Innovation - Need, Timing, and A Fresh Approach
Observation mixed with an innate, instinctual response
“to do something” set Anna Dorsey on the path of innovation. One could even say that becoming ‘an innovator’ for Anna has been a by-product of simply being someone who saw a need in her community in Tāhuna, Queenstown and took a chance to take action where solutions were needed.
When, like all of us have experienced these past 3 years , ‘Covid 19 happened’ Anna describes the community of Tāhuna in this time as “crumbled in a fear-based environment of feeling abandoned and isolated”. With local health infrastructure being inadequate to deal with the volume of need it was really hard for the community to navigate and access local support. Anna explains “there were huge waitlists for counselling services and many people were scared to reach out because of visa issues so the fear and rumour mill were rife with tragic stories of people struggling and failing to get help”.
With her work background in public health Anna felt “there was so much more we could be doing than simply telling people to call 1737”.
With a MOH work contract finishing Anna had capacity to respond and co-founded a new charitable trust, The Southern Wellbeing Trust. This was her platform from which to focus on building community connection and preventing mental distress. These were the priorities they could see and hear their community needed to support its mental health and wellbeing. Ember Innovations were able to offer support to Anna then in her role at The Southern Wellbeing Trust by providing a sounding board, business mentoring and connections for the development of the Trust.
Anna highlights the mix of ethnic and cultural diversity within the community of residents living in Tāhuna, the unique tourism-driven economy that drives and shapes the lives of locals, the geographical isolation of the area from urban centres and the misperception of all locals in Tāhuna being presumed to be wealthy as impacts that uniquely shape what it is like to be a local resident there in distinctive ways. This town’s special combination of place, of the unique community and of this time being experienced during the Covid pandemic provided the inspiration and the creative possibilities for Anna and her team to respond and co-create innovative solutions with. For the next 6 months Anna worked full time unpaid with nothing certain to bank on except her instinct that this was important work and to “just keep going”.
Anna and her team helped run a community mental health forum that asked residents to identify the key challenges being faced with regards to supporting mental health and wellbeing locally. Mental health education was identified as a clear priority and in December 2021 they were able to secure a small amount of funding from Lotteries and a local funder to begin to develop and deliver their first project
-The Good Yarn Community Pilot.
The GoodYarn Programme is an already established NZ grown evidence-based, peer-delivered, mental health literacy programme for large workplaces that enables people to talk about mental health (https://www.goodyarn.org/). It’s peer to peer model is centred in the workforce to create cultural change around the stigma of mental health and to give people the tools, skills and confidence to talk about mental health with colleagues and clients. It has had great success amongst rural and farming communities around the country, notably in the Southland area local to Tāhuna. Inspired by the success of this peer delivered programme, Anna and her team approached The Good Yarn team about the possibility of her bringing their workforce centred programme to apply it within a community setting in Tāhuna.
Simply put, their hope was “to train a diverse group of people from within the community who could take this important information back to their friends, family and whanau in a language, location and way that was going to best engage and reach them.
The Good Yarn Community Pilot has since trained 15 facilitators in Tāhuna representing diverse priority groups in their community. These facilitators were then supported and resourced to deliver workshops to their own communities. 267 local residents went through the training, many of these people had English as a second language. In a rippling effect these locals were then empowered to share this knowledge in their own networks and families. Anna shares how their approach was centred in simply asking people “do you think this is something you can use? Does it have value for you, your family and your community? If so we will work with you to deliver it”. The programme focussed on a process of co-design, and building relationships alongside continuous reflection, learning and adaptation.
“People came motivated to help others around them, but in being there they learned about resources and insights that helped them help themselves also”.
Many of their facilitators came with their own lived experience of mental distress and were able to apply their insights and knowing’s. Anna observed that what seemed to be creating the positive experiences for people’s mental health in this pilot was that facilitators already had a relationship to their community so connection was often immediate and their lived experience shaped their facilitating in empowering ways for those attending. This peer-to-peer community-based approach enabled trust to be created quickly, and the vulnerability and the leadership shared by those with lived experience made it easier to break down stigma and empower people to enter those harder, but necessary, conversations that can lead people experiencing distress towards effective and meaningful support.
Pilot evaluation data found that 100% of participants would recommend this workshop to others and 97% agreed it improved their knowledge of mental health and mental wellbeing. The most valuable components were found to be around learning the signs and symptoms of mental distress, connecting to resources and support and also provided important information about suicide awareness.
Evolving in 2022 into a new organisation, The Headlight Trust (www.headlight.org.nz), and with 14 months of experience and their data gathered Anna and her team of 12 recognise now the opportunity moving forward to scale what they have done nationally thereby making it available to other communities in Aotearoa, NZ. It is a highly effective model that enables generic mental health education that is interactive and empowering to be re-adapted and delivered to remote and hard to reach communities. It also actions one of our Government’s strategic goals as laid out in the high-level plan Kia Manawanui Aotearoa - Longterm pathway to mental health report; to empower communities to be able to support each other's mental health ( www.health.govt.nz/publication/kia-manawanui-aotearoa-long-term-pathway-mental-wellbeing) Anna has yet to find another programme which is bringing mental health education to diverse and remote NZ community members in this way.
As Anna shared, the hard stages for an innovator is the initial stages of delivery, development, piloting and evaluating to provide the evidence that will enable programmes to be scaled up to do what we all want, and that is to have positive impact by providing all NZ’ers access to culturally relevant wellbeing support. Yet there is currently no funding support provided from within the Health sector to support this essential initial stage of innovation or to support innovators' own living costs while they innovate and pioneer better ways of doing things. Sadly, while we as a society look desperately for solutions in mental health, we continue to operate with the expectation that innovators become overtly vulnerable and stressed just trying to survive themselves while they provide the solutions we collectively need. The absurd irony of creating stressors that lead to mental distress for those who are working passionately to generate real solutions shines in neon lights!
Anna and her team have just been able to scrape by through small grants from community funding streams, the local council and agencies such as the Lotteries, and are starting to secure small contracts to deliver some workshops locally. The effort to generate this basic support though takes a toll and they are still trying to navigate a way to secure sustainable health sector funding and support so that the programme can keep on operating. The fact that Anna herself spent over a decade working in the NZ public Health sector regionally and nationally and has established networks to work from to access and navigate the system, unlike many other innovators, has not provided her any easy solutions. Anna is continuing to knock on doors to raise awareness of their work and try and garner support. As Anna exclaims “Im not trying to make myself rich here. Im trying to mobilise a model that other communities can access and to make it sustainable. It is just ridiculous we are having to beg for money to do something that works”. Some may wonder why Anna didn’t stay in her paid contractual role with MOH but she is clear on why, because she could never have created and delivered The Good Yarn Community Pilot and generated the much needed positive impact of mental health support in her community if she had of stayed in her job.
Some may wonder why Anna didn’t stay in her paid contractual role with MOH but she is clear on why, because she could never have created and delivered The Good Yarn Community Pilot and generated the much needed positive impact of mental health support in her community if she had of stayed in her job.
We are collectively and publicly aware that our Health system in this country is broken. Being in the system doesn’t enable innovation or provide support to innovators. Yet being outside the system support for an innovator is not available either. SO how can we hope to make the changes individuals and communities are so desperately crying out for? This is the very focus we hold at Ember Innovations, to impact systems change in ways that better support and enable innovators to be able to generate real solutions. Meanwhile current systems in our health sector continues to dominate where and how funding is delivered while obstructing the very solutions the government’s mental wellbeing policies articulate. Protectionism over funding is a dominating reality that holds a dynamic in the sector that continues to disable responsiveness in the services being offered.
Despite trying to work alongside local health service providers, regional decision makers and administrators to deliver their programme, Anna says there was little support or assistance from the health sector initially for the work they were doing and yet the non-clinical community were completely the opposite: “really supportive and embracing of this approach - they wanted us to do it”. Anna feels that they are now finally starting to get some support from local health providers but there is still a long way to go to build a sustainable, integrated foundation from which to grow their community-based work.
Words without real actions is a dangerous rhetoric to continue to feed to those who are vulnerable. The impact of change needs to be felt, on the ground and in people’s daily. Again we know this, this has been acknowledged in the health sector, but when will experience change, instead of just researching and theorising around it? And what does that change look like that will see us ceasing the dominance of money on our collective capacity to respond to health and wellbeing?
I want to reflect here on what I perceive as essential for good health and wellbeing, and that is trust. If a client or patient does not trust their practitioner or therapist they will not be empowered to take the actions they need to improve their health and wellbeing. Yet trust cannot live on a one-way street, it is a circulating, interactive reality built through exchange. Anna has observed and articulates the culture of distrust of community initiatives and of people in the community leading pathways forward that sits within the government and the health sector. Distrust that is built on the arrogance and elitism of an attitude of ‘we know best’ which contradicts their policies prioritising community-based responsiveness; we need peer led solutions to increase the workforce they write, yet where are they in supporting the growth of these solutions? The funding being thrown around in the health sector is huge, we have all witnessed it during Covid19.
Within the mental health sector alone there is continual acknowledgement of the amount of funding floating around at the moment to deal with our mental health crisis, but if it is only the big organisations doing things their same old way that are receiving that funding because that is who the government chooses to trust, how can we ever generate the changes we need and want?
I still haven’t even touched the topic of cultural diversity in how we perceive, articulate and respond to health and wellbeing in this country and the obstructions caused by the fact that we are still dominated in our health system, and in all our societal systems, by the arrogance and righteousness of our dominating and hyper competitive Pakeha, Western European worldview and value system that considers still that its perception and knowledge of the world is greater and more right then any other culture or knowledge. This is demonstrated by how evidence and evaluation of any approach is based and valued only on western clinical perceptions and measures. The valuing of any approach to mental health from ‘other’ cultures, such as Māori, is still quantified and qualified by a western clinical model, even while western clinicians are begging for, ‘borrowing’ or intellectually mis-appropriating/stealing knowledge and traditions from the very cultures they innately distrust, devalue and place ‘beneath it’.
Despite the different challenges being faced out there, innovators like Anna continue to “just keep doing it and believe we are going to get there”. This is a common trait we at Ember Innovations recognise in many of the innovators we are communicating with. As Anna concludes “We are just having to hold the space of trust, keep moving forward and doing the good work. We are now seeing that this pilot could be just the start. It’s enabled us to grow a new empowered peer workforce here locally that didn't exist before and who are passionate about mental health. We want to keep layering and building our peer service offering to help fill the gaps in health services and infrastructure that exist here and in so many rural communities. We want to support other communities who are knocking on our door saying they want it” (the GoodYarn community programme). For this attitude of resilience and persistence in Anna, we can all be grateful. “We have done something no-one else did and we didn’t realise till we’ed done it. And now we are doing it, we need to tell everyone”. Ember Innovations continues to be a trusted ally and to assist in capability and connection support to Anna and her social enterprise, The Headlight Trust.