A WHOLE OF COMMUNITY, SYSTEMS APPROACH TO GROWING INDIVIDUAL AND COLLECTIVE WELLBEING
In 2018, Healthy Families Whanganui, Ruapehu, Rangitīkei (WRR) was commissioned by the District Health Board to engage communities in a conversation about suicide prevention. Everyone showed up to share. Communities knew this conversation was important. People were interested in finding solutions for those most in need of support, while also considering how we could collectively reduce the growing number of people experiencing hopelessness and distress.
After 18 months of engagement a set of key insights was formulated with a strategic framework to guide the design of a new prevention system. Two key recommendations emerged. The first proposal suggested reframing the problem. Traditionally, the issue is framed as “how do we prevent suicide?” which leads to a focus on intervention. However, should we reframe the problem to view suicide as an indicator, with the real challenge being how to improve individual and community wellbeing? This shift, we believe, would promote a broader and more balanced approach.
The second suggestion was to maximise the energy and interest in contributing to change by focusing on a whole- of-community, whole-of-system approach. This required a targeted and iterative approach, building community capability and capacity while supporting the health system to share power and recalibrate at critical touchpoints.
The Growing Collective Wellbeing Strategy released in2020 was activated by a movement of stakeholders and community groups, who together created the building blocks to a new future reality. The strategy is a completely different way of thinking and doing that does not solely rely on the Mental Health system. It was about building a movement - inclusive of whānau and community. Growing Collective Wellbeing redefines networks of support and calls for a more joined up ecosystem of service.
The region’s Mental Health & AOD sector has embraced a Te Ao Māori worldview to shift the system from a clinically-led model to a more inclusive human and ecocentric continuum of care. From 2018-2022, $480 million was spent on first response crisis management. Mapping five years of this crisis data (15,200 data points) against the Maramataka revealed, crisis occurs within four phases. This was the first time a traditional indigenous framework provided new insight and narrative to point where earlier intervention or prevention might occur. Over 200 stakeholders have visited the Maramataka patterns walk-through, with positive feedback and eagerness to prototype interventions based on these findings. These efforts underscore the strategy’s inclusive
and proactive approach, showcasing the community-led, systems-enabled nature of Growing Collective Wellbeing.
Other activations have included redesigning and testing a referral pathway to intervene earlier before crisis support is needed; services hacking different practice challenges by co-designing and testing new solutions; lived experience and peer support workers have reframed how we talk with whānau experiencing distress so stigma and bias can be eradicated at every touch-point, and tāne Māori revealed the benefits of sharing feelings and emotions to change the stereotype of ‘harden up’ men to vulnerability is strength and courage.
Te Whatu Ora Whanganui has embedded the Collaborative Design of Mental Health & AOD strategic priorities into its Quality Assurance framework, signalling a systemic shift towards holistic approaches. In addition, they redesigned the risk assessment framework to a wellbeing framework further emphasising this shift.
Looking ahead, the strategy aims to prototype interventions to address the impact of toxic stress on pēpi and whānau, while looking at how communities and services can further develop their capability to role model and apply wellbeing practices in the places we live, learn, work, and play. Organisations are increasingly eager to participate in the strategy’s initiatives, reflecting its growing influence and impact. With strong regional and national networks, the strategy has laid the foundation for bringing a new future reality to fruition.
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