Pānui #6: MAPS implementation progress

Nau mai, welcome to our sixth pānui, where we will update you on the progress of the Te Kete Rongomau project.

Progress so far...

The implementation of the Mental Health Advance Preference Statement (MAPS) at Health New Zealand Te Whatu Ora Lakes (Rotorua) and Waikato (Hamilton) is in full swing, with people from various mental health and community services filling in their MAPS, eager to have their will and treatment preferences recorded with the services. We have been interviewing people to understand what the experience of creating their MAPS was like and have been getting some amazing feedback. In this newsletter, we’d like to tell you about how you can fill in a MAPS for yourself and how you can tell us about your experience, too, if you would like.

We’d also like to share a special story with you from Connie, our dear colleague from the Lakes project team, who has kindly allowed us to share her reflections on how MAPS would have helped with her mental health recovery journey and how important it is to have our voices heard.

In the last newsletter, we introduced members of the Waikato team, including project manager Debbie, Areta and research assistant Cindy Shepherd. Previously, we introduced members of the Lakes team, including project manager Maryanne Richardson, Ty, Connie, and Wi. Please look out for any member of our friendly project teams for help and advice about filling in your MAPS, or contact us on our website:

Please feel free to share our website with people you think may be interested. We have a ‘follow us’ section at the end of this pānui where you can sign up to receive updates, news, and invitations to our events. And, of course, the links to the MAPS resources at Lakes and Waikato are now live and available for use.

Connect to the Waikato MAPS page here: https://www.teketerongomau.com/waikatomaps

Connect to the Lakes MAPS page here: https://www.teketerongomau.com/lakesmaps

Tell us what it was like to fill in your MAPS

There are three ways to participate in our research evaluation of MAPS.

Firstly, you can tell us in person about what it was like to fill in your MAPS. Cindy and Rachel have been setting up interviews and visiting people across the region (Rotorua, Bay of Plenty, and Waikato), and have already heard a wide range of stories. Some people have been admitted into mental health acute services for the first time and found MAPS helpful to record what they would like to happen next time if they were to become unwell again. Some people have used services multiple times and have a good idea of what works and doesn’t work for them, and would like these preferences to be recorded. Some people only use community services and would like this recorded as their preference. Others have told us about their mental health journey and their inspiring stories of recovery. We are keen to hear more! If meeting in person isn’t an option, we're also happy to talk with you over the phone or via video call. You’re also welcome to have a support person join you if you would like.

The second way you can take part in the research is to give a copy of your MAPS. We will remove your name and any other identifying features and compare them to what others have said in their MAPS to gain a better understanding of what is important to people.

The third way to participate is to allow us to contact you again if your MAPS is ever used. We would love to hear about how it works in practice and whether your will and preferences, as laid out in your MAPS, were followed as you intended. Clinicians/kaimahi and staff at Lakes and Waikato will also have the opportunity to share their perspectives on how it went.

We look forward to hearing from you!

And now, some insights and reflections from someone who has experienced services and how MAPS could have helped…

Constance and Maple

Kōrero with Connie

I’m very fortunate to sit on the Te Kete Rongomau project team, contributing advice and insights from a lived experience point of view.

Mental Health Advance Preference Statements (MAPS) are something I’m passionate about and believe could change individuals’ treatment for the better. On a personal note, I wholeheartedly believe that the correct use of MAPS within my previous journey through the mental health system would have helped me immensely in the early and later parts of my recovery.

This is my story: I’m Constance. When I’m not studying or working on assignments, I enjoy spending time with family, my partner and our fur baby Maple (yes, I’m one of those obsessed dog mums, I said I would never be). I like going for walks, embroidery, and spending time in the garden with my mum.

Throughout my teens I was consumed by my mental health issues, it felt like a revolving cycle in and out of hospital wards and appointments. After turning 18, I agreed to attend an inpatient treatment (at that point, I agreed for the sake of my mum and family, and not because I truly believed anything would ever get better), returning home after 22 months.

If anybody had asked me 6 years ago what I thought my life would look like, I would have never ever imagined or even believed I would be able to build a life worth living. Yet, here I am, proud and grateful to just be. Life now looks very different to what it was not all that long ago, recovery has not been easy or linear and funnily enough looked very different to what I once thought it might. For me, it was about paying attention and holding close to me the things that made life worthwhile and learning that sometimes life sucks, but the way I feel at that time wouldn’t always be that way.

Having had interactions with a range of teams, such as ED, the Crisis Team, my GP and even after-hours doctors, a MAPS would have been a way for nurses and doctors to gain an understanding of what I looked like when I was well and what to look out for when I was unwell. This would have also given a brief overview of the fact that family/whanau was important to me and the values I held dear.

MAPS, as a document that could be accessed by not only my mental health team, would have helped immensely, as many times I was in crisis after hours, and having to repeat information was a tedious job. Being able to access MAPS hospital wide would have made this easier.

Creating a MAPS and having a voice into what may happen to me at various times would have given me a sense of empowerment and an ability to worry less about trying to make my preferences known in the already stressful process of being admitted.

Reflecting on my experiences, the best outcomes were consistently achieved when decisions were supported and made together with clinicians and where my preferences were considered. I understand that there are protocols, and other possible reasons out of my own control or the clinician’s as to why some preferences couldn’t be followed. In that case, if an explanation was given, even at the risk of highlighting shortfalls within the system, I felt listened to and respected as a human being rather than feeling that no effort had been made to meet my wishes. My inclusion in these decisions gave me a sense of respect and autonomy instead of feeling that I was just a sick, crazy, delusional individual whose voice didn’t matter.

I am aware that resourcing and timing constraints are pressing issues in mental health care. My experience is that when my preferences were considered, although this may have been time consuming for the clinicians, it saved time later, and overall, this approach has been much more helpful in my journey.

Thank you. 

Next steps

All the MAPS tools and resources can be found on the website: https://www.teketerongomau.com/

We would love to hear from people who have used mental health services about their experiences of creating their own personalised MAPS. We would also love to hear from whānau or any other person who supported someone in filling in their MAPS – with the person's permission, of course.

Overall, our research aims to evaluate the impact of implementing and using MAPS on service- and individual-level outcomes and experiences from the perspectives of tāngata whaiora, service users, whānau, family, kaimahi, and clinicians. This approach was chosen to gather the necessary information to evaluate the impact of MAPS on health, equity, social and cultural benefits, particularly for Māori. (Note: Economic benefits are also considered a likely impact but will not be an area of focus in the present work).

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We look forward to re-engaging with all of you soon and hearing about your experiences creating or using MAPS.

Ka kite me noho ora mai