A case study of PACT Otago's journey in establishing and providing community mental health services, 1990-1999

Abstract

There are many service providers in community mental health in New Zealand since the closing of psychiatric hospitals. Non-government organisations (NGOs) have developed to provide services but little is known of their work. This study describes the establishment and development of one NGO, PACT Otago, to deliver mental health services from 1990-1999. The changes in mental health policy and service delivery in New Zealand provide the background to the study. Funding and contracts are explained in the context of the competitive environment that existed during these years, and there is a detailed description of the different services that were developed. Six key informants were interviewed and their experiences documented to offer detailed description and interpretation. Documentation was used from within PACT Otago and from outside the organisation. Community-based care has highlighted the need for different training for the mental health workforce. This includes nurses and support workers who staff these services. There has also been a move away from the medical model of care to more empowering ways of working with people who use mental health services. The areas of workforce and training, models of care, and the role of people using the services are explored and discussed. The findings highlight obstacles that occurred during PACT Otago's development that may be relevant to other organisations developing community mental health services. Research is now needed on the effectiveness of this model from the perspective of the people who use the PACT mental health services.