Recovery

Recovery is the guiding principle of care provided at Te Whetu Tawera (TWT). Recovery
means living well in the presence – or absence – of mental illness and the many losses
that can come in the wake of mental illness. Recovery is supported at TWT by: working
with our service users to stay in touch with their community, minimising coercion,
promoting choices, and most importantly by expecting recovery to happen.
We offer a range of programmes and activities that promote recovery through exercise,
spiritual wellbeing, art, music, therapeutic relaxation, accurate information about
medications and developing specific skills to help one live well in the presence of a
mental illness. These skills include Distress Tolerance, Cognitive-Behavioural Therapy,
managing auditory hallucinations (hearing voices).

Schizophrenia
Schizophrenia is a serious mental disorder that affects about 1% of the general
population. It is a complex illness characterised by ‘psychosis’, a word used to describe
disorder of thoughts (e.g. delusions - false beliefs held in spite of evidence that they are
not real), perceptions (e.g. hallucinations - seeing, hearing or feeling things which are not
there), disorganised speech and grossly disorganised behaviour, which are not
experienced by others and which are not seen as abnormal by the sufferer. These four
symptoms are often referred to as the ‘Positive Symptoms’ of schizophrenia because they
are the result of the disease process.
The fifth group of symptoms: withdrawal, decreased ability to feel pleasure, lack of
energy, and flat affect, are referred to as ‘Negative Symptoms’ because they represent a
loss of normal functions.
Schizophrenia affects different people in different ways. Some people may experience
only a few short episodes and then fully recover. For others it lasts throughout their lives
and needs to be treated like any other physical illness such as asthma or diabetes.
It is important that schizophrenia is treated as soon as it is diagnosed by a psychiatrist to
prevent long-term disability and loss of function.
Treatment
Schizophrenia may be treated using a number of different approaches:

• Use of antipsychotic medication

• Psychosocial education programs e.g. education, support, counselling and

assistance to return to job/studies/performing daily tasks

• Ongoing support e.g. housing, monitoring of treatment, support groups

Bipolar Disorder/Manic Depression
This is a mood disorder in which both depressive (persistent low mood) and manic
(elevated or high mood) episodes are experienced. It is usually a recurring (i.e. keeps
coming back) disorder that can cause a lot of havoc in all aspects of a person’s life.
People with this disorder will experience periods of extreme mood changes but also
periods of stable mood during which they may be able to return to everyday routines.
These changes of mood can be very extreme and occur for no apparent reason. Different
people will experience this disorder in different ways; some may have few episodes,
others many, and symptoms may vary from mild to severe. When severely depressed or
elevated, a person can become ‘psychotic’ i.e. lose touch with reality.
Treatment

• Usually by medication (antidepressants if depressed and mood stabilisers if

depressed and manic)

• A combination of counselling and psychotherapy (‘talking therapy’) may hasten

recovery

• Hospitalisation may be required for those who are very unwell and are posing a
risk to themselves or to others.

Depression
Depression is a mood disorder. Emotional states like sadness, ‘feeling blue’ or tearfulness
are part of normal human experience. Clinical depression is called Major Depression and
is characterised by the presence for at least two weeks of symptoms such as depressed
mood, diminished interest and pleasure in most activities, change in appetite and weight
(these can be increased or decreased) sleep disturbance, fatigue, bodily symptoms
(headache, backache etc) poor concentration, feelings of anxiousness, worthlessness,
hopelessness, guilt, and suicidal ideation.
Depression is a common disorder and about 10-20 % of the population in New Zealand
will suffer from depression during their lifetime.
Treatment
Once depression has been diagnosed by your GP/Psychiatrist, it can be effectively treated
by:

• Antidepressant medication

• Psychological interventions e.g. counselling (various types) and psychotherapy

 (talking therapy which is of various types).

Anxiety Disorders
We all feel some anxiety at some time or other. Anxiety may serve as an alerting signal,
warning us of external /internal threats and consequently acting as a prompt to take
appropriate action.
When anxiety is very severe and present even when there is no threat of any kind, then it
interferes with our functioning and can become an illness. In this circumstance, anxiety
becomes a disorder characterised by an unpleasant emotion with feelings of fear, threat
and impending danger and can be associated with numerous bodily symptoms like
breathlessness, trembling, tightness in throat, dry mouth, racing heart and
nausea/vomiting.
There are varieties of anxiety disorders like panic attacks, phobias (unhealthy fear of
something), agoraphobia (fear of open spaces), social anxiety, post-traumatic disorder
and obsessive compulsive disorder. Anxiety can often be associated with a depressive
episode.
Anxiety disorders are very common and if unrecognised and untreated, can cause severe
disability.
Treatment

• Self help: learning techniques like relaxation, distraction and education

• Cognitive Behavioural Therapy (CBT)

• Medication.

Te Whetu Tawera 'Evening Star'

Te Whetu Tawera is the Auckland District Health Board's Acute Mental Health Inpatient
Unit and Te Whetu Tawera means the evening star. The meaning in relation to the service
is that even in times of darkness for people who are unwell and who use this service,
there is a light for them and their family. The serrated light of this star is representative of
peoples' healing pathway and journey - that this journey is not always along a straight
path, there are always "mountains to climb and rivers to cross" - that there are challenges
along the way to test our resolve to attain and maintain wellness. However, if we keep the
guiding 'star' of Te Whetu Tawera in our sights we will remain on our pathway to
healing.
Within Te Whetu Tawera there are four areas in three wards whose names reflect the
challenges and support that can be encountered on the journey. We may become totally
disconnected from our internalised wairua dimension and seek to reinstate that which
gives our very existence meaning. We seek unconditional love/acceptance: Arohaina. Te
Whetu Tawera remains our sight and sustains the hope; Te Tumanako, that challenges
along the way will not diminish this. There are mountains to climb; Te Kakenga, and
rivers to cross; Te Whitianga, that test our resolve to attain and maintain wellness.

So what is the connection between the meaning of Te Wheta Tawera and the service we
deliver?

• all interactions and interventions are about supporting service users and families
on their journey to sustainable wellness

• celebrating periods of wellness that service users experience between admissions,

building on their knowledge, skills and confidence to reconnect
We have a vision to be the best Acute Inpatient Mental Health Service in the Pacific
The core values of the Unit include:
The right to self-determination - participation and family involvment in care, planning
and the decision making processes towards service users gaining control over their lives
to the best of their ability
Inclusion of family - supporting inclusion of family and care givers in treatment
decisions and discharge planning. Resourcing families and care givers with information
and support
Honesty, respect and intergrity - we value delivering these three dimensions as one
Manaakitanga - This dimension embraces support, caring and providing the best that
can be offered to the service user and family in terms of the environment, the warmth and
caring of interactions between staff, the service user, family and other professionals and
the ability of staff to give their best at all times.
Striving towards wellness - maximising the strength of service users and families and
developing new skills and ways of living to maintain wellness
Integrity - this concept acknowledges the requirement that each staff member working at
Te Whetu Tawera is bound by the ethical principles of his/her discipline and will place
the wellbeing of the service user at the forefront of his/her working effort, within the
limits of his/her own personal capacities.
Wairuatanga - Before the coming of the Pakeha and Christianity, Maori religion both
dominated and was a reflection of the Maori way of life. It emanated from the everyday
existence of Maori and at the same time gave that existence meaning. Spirituality is seen
as a dimension internalised within a person from conception - the seed of life emanated
from the supreme supernatural influence. Maori beliefs, values and traditions ensure that
both realms are recognised, sustained and nurtured together in a holistic way. This is the
recognition of the spiritual dimension and vibration. The level of spiritual wellness is
reflected in a person's physical and mental wellness.
Solidarity - refers to the cultural imperative to work for the common interest of the
group. "e hara taku toa i toa takitahi engari he toa takitini" "my strength is not that of the
individual but that of the multitudes"

Respectfulness - This concept recognises the fundamental uniqueness of the individual

and his/her right to self-determination. It embodies a profound valuation of life and the
cultural, spritual, mental and physical aspects that support and sustain it for each person.
Optimism - this acknowledges the assumption that improvement in the quality of life is
not only possible but expected, and that the time spent at Te Whetu Tawera will be
focussed on movement towards recovery
Excellence - each staff member at Te Whetu Tawera pursues professional betterment, the
personal journey of each staff member is no less ambitious than that for patients, namely,
a journey focussed on a commitment to improvement
This unit recruits for Psychiatrists, Nurses and Allied Health Professionals.