Community Mental Health Assessment

What is the interRAI Community Mental Health Assessment

The interRAI Community Mental Health (CMH) Assessment was designed to be used for community-based individuals with a broad range of mental and physical health needs. The target population is all adults aged 18 and over in community mental health settings, including those with dual diagnoses. It has been designed to incorporate the person’s needs, strengths, and preferences when assessing the key domains of function, mental and physical health, social support, and service use, and complements the interRAI Home Care (HC) Assessment.

The Pilot

The Community Mental Health Assessment pilot was initially proposed to the (then) interRAI NZ Governance Board in June 2021 by a group of seven District Health Boards (DHBs) including Bay of Plenty, Canterbury, Capital and Coast, Counties-Manukau, Hawkes Bay, MidCentral, and Southern.

Approval was sought for the pilot and, if successful, national rollout of the interRAI Community Mental Health tool for Tangata Whaiora with severe and enduring mental illness seeking residential care and/or community-based support.

The proposal was lead by Dr Carin Conaghan (Canterbury) and Andrew Neas (BOP). A Steering Group was then formed to lead the project including the two proposal leads and representatives of interRAI Services, initially limited to assessing clients in the Waitaha Canterbury and Hauora A Toi Bay of Plenty Districts only. A working group was then formed to develop course content and resources for training, this included interRAI Education and Support Service team-members, and external invited subject matter experts (SMEs) identified by the DHBs

This project supports the Ministry of Health’s acceptance of several recommendations made following the He Ara Oranga Report. Specifically:

• To increase access to publicly funded mental health and addiction services of people with moderate to severe mental health and addiction needs by better identification of needs that prevent access to currently available services.
• That access to mental health and addiction services should be based on need so that people with the highest need continue to be the priority by the provision of a standardised assessment tool.
• Provide data to assist with the Government’s commitment to a staged funding path to improve access and choice including designing and implementing improvements to create more people-centred and integrated services.
• Provide data to assist in a central agency taking a lead role in improving commissioning of health and social services with NGOs.

The use of interRAI to assist with assessment and service procurement for people with severe and enduring mental illness is in keeping with the governments vision whereby the health system delivers healthy futures for all New Zealanders to live longer and have improved quality of life. Using the interRAI tool to identify needs and inform resource allocation and quality of service delivery reflects the underlying principles of Pae Ora namely: equity; partnership; excellence; sustainability and person and whānau-centred care. 

Where are we up to?

We had a delayed start to the pilot due to COVID, but training began in November 2022 for the initial two districts involved. Due to low assessment numbers and pilot limitations identified, a request was approved by the interRAI Leadership Advisory Board (iLAB) in May 2023 to extend the pilot duration and include more districts. At the pilot end, seven assessors had been trained to competency from Bay of Plenty, Hawke’s Bay, Canterbury, and South Canterbury.

The Community Mental Health (CMH) assessment pilot outcomes were discussed at the iLAB meeting in June 2024 and the pilot is now closed. Lessons learned from clinicians piloting the CMH indicated the assessment outputs (Outcome Scales and Clinical Assessment Protocols), offered benefit to the mental health sector but they felt with the current operating model, the CMH may have been better being completed by clinicians in an acute environment.

interRAI’s next focus will be early intervention in mental health care. Dr. Gary Cheung, an interRAI Fellow, is leading a research project through the University of Auckland to assess the viability of Self Check-up Mental Health Assessment in New Zealand.