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

Abstract

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.