Promoting mental health, demystifying mental illness, countering stigma and discrimination

Care Pathway

Assessment, Treatment and Rehabilitation and Discharge:

Understanding what treatment is intended to achieve and being actively involved in the treatment process is most important.

Accessing Mental Health Services:

Usually the first step to accessing treatment is through consultation with a GP (General Practitioner.)  The GP may then arrange a referral to a psychiatrist for an initial assessment - just as they would for any other specialist service.

Family/Whanau, other support people, or an advocate is welcome to be involved in all aspects of the care and treatment of the person if the person so wishes.


Assessment is the process used to access a person's mental status.  The process used will vary from person to person depending on the particular circumstances of the person being assessed.  Usually, the person doing the assessment will be a Psychiatrist or Senior Medical Officer.  The process will be mainly through discussion with the person (and where appropriate, with their family/whanau) about their presenting symptoms and circumstances.


A diagnosis simply means an identification of an illness.   It is based on a particular pattern of symptoms and enables medical staff to treat the illness.
Examples of a diagnosis are:
  • Bi Polar Disorder
  • Depression
  • Psychosis
  • Schizophrenia

Do ask the psychiatrist or other mental health professional to fully explain the diagnosis and request written information about the illness.

If someone has a particular diagnosis it doesn't mean that they will have all the symptoms associated with it.  Nor does it mean that the illness is life-long or that it cannot be treated.  Most mental illnesses can be cured or managed well.

Everyone diagnosed with a mental illness will present differing mixes of symptoms that will change and improve with the correct treatment.

It can happen that a diagnosis may alter.  This may occur because the symptoms change or new information is gained.

It is important to concentrate on what a person's symptoms are, how they are reacting to medication and other life changes and how they, their family/whanau and the mental health team can work together to enable the very best recovery possible in the shortest period of time.

What Treatment Means:

Treatment can be a complex process involving medications and rehabilitation and the involvement of a whole team of mental health professionals as well as the person, and, with their approval, their family/whanau or other person(s) they may wish to be involved.

Treatment Plan:

This is sometimes called the 'care plan' or 'management plan.'  It is a written summary of the treatment being provided by mental health staff.  This plan is available to the person and the person can give a copy to other people in their support group if they so wish.

The treatment plan will be developed through a process of discussion between the person, and with their permission, their key support people.  Sometimes their GP (General Practitioner) and other health workers will also be asked to be involved with this process.  The key thing is the involvement of the person.

The treatment plan is important.  If it contains information that is not clear to the person or you, or you do not understand, then please ask the person's clinician to go through it with you.

The treatment plan is also a summary of important information:
  • About the person, their illness, the nature of the illness or illnesses they experience and the names of the staff working with them.
  • About the goals the person has made for their rehabilitation and recovery.
  • About the treatments available, who has responsibility for these and progress made with treatment.
  • About medications prescribed.
  • About what the person and others may notice if they are becoming unwell and what to do if this happens.
  • About any relapse management of crisis plans.

The treatment plan is a 'living' document.  It will be reviewed and updated regularly.  This plan will be readily available, should the person require hospitalisation at any time.

If there is any confusion about the treatment plan, please discuss with a member of the treatment team.

Understanding what the treatment plan's goals are and being actively involved in the treatment process will ensure the person gets the best service possible and the best chance of full recovery.

Accessing Treatment:

Usually the first step to accessing treatment is through consultation with a GP (General Practitioner) just as with any other medical condition.  The GP may then arrange a referral to a psychiatrist (a medical doctor who specialises in mental health) for an initial assessment - just as they would for any other specialist service.

After the initial assessment the psychiatrist may recommend that the person be admitted to Te Puna Waiora until their symptoms are under control.  Alternatively, it may be decided that the person does not need to go into hospital but can be treated from the start in the community with regular visits from the community mental health team.

The treatment programme will usually involve a combination of medication and rehabilitation.  The treatment plan will be developed with the person, and with their permission, their family/whanau and a team of mental health professionals.  Goals will be developed and the person and their family/whanau supported to achieve these.

While the psychiatrist stays responsible overall for their treatment, other members of the treatment staff may carry out day-to-day management.


Modern medication can be a powerful influence in recovery; therefore taking medication as prescribed is advisable.  Usually the person will notice improvements in their symptoms within a few days of taking medication.  Occasionally, medication isn't easy at first.  There may be side effects that need attention, especially in the early stages.  These need to be discussed with the psychiatrist or other mental health professional.

It is not advisable to increase, reduce, stop or change medications without full discussion with the psychiatrist.  Please ask for any written information about the medications prescribed and ask about any anticipated side effects caused by medication.

Understanding the nature of the medication and what you can expect it to achieve is an important part of the recovery process.


Whether being treated in Te Puna Waiora or within a community setting, there will be a whole team of mental health professionals overlooking and advising on the person's treatment and rehabilitation.  Members of the team, and sometimes a specific member referred to as a Key Worker, will ensure that the person has access to the range of resources available to support and ensure recovery.

The person will have access to a social worker and help them access benefits, find a place to live, and access other community support services as appropriate.


Discharge planning is mostly associated with the process of assessing and preparing individual mental health persons for discharge or release from one care setting to another.

e.g. From hospital inpatient care to care by community mental health services, or from a community mental health team to  private or independent (self) care.

The discharge process commences at the time of admission into a care setting, e.g. Te Puna Waiora, Taranaki Health's Mental Health Service inpatient unit.  This is to ensure time to plan and put in place all the desired after-care, support and supervision arrangements before the person leaves the care setting.

It is important that the person and anyone they wish, e.g. Family/Whanau and significant others, are fully involved in the planning for discharge process.  The person can view this plan at any time, and on discharge will receive a copy of this plan.  A copy will be sent to other people whom the person wishes to receive a copy, e.g. Family/Whanau, and a copy is sent to their GP.  A copy of the discharge plan is also kept on their hospital file.

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Taranaki Mental Health Sector