School of Health and Social Services

Permanent URI for this communityhttps://mro.massey.ac.nz/handle/10179/1256

Browse

Subject: search.filters.subject.Mental health services

Search Results

Now showing 1 - 3 of 3
  • Thumbnail Image
    Item
    Understanding service development in statutory mental health organisations in Aotearoa New Zealand : an organisational case study : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Social Work at Massey University, Manawatu, New Zealand
    (Massey University, 2013) Stanley-Clarke, Nicola
    This research aimed to understand service development in statutory mental health organisations in Aotearoa New Zealand. Of major focus was the analysis of the elements that influenced service development as well as developing an understanding of decision-making in the service development process. The study involved an organisational case study of one statutory mental health provider, Living Well and included the collection and analysis of both primary and secondary data. The primary data included qualitative interviews, document analysis and the observation of meetings. Secondary data included literature, research, policy and external reviews of the organisation. Archetype theory provided the theoretical framework for analysing the processes of service development within Living Well. This enabled a holistic assessment of service development as it related to the structures and systems of the organisation alongside its central purpose (raison d’être) and the values, beliefs and ideologies that comprised its interpretive scheme. The use of an organisational case study contributed to the body of knowledge and theory building on service development and archetype transformation within statutory mental health providers in Aotearoa/New Zealand. The findings of this research supported the development of an approach for understanding service development within statutory mental health organisations and a guide for service development. The approach emphasises that Living Well’s interpretive scheme was central to the service development process and was in an ongoing state of flux as the organisation attempted to balance conflicting priorities and demands with the delivery of responsive mental health services (the organisation’s raison d’être). The complexity of the service development process within Living Well was exemplified in ongoing tension between clinical values and management priorities. The research findings reveal that service development within statutory mental health organisations like Living Well, requires alignment between the different factors that influence the service development process. Further, the likelihood of successful implementation is dependent on the priority allocated to service development related to its necessity; the organisation’s current operational and clinical demands; as well as the relationships and roles of those involved in the service development process. The guide for service development provides recognition of these core features of Living Well’s interpretive scheme, utilising informal processes to engender support, to minimise opposition and to ensure client care is the primary focus.
  • Thumbnail Image
    Item
    From the ward to the home : caring for a family member diagnosed with schizophrenia in New Zealand : this thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Social Policy and Social Work at Massey University
    (Massey University, 1996) Richards-Ward, Leigh Anne; Richards-Ward, Leigh Anne
    The research question examined in this thesis is: 'What are the characteristics and complexities of the informal care provided within a family to a member diagnosed with schizophrenia, in New Zealand? This research question is divided into two parts. The first part examines the characteristics and complexities of the unpaid caring work provided to a family member diagnosed with schizophrenia and the second part explores how this care provision is influenced by the social, political, cultural, legal and economic context of New Zealand. This research is important because first, very little is known about the process and interpretation of care provided to a family member diagnosed with schizophrenia and second, New Zealand places great emphasis upon deinstitutionalisation and community care. Ten women and four of their husbands were invited to participate in this research. These women were the primary informal care-givers of a family member who had experienced the cyclical acute and chronic episodes of schizophrenia. The women's husbands filled a secondary supporting role in relation to the women. The women met to identify themes related to their informal care provision. These themes were translated into an interview guide which acted as a prompt for the researcher while the women and men were articulating their stories of care-giving. Foremost amongst the findings of this research was that the dominant understandings of care should be extended in order to reflect the informal care provided to a family member diagnosed with schizophrenia. The men supported the women's care provision which reflected their family member's unpredictable, changeable and cyclical symptoms of schizophrenia. It was characterised by the primacy of supervision and monitoring and was provided on a continual (flat-line) basis. It was also established that the women were finding it increasingly difficult to meet their informal caring responsibilities, these responsibilities being increased and extended by the Government's actions to reduce both state expenditure and state caring responsibilities. The difficulty the women were experiencing in meeting the complex and changing care needs of their family member indicated that a continuum of care needs to be provided. It is argued that a continuum of care will need to include early intervention services, a range of community-based and institutionally-based mental health services, and a review of the definition of 'mentally disordered' contained within the Mental Health (Compulsory Assessment and Treatment) Act 1992. In order to coordinate and provide such a continuum of care, state, community and family caring responsibilities need to be combined, these three caring agents working collaboratively.
  • Thumbnail Image
    Item
    "Someone to walk with me" : supporting caregivers who look after children with mental health problems in statutory care : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy at Massey University School of Sociology, Social policy and Social Work
    (Massey University, 2004) Wells, Philippa Mary
    The role of support to caregivers in strengthening care outcomes was explored for a group of children and young people with mental health problems in the care of the Department of Child, Youth and Family Services. Four studies were integrated in a mixed methods design. In the first study a survey of 237 social workers established that informal support and caregiver factors were regarded as more effective than formal support services to caregivers in strengthening care outcomes for this group. Social workers described poor access to mental health services and deficiencies in their support to caregivers looking after children and young people with mental health problems. In the second study a focus group of caregivers viewed effective support as constituting a number of factors, including, informal support from caregiver networks, boundary setting by caregivers, training and support in managing behaviours and participation by children and young people in school or work. The role of religious beliefs, religious networks and respite care, in strengthening care outcomes was emphasised. Caregivers identified poor levels of support from Child, Youth and Family social workers and from mental health services. In the third study, a composite construct for measuring positive care outcomes for children and young people with mental health problems was established by a group of Child, Youth and Family experts, using a Delphi process. In the final study, case history data for a large group (n=1071) of children and young people with mental health problems in care of Child, Youth and Family were explored in a multivariate analysis. This analysis utilised, as independent variables, those factors identified by social workers and caregivers in studies one and two. The composite criterion designed in study three was employed as the dependent variable in this study. Multiple regression procedures provided some evidence for the role of religiously affiliated care and respite care in strengthening care outcomes for this group. The implications of these findings for Child, Youth and Family are discussed.