A Mental Health & Addictions service Transformation Agenda to an Integrated system of care

Counties Manukau Health have begun implementation of a whole of system Integrated Mental Health and Addictions service transformation to a system of integrated, seamless person centred care, integrated vertically with primary care and horizontally with general health services. We have utilised co-design, and improvement science to inform and support the transformation across our system.Core specialist mental and addiction health teams are being devolved into ‘Locality teams’ with clinicians embedded within primary care and community care providers. The integration focuses on early detection of and intervention for mental health problems; ensuring people with a serious mental illness (SMI) are well engaged with primary care to address their physical health needs, and on supporting primary care in the routine screening and treatment of people with long term conditions and mental health comorbidity. Self-management and the principles of the Recovery model have an important place in this agenda.Key to integration is the re-design of core support services provided by the NGO sector and the full integration of specialist Addictions services within the Locality integrated MH&A teams. A Maori-led integration initiative is under development to address the issues for Maori in Counties Manukau. We describe early challenges, successes and failures in this large scale change; the use of the ‘model for improvement’ in testing different approaches, and the development of an evaluation framework

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