Rethinking the place of compulsory community mental health treatment in Aotearoa New Zealand: Implications of an assemblage theory approach.

Many countries with developed mental health systems permit compulsory treatment for mental illness in community settings. Research has challenged practices associated with the increased use of compulsory community treatment due to non-compliance with human rights and lack of therapeutic efficacy. In the cultural context of Aotearoa New Zealand, this paper introduces a study of the medico-legal process for making compulsory community treatment orders.

Cultural Influences on the Creation and Use of Psychiatric Advance Directives.

Little published research exists on how culture influences mental health service users when they create or use psychiatric advance directives (PADs). This column reports the results of a study (N=38 participants) of cultural factors that might encourage New Zealand Māori who engage in mental health services to make greater use of PADs in their care. The most important factor identified was the inclusion of family and friends in decision making during PAD creation and use.

Use of advance directives to promote supported decision-making in mental health care: Implications of international trends for reform in New Zealand.

Advance directives are advocated, in many jurisdictions, as a way to promote supported decision-making for people who use mental health services and to promote countries' compliance with their obligations under the United Nations Convention on the Rights of Persons with Disabilities. The United Nations Convention on the Rights of Persons with Disabilities promotes the use of tools to further personal autonomy which would include integrating the use of advance directives into mental health law, to clarify the effect (or force) an advance directive carries when its maker comes under the relevant mental health legislation. In addition, securing the active use of advance directives requires adoption of certain supportive practices and policies within health services.

The nature of police shootings in New Zealand: A comparison of mental health and non-mental health events.

The use of firearms by police in mental health-related events has not been previously researched in New Zealand. This study analysed reports of investigations carried out by the Independent Police Conduct Authority between 1995 and 2019. We extracted data relating to mental health state, demographics, setting, police response, outcome of shooting, and whether the individual was known to police, mental health services, and with a history of mental distress or drug use.

Help and Hindrances to Completion of Psychiatric Advance Directives.

Psychiatric advance directives (PADs) allow service users to participate in their own mental health care in the event that they have a future mental health crisis and are deemed incompetent to make decisions, but few patients complete these documents. This Open Forum reports on factors that have helped or hindered completion of PADs in New Zealand. Perceived barriers to completion include resource limitations, procedural issues, access and storage problems, and mistrust between clinicians and service users regarding implementation.

The content of Mental Health Advance Preference statements (MAPs): An assessment of completed advance directives in one New Zealand health board.

Background: Mental health advance directives support service users' autonomy and provide a voice in their care choices when they may not have capacity to give informed consent. New Zealand's Southern District Health Board has recently introduced advanced directives in mental health services.

Method: Completed advance directives (n = 53) and additional demographic data were accessed from clinical records.

Service user, whānau and peer support workers' perceptions of advance directives for mental health.

Advance directives allow users of mental health services to make statements for their future care. In New Zealand, use of advance directives is supported by the Health and Disability Commissioner and was identified in the 2012 Blueprint as a key mechanism for service users to advocate for responses they find most helpful. This study used a qualitative descriptive methodology involving focus groups to explore the perceptions of service users, whānau and peer support workers concerning advance directives.

A MAP to mental health: the process of creating a collaborative advance preferences instrument.

Aims: To document the process of developing a local advance directive for mental health care, which we are calling a MAP (Mental-health Advance Preferences statement).

Methods: Data on advance directive preferences were collected from consumers and service providers using online surveys and analysed using quantitative methods.

Results: Both groups reported strong overall support for advance directives.

Nga Whenu Raranga/Weaving Strands in the Alcohol and Other Drug Treatment Court of Aotearoa/New Zealand.

This article reports findings from an ethnographic study that explored the meaning of therapeutic in the Alcohol and Other Drug Treatment (AODT) Court in New Zealand. Descriptions are provided of the therapeutic framework called ngā whenu raranga/weaving strands that resulted from interviews with court team members (n = 25), courtroom observations (200 hours), and document analysis. This includes the details of four strands; Law, United States Best Practice, Recovery and Lore that compose the framework.

Mindfulness-based interventions for youth in the criminal justice system: a review of the research-based literature.

Mindfulness is a technique and sense of being present in the moment that incorporates aspects of acceptance, openness and meditation with the ultimate intention of improving well-being. Research indicates that mindfulness can significantly improve negative personality traits, reduce stress, increase attention, alleviate chronic pain and enhance mental health. Mindfulness-based interventions in correctional facilities have resulted in reduced hostility and improved self-esteem for adults, but less is known about its applicability amongst youth.

Sharing power in criminal justice: The potential of co-production for offenders experiencing mental health and addictions in New Zealand.

Co-production has begun to make inroads into research, policy, and practice in mental health and addictions. Little is known, however, about the role co-production has or could have in shaping how the criminal justice system responds to mental health and addictions. Given that a large majority of prisoners in Aotearoa New Zealand have been diagnosed with either a mental health or substance use disorder within their lifetime, it is imperative alternative approaches are considered if we are to reduce the high imprisonment rates and contribute positively to health, safety, and well-being of all New Zealanders.

Police and mental health responses to mental health crisis in the Waikato region of New Zealand.

New Zealand police report a high level of involvement with people in mental health crisis, something that has been reported in the international literature in recent decades. Involvement of police represents a coercive pathway to care and is likely to be associated with use of force. The aim of this study was to investigate the clinical, legal, and social characteristics of individuals subject to police response in the Waikato region of New Zealand.

Service user and clinical perspectives of psychiatric advance directives in New Zealand.

Advance care planning is becoming an increasingly important feature of health service provision. Although the New Zealand Mental Health Commission has advocated strongly for the provision of advance directives in mental health services, little is known about clinician or service user views on advance directives. The aim of the study was to survey the perspectives of service users and clinicians on the use of psychiatric advance directives.

The decision-making of the Mental Health Review Tribunal in New Zealand.

This article reports the findings of a qualitative research project that explored the decision-making of the Mental Health Review Tribunal in New Zealand, providing "thick descriptions" of the hearing process by closely focusing not only on the content of final written decisions, but also how decisions are made and delivered within the context they are formed. Drawing on interviews with tribunal members (n = 14), observation of hearings (n = 11), and review of written decisions (n = 60), the article illustrates how the MHRT attempts to practise in a way that enhances rather than damages ongoing relationships between applicants and clinicians. The factors that constrain its ability to conduct a hearing perceived as fair and participatory by the applicants is considered, and synergies with the international literature are noted in relation to the heavy use of medico-legal language, dominance of public safety concerns, and the covert interventionist practices of the MHRT.

New Zealand's Mental Health District Inspector in historical context: "the impartial scrutiny of a citizen of standing".

The Mental Health (Compulsory Assessment and Treatment) Act 1992 (NZ) legislates for District Inspectors who ensure that mental health consumers held under the Act are aware of their legal rights. The New Zealand District Inspector role first appeared in 19th century legislation. Its historical longevity does not, however, denote that this role has been consistent since its inception.

New Zealand Mental Health Review Tribunal characteristics and outcomes 1993-2011.

Objective: This paper provides a descriptive statistical overview of Mental Health Review Tribunal outcomes from 1992 to 2011.

Method: A database used by administrators of the Mental Health Review Tribunal to store information on applicants and their hearing outcomes was subjected to basic descriptive analysis.

Results: A total of 3117 applications were received, with most applications received from males (n=2039, 65%) of New Zealand European ethnicity and a mean age of 49 years.

Police use of TASER devices in mental health emergencies: a review.

The proliferation of TASER devices among police forces internationally has been accompanied by concerns about injuries and health effects, and about the use of TASER devices on vulnerable populations such as people with mental illness. TASER devices have generated a flood of research studies, although there remain unanswered questions about some of the key issues. This paper outlines the introduction of TASER devices to policing and their subsequent widespread adoption.

Insanity, methamphetamine and psychiatric expertise in New Zealand courtrooms.

The use of methamphetamine in New Zealand has increased significantly over the last decade. Due to the potential of methamphetamine to induce, exacerbate and precipitate psychotic symptoms, this drug has also taken centre stage in several criminal trials considering the sanity of defendants. Highly publicised and often involving contested expert evidence, these criminal trials have illustrated the limits of using psychiatric expertise to answer legal questions.

Use of Tasers on people with mental illness A New Zealand database study.

Background: In 2006-2007 New Zealand police deployed the Taser X26 electro-muscular incapacitation device for a twelve month trial across four police districts. Criteria for use of the Taser included "individuals in various states of mental health crisis".

Aims: To provide a descriptive analysis of the use of Tasers by the New Zealand police; to identify those incidents that involved people in mental health emergencies; and to compare this use with that which occurred in incidents of criminal arrest.

In search of a national approach to professional supervision for mental health and addiction nurses: The New Zealand experience.

A competent nursing workforce is crucial for recovery of mental health and addiction service users. Professional supervision is central to facilitating this competency. This article reports on research that scoped the current provision of professional supervision then explores possibilities for developing a standardised national approach to professional supervision for mental health and addiction nurses in New Zealand.

Duly Authorized Officers' practices under mental health law in New Zealand: Are nurses meeting the requirements of the law?

The Mental Health (Compulsory Assessment and Treatment) Act (1992) introduced a number of statutory roles that are undertaken by mental health nurses. One of these roles is that of Duly Authorized Officer (DAO). The DAO is responsible for the procedural requirements necessary to facilitate compulsory assessment.

The provision of mental health care by primary health organisations in the northern region: barriers and enablers.

Aim: To identify barriers and enablers to the provision of mental health care by Primary Health Organisations (PHOs) in the northern region.

Methods: Information was generated from structured interviews with 22 of the 25 PHOs and the four District Health Boards (DHBs) in the northern region.

Results: Of the 22 PHOs who participated in the study, 17 had at least one specific mental health initiative; others had up to five initiatives.