This annual report - Taranaki District Health Board

this [350]. The review stated that there was, at that time, no good evidence to indicatewhat range and mix of services led to the best outcomes for young people with seriousmental health problems.The first Blueprint for Mental Health Services in New Zealand [351], published by theMental Health Commission in 1998, noted that the Government’s National Mental HealthStrategy required that mental health services be delivered to the 3% of the population who,at any one time, were most severely affected by mental illness. Ministry of Healthbenchmarks for access to specialist mental health services for different age groups wereset at 1% for 0–9 year olds, 3.9% for 10–14 year olds and 5.5% for 15–19 year olds [352].In 2005, Te Tāhuhu – Improving Mental Health 2005–2015: The Second New ZealandMental Health and Addiction Plan noted that while the number of specialist services forchildren and young people had increased, there were still gaps in access, and that theprovision of services for children still lagged well behind services for adults [353].Te Raukura – Mental health and alcohol and other drugs: Improving outcomes for childrenand youth [354] reported that, overall, access to child and youth mental health serviceswas still below expectations, with access rates in 2005/06 being 0.69% for 0–9 year olds,2.45% for 10–14 year olds and 3.44% for 15–19 year olds. Key access issues identified inTe Raukura were barriers to access for Māori and Pacific children and youth, lack ofculturally appropriate services, waiting times, inconsistency in how the severity criterion foraccess to CAMHS was applied, and workforce shortages and vacancy rates. Gaps in childand youth service provision were highlighted: youth forensic services, severe behaviourservices, alcohol and drug services, and services for low prevalence disorders (includingautism spectrum disorders and eating disorders), children of parents with a mental illness,and maternal and infant mental health. Other nationally identified problem areas werestated to be: implementation of evidence-based best practice, inter-sectoral collaboration,workforce, and increasing the role of primary care in mental health service provision.The Mental Health and Addiction Action Plan 2010 [355] signalled the Government’sintention to move resources to primary care (to improve access to mental health andaddiction services) and to integrate efforts across sectors (Health, Special Education,Child, Youth and Family and other providers) to divert children from negative pathwaysthat impact on their life chances. The Plan sets out a number of actions to improve accessto parenting programmes intended to reduce children’s behavioural, emotional and mentalhealth problems. Primary care practitioners are being trained to deliver the Triple P –Positive Parenting Programme, some new CAMHS clinicians are being employed andCAMHS staff are being trained to deliver the Incredible Years programme tofamilies/whānau of children with behavioural or conduct problems, and it is intended thatparenting programmes which reflect Māori cultural values will be developed and provided.In response to increasing recognition of the importance of early mother-infant relationshipsfor emotional and social development, in 2011 the Ministry of Health published HealthyBeginnings: Developing perinatal and infant mental health services in New Zealand [356]to provide guidance for DHBs and other service providers on ways to address the mentalhealth and alcohol and drug service needs of mothers and infants.The Mental Health Commission has recently published Blueprint II highlighting the need tobroaden the focus of mental health services and take a life course approach to mentalhealth. Blueprint II promotes a stepped care model of mental health care in which servicesare delivered to people with less severe mental health conditions in primary care andcommunity settings as well to “the 3%”.The Provision of Specialist Child and Youth Mental Health ServicesCommunity Specialist Child and Adolescent Mental Health ServicesCommunity Child and Adolescent Mental Health Services (CAMHS) provide the majority ofspecialist mental health services to children. All 20 DHBs provide CAMHS and alcohol anddrug (AoD) services. Regional child and adolescent inpatient services are provided inAuckland, Capital and Coast (Wellington) and Canterbury (Christchurch). In areas withoutIn-Depth Topic: Mental Health Issues in Children - 370