6 October 2011

Pact CEO Louise Carr joined leaders in mental health from around the world at the International Initiative for Mental Health Leadership (IIMHL) Leadership Exchange and Networking Meeting in San Francisco in September. IIMHL brings together leaders to collaborate and build international partnerships.

Louise says the theme this year was “a different kind of leadership” and the sponsor was SAMHSA – Substance Abuse and Mental Health Services Administration. The trip was made up of both the conference and an exchange. Also on Louise’s exchange were people from NGOs and mental health lobby groups from the member nations (New Zealand, Australia, the US, Canada, England, Scotland and Ireland).

The exchange was in Sacramento and was hosted by California Council of Community Mental Health Agencies executive director and legislative advocate Rusty Selix. Louise says the council is an umbrella group for community organisations and Rusty represents them and lobbies on mental health issues their behalf to the state legislature.

She says the council’s biggest achievement was the passing of proposition 63, where it lobbied the government to pass legislation (the Mental Health Services Act), which imposed levied an additional 1% state tax on incomes of $US1 million or more in California. It brings in $700 million a year which is channelled into mental health programmes.

Louise visited several programmes funded partially by that funding and partially from federal, state and council money.

“They have quite complicated systems of funding.” Louise and others on the exchange were able to meet with California state senator (pro tempore) Darrell Steinberg, who worked to get the proposition 63 passed into legislation. Louise says it was rare to be granted so much time with a senator.

Pact has been promoting what is called the MH3 model of mental health, which would see mental health services move from hospitals into the community. “We went to visit a centre in Sacramento that was doing that. They employed a psychiatrist and a nurse and community support workers and ran day programmes and vocational programmes all from the same place.” The exchange also visited a treatment centre for children. “It was very interesting and very intensive stuff. They were teaching people how to parent.”

Louise presented on Pact initiatives while she was there, and she says it was very well-received. The presentation covered Pact’s training, systems and outcomes and innovations like The Apartment and the Helensburgh Road flats in Dunedin. “Some people, particularly the Canadians, were fascinated that we did it all with support workers rather than nurses.”

Louise says New Zealand’s mental health system is more medicalised when compared with the US system. Louise says that is because mental health funding is divided between those with insurance and those without. Among those with MedicAid, homelessness and drug addiction are big issues.

“Community services have had to grow because they can’t afford to have people in hospital. Their average length of stay in a hospital in California would be two days. In some hospitals they assess people every eight hours and if they can move you on somewhere, that’s what they’ll do.”

Highlights from the IIMHL conference included the keynote address from Inge Missmahl about leadership and advocacy in difficult economic times. Inge was a former executive advisor to the Ministry Of Public Health, but now works in Kabul, Afghanistan, where she does psycho-social counselling with Afghani people who are traumatised by their experiences of war.

A panel of people with lived experience of mental illness was also fascinating. One member, Youth Move board president Marvin Alexander, was particularly inspiring. “He had been shunted from pillar to post all his life. He talked about what it took to make young people’s services work. Basically he was saying listen to what they have to say and give them an opportunity to get together with other people. The thing that healed him best was being around other young people his age who had the same experience. “ Wharerata Declaration Presentations were also given on The Wharerata Declaration, which is an integrated model of leadership, for health, social and community inclusion for indigenous people. It has been signed by indigenous people from Canada, the United States, New Zealand and Australia. Louise says the presentations on this were fascinating, particularly one from a high school student, Coloradas Mangas. He is a Chiricahua Apache who lives on the Mescalero Apache Reservation who was upset at the suicides in his community.

“No-one would talk about it,” Louise says. “So he listened to the words of one of his leaders who said you have to step into the light. So he has and he is on the National Action Alliance for Suicide Prevention and has also testified before a senate committee on suicide prevention.” The next IIMHL conference is in New Zealand in March 2013.