What is the interRAI Community Mental Health Assessment

The interRAI Community Mental Health (CMH) Assessment was designed to be used for community-based individuals with a broad range of mental and physical health needs. The target population is all adults aged 18 and over in community mental health settings, including those with dual diagnoses. It has been designed to incorporate the person’s needs, strengths, and preferences when assessing the key domains of function, mental and physical health, social support, and service use, and complements the interRAI Home Care (HC) Assessment.

The Pilot

The Community Mental Health Assessment pilot was initially proposed to the (then) interRAI NZ Governance Board in June 2021 by a group of seven District Health Boards (DHBs) including Bay of Plenty, Canterbury, Capital and Coast, Counties-Manukau, Hawkes Bay, MidCentral, and Southern.

Approval was sought for the pilot and, if successful, national rollout of the interRAI Community Mental Health tool for Tangata Whaiora with severe and enduring mental illness seeking residential care and/or community-based support.

The proposal was lead by Dr Carin Conaghan (Canterbury) and Andrew Neas (BOP). A Steering Group was then formed to lead the project including the two proposal leads and representatives of interRAI Services, initially limited to assessing clients in the Waitaha Canterbury and Hauora A Toi Bay of Plenty Districts only. A working group was then formed to develop course content and resources for training, this included interRAI Education and Support Service team-members, and external invited subject matter experts (SMEs) identified by the DHBs

This project supports the Ministry of Health’s acceptance of several recommendations made following the He Ara Oranga Report. Specifically:

• To increase access to publicly funded mental health and addiction services of people with moderate to severe mental health and addiction needs by better identification of needs that prevent access to currently available services.
• That access to mental health and addiction services should be based on need so that people with the highest need continue to be the priority by the provision of a standardised assessment tool.
• Provide data to assist with the Government’s commitment to a staged funding path to improve access and choice including designing and implementing improvements to create more people-centred and integrated services.
• Provide data to assist in a central agency taking a lead role in improving commissioning of health and social services with NGOs.

The use of interRAI to assist with assessment and service procurement for people with severe and enduring mental illness is in keeping with the governments vision whereby the health system delivers healthy futures for all New Zealanders to live longer and have improved quality of life. Using the interRAI tool to identify needs and inform resource allocation and quality of service delivery reflects the underlying principles of Pae Ora namely: equity; partnership; excellence; sustainability and person and whānau-centred care. 

Where are we up to?

We had a delayed start to the pilot due to COVID, but training began in November 2022 for the two districts involved. Due to numbers and pilot limitations identified, a further request was made to the board in May 2023 to extend the pilot and include more Districts. To date, seven assessors have been trained to competency from Canterbury, Bay of Plenty, South Canterbury, and Hawke's Bay.

Feedback gathered from interRAI Educators and the trained assessors will be incorporated into the pilot completion report early this year. The report is due to be presented to the interRAI Leadership Advisory Board (iLAB) in March.