31 January 2024
Anatoly
[FYI request #24643 email]
Tēnā koe Anatoly,
Your request for Official information, reference: HNZ00032038
Thank you for your email on 3 November 2023, asking for the following under the Of icial
Information Act 1982 (the Act):
“I am a New Zealand citizen and reside in New Zealand. Under the OIA, I request a copy of
the following
For each of the current localities/ex DHB regions (Health NZ only not NGO)
1) Copy of the treatment plan template (myplan/wrap/shared care plan/treatment plan) used
within each mental health service
2) Description and number of mental health and addiction lived experience roles (CPSLE)”
On 15 November 2023, we contacted you to refine your request due to the initial broad scope. You
responded with the following:
1) Copy of the treatment plan template (myplan/wrap/shared care plan/treatment plan) used
within each mental health service (secondary service - cmh ect)
Please find attached the Mental health treatment plans from each district, the table below contains
details of documents supplied in each appendix.
• Assessment and Treatment Plan
Appendix 1 - Northland
• TRK Recoery and Transition Plan
• Adult recovery Plan
• Collaborative Recovery Plan
• Clinical Review Form Inpatient
• POPAO
Appendix 2 - Waitematā
• Treatment Review Regional
• IHCRP with Show plan
• Inpatient Careplan MHSOA
• Early Warning Signs
• Parent Infant Wellbeing Plan
• Transition Plan
• Care Plan template- adult inpatient. This plan is used in the Adult
Acute Inpatient Unit
• Care Plan template – adult community. This plan is used in all
outpatient (community) care settings catering to adults (18-65 years),
including Maori and Pasifika.
• Care plan template inpatient child and youth. Note this plan and
Attachment 4 are used by the Inpatient Child and Adolescent Unit,
Haumaru Orite, in Starship Child Health
Appendix 3 - Auckland
• Kari Centre review form. This plan is used by the Outpatient Child
and Adolescent Mental Health Services
• Care plan template. This care plan is used within a number of
specialist services: Maternal Mental Health, Eating Disorders, Youth
Forensic, Early Psychosis Intervention
• BRC care plan. This care plan is used within the Buchanan
Rehabilitation Centre (BRC) inpatient rehabilitation service
• Fraser McDonald Unit- Shared Care Plan 2023: This care plan is
the shared care plan which is used within Older Adult Mental Health
Services, both inpatient and community
• Starship Child Health PA Assess and Care Plan. This is used when
a Patient At ender is required on the medical ward
Appendix 4 - Counties
•Regional Collaborative Care Plan Printable Version
Manukau
• Regional Collaborative Care Plan V10
• Treatment Plan – Dialectical Behaviour Therapy (DBT)
• Recovery Plan – Health Care + Recovery (Dundrum),
Appendix 5 - Waikato
• Recovery Plan – Crisis Assessment and Home Treatment
• Recovery Plan – MH Services for Older people
• Recovery Plan – Infant, Child and Adolescents MH
• Ko Wai ahau interactive booklet
• Transition Plan Adult
Appendix 6 - Lakes
• Transition Plan iCAMHS
• Transition Plan MHSOP
• Risk Management Plan
• My Plan – Share Care Planning
• Inpatient Treatment Plan
• Treatment Plan 48 hour Initial Care Plan
Appendix 7 - Bay of Plenty
• Treatment Plan Community Services
• Perinatal Infant Mental Health Treatment Plan
• Multi Disciplinary Goals and Care Management Plan
• Wellness MICAMHS Youth Plan
• CAMHS Partnership template 2018
• CAMHS Risk Assessment and Transition Plan
Appendix 8 - Tairāwhiti
• MH Services Risk Assessment Tool
• MH Comprehensive Assessment Tool
• Wellness Plan – Alcohol and Drug
Appendix 9 - Taranaki
• Wellness Plan – Front Cover Sheet MHSOP
• Wellness Plan – MHSOP Adult MHAS
• Wellness Plan – My Hikoi
Appendix 10 - Hawkes Bay
• Health Record Policy for Mental Health and Addiction Group
• Mental Health Risk Assessment
Appendix 11 - Whanganui
• Go To Plan
• Transition Referral Checklist
• Treatment Recovery Plan
• Initial MDT Treatment Plan - Older Adult Mental Health
• Interdisciplinary Planning and Review Meeting - Form
• Mental Health and Addiction Service Discharge Summary - Form
• CAMHS My Just In Case Plan INTERACTIVE - Form
• CAMHS My Transition Plan - INTERACTIVE - Form
Appendix 12 – MidCentral
• CAMHS Specialist Community Consent and Confidentiality Form -
Child and Adolescent Mental Health Services - Form
• Te Ohu Whakarahi Whanau Mental Health MDT case Review
Meeting - Form
• Wellbeing Recovery Plan - Form
• Audit check list Template Vers 2
• Interdisciplinary Planning and Review –Policy
• Wellbeing Recovery Planning -Policy
• Comprehensive Plan (sample)
Appendix 13 - Capital, Coast, • Comprehensive Plan Visual Guide
Hutt Valley and Wairarapa
• Hui Hui Document
• RIDSS PBS Plan Template
Appendix 14 - Nelson
Marlborough
• Mental Health Wellbeing Plan Template
• Treatment Plan
Appendix 15 - Canterbury
• Wellness Safety Plan
• SMHS Crisis Plan
Appendix 16 - West Coast
• Wellness Treatment Plan
• Client Care Plan
Appendix 17 - South
Canterbury
• Wellness Plan
• Safety Plan
• Treatment Plan MHSOP Otago
• Consumer Treatment / Review Form [Manual Completion] MHAID
Service (District)
• Continuation Treatment Plan Inpatient Mental Health Unit
Appendix 18 - Southern
(Southland)
• Treatment Plan Forensic Service MHAID Service (District)
• Ward 9A Contingency Plan MHAID Service (Otago)
• My Transition Plan – CAFS
• My Shared Wellbeing Plan
How to get in touch
If you have any questions, you can contact us at
[Health New Zealand request email]. If you are not happy with
this response, you have the right to make a complaint to the Ombudsman. Information about how
to do this is available at
www.ombudsman.parliament.nz or by phoning 0800 802 602.
Nāku iti noa, nā
Michael Cleary
Acting OIA Manager
Government Services
T
eWhatuOra.govt.nz
