Te Hiringa Mahara oversees the performance of the whole mental health and wellbeing system, providing leadership and support, and challenging it to perform better.
The Initial Commission developed the He Ara Oranga wellbeing outcomes framework, a holistic outcomes framework for mental health, addiction, and wellbeing, for Te Hiringa Mahara to consider adopting.
The He Ara Oranga wellbeing outcomes framework provides a structure for measuring performance across the whole mental health and wellbeing system. A successful outcomes framework will determine if we are making a real difference to improving our mental health and wellbeing – if we are achieving the outcomes and equity of outcomes, set out in He Ara Oranga(external link).
The Initial Commission was also involved in the early stages of development of the He Ara Āwhina service monitoring framework. Their early development work was handed over to Te Hiringa Mahara to carry forward. The He Ara Āwhina framework is a separate, but interconnected, framework that will monitor mental health services and addiction services and be used to advocate for improvements to those services.
Alongside these frameworks, the Initial Commission made recommendations to address information gaps to monitor performance, and how measuring outcomes fits within the broader performance story of the mental health and wellbeing system.
How the Initial Commission developed the He Ara Oranga wellbeing outcomes framework
The He Ara Oranga wellbeing outcomes framework was developed in phases:
- Co-define (hearing views on how a framework could be developed) April 2020 to May 2020
- Conceptual framework (what is important to demonstrate success) June 2020 to September 2020
- Data (how success can be measured and where data gaps exist) September 2020 to January 2021
Outcomes framework principles
The Initial Commission was guided by an overarching set of principles. You can see these on the Initial Commission home page.
The following principles guided the Initial Commission's work to develop the outcomes frameworks.
Framework design
Scope and content
- Wellbeing (oranga) focused, whilst anchored and relevant to mental health and addiction
- Population-level (everyone in Aotearoa), with a focus on groups who experience poorer wellbeing outcomes, and cascading of population outcomes to mental health and addiction service-levels
- Focused on outcomes, not processes or outputs
- All-of-life wellbeing view
- Wellbeing includes a balanced view of multiple interconnected domains
- Wellbeing is relational and experienced at many levels – including individual, family, community, and society
- Positive – focuses on the development of strengths and growth, rather than absence of difficulties, and includes prevention and early intervention
- Draws from and connects to (where appropriate) existing models, frameworks and thinking – “don’t reinvent the wheel”
Easy to interpret and relatable
- Simple to understand and concise
- People can see themselves in it
Designed to support use and improve results
- Provides a clear sense of direction
- Drives collective action, including what is and is not working
- Clarity on who is accountable for what, and to whom
- Meaningful to, and promotes alignment between government and non-government audiences that contribute to wellbeing and have a role to play
Indicators and measures
- Conceptual - drives the data, not data drives the conceptual
- Selective – measure only what is most important and relevant for current and future growth
- Try to use existing data first (where appropriate)
- Strive to measure outcomes, from short-term to long-term. Noting some proxy process data may be necessary (but not necessarily desirable)
- Acknowledge not everything important is currently measured. Seek to address data gaps going forward
- Enable monitoring of change over time
- Combination of quantitative and qualitative
- Honour principles and practice of data sovereignty
Implementation
- Enduring framework with a long lifespan
- A living framework – evolves over time and is iterative so content is relevant and current
- Significant and sustained support for implementation and embedding its use, noting this will take time and will require a shared responsibility
