis and during the writing process. The overarching findings are that crisis intervention is affected by four predominant discursive constructions. These include mental disorder, risk management, expertise and uncertainty. The discursive constructs are influenced by three dominating biomedical, accountability and social development discourses, working together to produce power/knowledge of the people involved in crisis, whilst simultaneously subjugating a personal recovery discourse and the potential of uncertainty. Consequently, participants bear disproportionate amounts of responsibility during a mental health crisis in which they are held accountable for much of what occurs in the clinical and community setting. They have limited control over the decisions that affect care, and largely, the way services are delivered. In order to disrupt structural and systemic inequities, I argue that self-reflection is required to attend to the ways that the experiences of people involved in a mental health crisis affect and contribute to maintaining the status quo. Attending to the possible stages of resistance surrounding the dominating discourses allows the potential for building authentic relationships within crisis intervention. Foucault’s framework of ethical practice is utilised to counter conditional citizenship and redefine responsibilities in the field.