The Historical Context of the Blueprint for Mental Health Services

Article excerpt

Abstract

The Blueprint for Mental Health Services in New Zealand has had a major impact on the provision of mental health services in this country. In 2004 the Mental Health Commission consulted with stakeholders to review the current Blueprint which culminated in the publication of 'Te Tahuhu: Improving Mental Health 2005-2015'. Although the review is now complete the purpose of this article is to provide occupational therapists with an understanding of the key factors that led to the establishment of the Blueprint. It is anticipated that this background information will provide an over view of the historical and socio-political context in which the Blueprint was written. This will inform occupational therapists of the factors that have influenced contemporary mental health service provision and enable them to contribute to the ongoing process of planning for, and delivery of, mental health services in the future.

Key words

Mental health, health planning, New Zealand

Reed, K. The historical context of the blueprint for mental health services. New Zealand Journal of Occupational Therapy, 53(1) 5-9

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The Mental Health Commission was established in 1996, as a replacement for a ministerial committee formed to monitor the implementation of the National Mental Health Strategy (Ministry of Health, 1994). As part of this monitoring role the Commission published the 'Blueprint for Mental Health Services in New Zealand: How things should be' (Mental Health Commission, 1998). The development of the Blueprint was influenced by factors that included; national and international socio-political trends, changes to the funding and management structures of health services, the Treaty of Waitangi and the consumer movement.

The aim of this article is to explore these and other significant factors to indicate how they have contributed to the development of the document. While it is acknowledged that not all contributing factors have been identified, it is envisaged that an understanding of the historical context in which the Blueprint was developed will inform occupational therapists when they contribute to the planning of mental health services in the future. In 2004 the Mental Health Commission initiated a process of review of the Blueprint through a discussion paper entitled 'Applying the Blueprint'. This in turn led to the Ministry of Health (2005) publication of 'Te Tahuhu--Improving Mental Health 2005-2015: The second New Zealand mental health and addiction plan'. It is envisaged that the next major review of the Mental Health and Addiction Plan will occur before 2015. It is hoped that this article will encourage occupational therapists to take an active role in the ongoing process of planning for mental health services.

Philosophical constructs

An important point to highlight at this early stage is that the Blueprint was written in the late 1990s to describe the implementation of mental health services nationally. This indicates that central government took responsibility to plan for and provide services for people with a mental illness. Significantly this was at a national, rather than regional level, which created a sense of a central body taking charge. In terms of defining mental ill health the Blueprint refers to mental illness in broad terms. An advantage of not having a clear definition is that as the understanding of mental illness changes over time, so to can the way in which services are delivered. Alternatively not making a definition explicit makes it difficult to know what mental health services are trying to achieve and for whom. The Blueprint however does define mental health services as those "organisations whose primary function is the provision of care, treatment and support, and education for recovery to people with mental illness, or mental health problems" (Mental Health Commission, 1998, p. 111). Of significance in this definition is the use of the word 'recovery'. …