A new survey, which is not designed to be part of the government’s current Mental Health and Addictions Inquiry, is looking to set a benchmark for the current quality and safety culture in services.

It comes at a time when both staff, service users and families have been speaking out during the Inquiry about safety concerns with reports of assaults on both staff and patients.

Dr Clive Bensemann, clinical lead for the Commission’s Mental Health and Addictions (MHA) quality improvement programme, said the national survey would play an important part in shaping future sector improvements, with organisations’ quality and safety cultures affecting the quality of care, the experiences of consumers and families, plus health outcomes.

‘Where there is a strong quality and safety culture, you will see leadership supporting all staff to continually update their skills,” said Benseman.

“Staff are able to talk safely about mistakes, near misses and adverse events. On the other hand, where there are issues with the organisational culture, such as lack of teamwork or communication failure, the result can be medication errors and adverse events.”

The survey, known as the Ngā Poutama Oranga Hinengaro: Quality in Context Survey or Ngā Poutama for short, will involve mental health and addictions staff working for DHBs, non-governmental organisations and primary health services. Survey invites will be sent to staff in August. It will include questions about their beliefs, attitudes and behaviours in regards to quality and safety.

The aim of the survey,  is to establish a baseline of information about the quality and safety culture in services to inform the design of quality improvement initiatives and to monitor change with the survey to be repeated every two to three years.

Results are expected to be confirmed by late 2018, and findings will be made available on the Commission’s website, as well as provided to key stakeholders and survey participants.

‘We urge those working in MHA services to take a few minutes to complete the Ngā Poutama survey, so that they can help us maximise our efforts to improve the quality and safety of MHA services over coming years,’ says Dr Bensemann.

A Commission spokesperson said the results were likely to be available after the Inquiry’s October 31 reporting date to Government.


  1. Please, may I first say that I am puzzled as to why this survey is named in a language only understood by at most 10% of us – when we have an equally beautiful language understood by 100% of us!! It is confusing – and, of course, wholly unnecessary.
    Dr Clive Bensemann mentions only two issues relevant to his survey : 1. that staff can talk freely about mistakes, near misses and adverse advents; and 2. issues re the organisational “culture” (is that the right word?) such as lack of teamwork or communication failure. Correct me if I am wrong, but it seems to me that Dr Bensemann has already in his own mind decided that the survey will show that everything will be rosy if “all staff [will learn to] continually update their skills”. In other words, all our safety problems are caused by present mental health staff and their ways of doing things.
    With all due respect to Dr Bensemann, it seems to me that we have a third factor which more than any other has caused our problems re assaults on staff in mental health units and the safety issues here. Let us add the radical change in mental health legislation in 1992 when suddenly it was decided that psychotic patients must be asked whether they would agree to be medicated or not. Before 1992 insane patients were given adequate medication from day one, and the huge majority accepted this without arguing – simply because we never asked them! Previous legislation simply assumed (correctly, I believe) that acutely ill, psychotic patients cannot know what is in their best interest.
    We never met with today’s problems in acute mental health units before 1992 : these were then peaceful, quiet and safe places – which is evident from the fact that patients suffering from depressive illnesses gladly admitted themselves here for a few days’ rest, soul-searching and treatment. And we never segregated them from other patients in the unit (once the acutely ill, insane patients had settled and were out of their initial secure room).

  2. This survey was so specific and limiting that any useful or meaningful opinions identifying why mental health care and treatment is not working could not be expressed.
    Bravo to Andy above who nails it. We now have a culture that puts patients rights above other patients and staffs safety. Unfortunatley a small number of patients who accept these rights do not have any sense of responsiblity to act in a respectful and considerate way in our mental health units.
    Consequently we have acute environments that are often unpredicatable, unsafe and downright dangerous.
    As a mental health nurse who has worked both in the community and inpatients services for many, many years I do not have any conviction that the mileau that our patients are trying to recover in is, for most part, any improvement on what we had twenty or thirty years ago.
    While I acknowledge there has been a need for a shift in the power inbalance in favour of patient rights, it would seem that this pendulum has swung far too far .
    It is time for a serious rethink about what we are doing. It is time to provide an environment where unwell, dangerous, antisocial, often Methamphetamine charged patients are contained and managed effectively, humanely and that the rest of the patient population and staff are not traumatised unnecessarily.
    It is time for the Ministry to address the serious problems of leadership, culture, resourcing and environment with a no blame, open minded attiude inviting meaningful dialogue.
    It is time we took charge of the care of our patients , and not have our mental health units hijacked by one or two individuals who are unble, or choose not to live by societys rules or expectations.


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