Our tour down under!

Ann and I have been very privileged recently to do a couple of weeks work in New Zealand and Australia around CAPA. We spent three days in Auckland working with the Werry Center (NZ’s excellent CAMHS change organization) including one day’s masterclass with CAPA champions from cross the country. Then we flew to Wellington, met with the local Adult mental health team in their service (great to visit actual buildings and staff) followed by a CAPA conference for the whole DHB (organization). After that we flew to Sydney briefly and on to Orange (160 miles west and inland of Sydney) doing two workshops there – one for staff and another for clinical leads, planners, clinical directors etc. After flying back to Sydney we had a day off on the Wednesday and then two metropolitan conferences in the city.

So much to talk about but for me the highlights were:

  • the positive feedback from the Christchurch team about how CAPA had increased their team cohesion so they had been able to provide a service through the difficulties and been able to flex choice capacity in responses to waves of referral demand. Humbling experience to hear about them, their situation and their efforts.
  • the discussions with adult consumer advisers (service users) about what they would like the initial appointment to be called. They said they really did not like “First Assessment” as they did not want to be “Assessed” not did they like that the service was counting already! The loved “Choice” as “we wold love to be really able to feel that we had a choice”
  • turning up to Wellington airport to discover our booked flight to Sydney did not exist!
  • the size of some of the patches in the Orange area and especially so further inland, The size of Germany with only 100K people in them. And the challenges of the lone workers in these patches were enormous and their resilience was extraordinary.
  • cycling round the Manly dam cycle track on a hire mountain bike. This was not for beginners to advanced as advertised. Very scary for me anyway!
  • the energy of the Sydney metro conferences
  • and finally arriving at Sydney to come home to discover that our return flights had been unbooked by the airline as we had missed the non-existent plane!

We plan to be back in a year maybe. Thanks to all and to Ann for sharing it all with me.


Choice and Assessment

At a recent consultants meeting in Hertfordshire we spent some time thinking about Choice appointments and, as i discovered, some continuing myths about the role of assessment. First off let me state the myth: that Choice appointments do not contain any assessment – it is just offering a range of Choices. I can see where this myth comes from as Ann and i talk a lot about Choice and the need to work with the users wishes, hopes and wants. As well as our recommendation that we stop calling the initial contact “Assessment” (as we think this word is not collaborative) and to call it something else, maybe “Choice”.

BUT we also say that our job is to “facilitate their choices using our expertise”. In other words we have to do think about both assessment and risk to be able to have conversations with the young person in a collaborative and informed manner. The trick is to move away from an expert assessment that makes the young person and family feel passive to being able to do our assessment and risk thinking in a conversational manner that both gives us the information we need and keeps the young person and family active and engaged.

In fact it is this open and honest conversation with the young person and their family using my ideas as well as their hopes and wishes that I find so rewarding in a CAPA service!