The Mental Health Infrastructure Programme is a part of the Infrastructure and Investment Group within Te Whatu Ora. The Programme links together 16 mental health and addiction infrastructure projects, all at different stages of completion. Two of the 16 projects are complete (Manawai individualised service units at the Rātonga-Rua-O-Porirua campus and Tiaho Mai at Middlemore Hospital).
These 16 projects were initiated and led by the former District Health Boards before the transition to Te Whatu Ora in July 2022.
The projects within the Mental Health Infrastructure Programme have been allocated $836.1 million of government funding. Five were allocated funding through the $1.9 billion Budget 2019 mental health, wellbeing and addiction initiatives. These five projects are profiled below.
Please note: Figures on bed numbers exclude those located in seclusion rooms, sensory modulation rooms, and/or de-escalation areas.
Once construction and fit-out of a new or newly-refurbished facility is complete (the Practical Completion stage), there are many operational decisions and activities that need to take place before the facility is ready to welcome patients and their whānau (go-live). These requirements are managed by the local project teams, which are best placed to understand the needs of their staff and the communities they serve.
Mauri Ora - Mental Health and Addictions Inpatient Facility
Project: Replacement of the current mental health and addictions facility at Rotorua Hospital, providing greater capacity, and a space better suited to contemporary models of care.
The existing acute mental health and addictions facility is over 40 years old.
The new, purpose-built facility will enable modern mental health and addiction services that are safer both for patients and staff.
The new building will also have a more welcoming feel, thanks in part to input from the Ngāti Whakaue cultural and art committee. A co-design process with the iwi resulted in a new model of care, Te Ara Tauwhirotanga (or Pathways That Lead Us To Act With Kindness), that has since driven the design of the new building.
As a result, the building will incorporate kaupapa Māori design features, such as a whare manaaki, to enable a culturally appropriate space for rongoā.
The facility will have 16 beds, with the space to increase that to 20 (the current unit has 14). The configuration of the bedrooms (in pods of four bedrooms each) will allow people with similar needs to be grouped together; for example, older people, people with vulnerabilities, or people who require a safe, low stimulus environment with more intensive nursing.
Work is currently underway preparing the site for the foundations of the new building, and a main contractor is being sought to carry out the building work.
Start date: Enabling works underway since November 2022
Estimated date of Practical Completion: Q1 2025.
Budget: $33 m
E Tū Wairua Hinengaro forensic mental health facility
Project: Replacement of several buildings at the Mason Clinic in Waterview, Auckland, with one single building
E Tū Wairua Hinengaro will enable the closure of the Totara, Kauri and Rata units, which are all leaky buildings. All the service users from these buildings, as well as from the Kahikatea building, will be relocated to the E Tū Wairua Hinengaro building. The Kahikatea building will remain operational to allow for the consolidation of the remaining support services.
Once complete, the E Tū Wairua Hinengaro building will provide high, medium, and minimum-security care.
The design of E Tū Wairua Hinengaro as a multilevel forensic mental health building will support contemporary models of care, with greater emphasis on privacy, dignity and wellbeing. E Tū Wairua Hinengaro will also allow for greater flexibility in its future use, so changes in demand, operating policies and the environment can easily be responded to.
E Tū Wairua Hinengaro will include kaupapa Māori design features such as an ātea, wharenui and wharekai to enable manākitanga, pōwhiri and whakatau for patients being admitted to the facility.
To improve the ability to care for patients during a pandemic, the building will also include a negative pressure environment for up to 15 beds.
It will also feature secure internal courtyards, and therapeutic activity spaces.
The new building will provide around 10,000 square metres of floor area ― almost double that of the facilities being replaced ― and a total of 60 inpatient beds.
The project has been registered with the New Zealand Green Building Council and will be constructed to achieve a Green Star Level 5 certification; the Green Star system measures a project’s sustainability, awarding points across various credits to rate a building’s performance and environmental impact. Level 5 falls into the ‘New Zealand Excellence’ category.
A business case was approved by the Minister of Health in February 2020 to replace two of the four leaky units at the Mason Clinic. This part of the project is now referred to as ‘Tranche 1A.’ ‘Tranche 1B’ was later approved to replace the other two units. Combined, the two tranches will result in a single building envelope with the two inpatient wings connected by a three-level support wing. A future Tranche 1C will include the fitout of a shell spaces, and the building of an energy centre, and a carpark.
It should be noted that the different tranches of the project have received funding from different sources, including from the Budget 2019 Mental Health and Wellbeing package, of which $235 million was put aside in the Health Capital Envelope for mental health infrastructure projects.
Start date: Enabling works underway since January 2023
Estimated date of Practical Completion: Q3 2025
Budget: $162.8 m (Tranches 1 and 2)
Te Whare Awhiora - Acute Mental Health and Addictions Facility
Project: Replacement of the existing Acute Mental Health and Addictions unit at Gisborne Hospital, which does not easily allow for the delivery of contemporary models of care and does not adequately cater to the needs of Māori, who make up a large proportion of this community.
The facility will be a welcoming whare, with 10 beds, whānau spaces, flexible therapy rooms and a specially designed functional outdoor courtyard to allow a connection with nature.
While the facility will be able to provide slightly more beds than the current building, the main benefit will be that it will better support contemporary models of care and provide better access to whánau.
The new unit has been designed with input from local clinicians, a users’ group, and representatives from consumers, iwi and staff. The building’s narrative has been developed with this group by local architects and a local artist.
The building will have both Zero Energy and Core Green sustainability certifications, meaning it will have a very low environmental impact on the community, through all stages of its intended life.
Currently, work is underway on the building’s foundations. The building will be built by Hawke’s Bay Construction, with help from other local subcontractors.
Start date: Enabling works started September 2022. Work on foundations currently underway.
Estimated date of Practical Completion: Quarter 3, 2024
Palmerston North Hospital - Acute Mental Health Unit replacement
Project: Replacement of the 24-bed acute adult mental health facility at Palmerston North Hospital with a new 28-bed facility.
The design for the new building is intended to create an environment from which people will be able to return home sooner, and to address the current facility’s existing problems with a lack of space and privacy ― which can compromise the safety and security of patients and staff.
There will be more shared spaces for whānau, and the flexibility to allow for a growth in demand.
Work is underway on the new building’s foundations. LT McGuinness was recently selected as the main contractor.
Start date: Enabling works underway since February/March 2023. Work on foundations currently underway.
Estimated date of Practical Completion: Q2 2025
Current approved budget: $60 m
Te Pae Tawhiti - Mental Health Adult Acute Inpatient Facility
Project: To relocate, replace and expand the current Acute Adult Mental Health facility at Waikato Hospital.
The Te Pae Tawhiti Adult Acute Mental Health Inpatient Facility will be a 64-bed facility, built on the current site of the Waikato Regional Renal Centre.
The new facility will provide a welcoming and therapeutic environment for people who are experiencing mental illness, and their whānau.
Cultural pathways have been designed and woven into a refreshed adult acute health care plan for patients, which is being implemented into the current facility, and which will be a core component of the therapeutic experience when the new facility is opened.
The project is part of a wider piece of work to ensure people in the Waikato can access mental health services earlier, and closer to where they live.
To manage the constraints of where the current Waikato Regional Renal Centre is sited, the Mental Health facility will be built in two stages, with the construction of stage 1 commencing around Q4 2023. Meanwhile, site enablement activities are underway on the site of the new renal centre, with construction due to start shortly. The new renal centre will be built over approximately one year, meaning the old renal centre will be demolished around mid-2024 ― allowing stage 2 of the new mental health facility to commence.
Build start date: Q4 2023
Estimated date of Practical Completion: Q2 2025
Mental Health Infrastructure Programme Review - Technical Review
28 June 2023
The Mental Health Infrastructure Programme Review was undertaken by the Department of Prime Minister and Cabinet’s (DPMC’s) Implementation Unit, with assistance from The Infrastructure Commission, Te Waihanga. The Commission appointed expert reviewers to provide objective advice and prepared a detailed Technical Review for Te Whatu Ora.
The Review stemmed from the Year Three Stocktake of the Budget 2019 Health and Addiction Package carried out by the DPMC, which assessed progress on the Budget 2019 initiatives. The Stocktake recommended that a ‘deep dive’ of the Mental Health Infrastructure Programme’s (MHIP’s) 16 projects be done to provide advice on the projects’ delivery status, the robustness of the estimated completion dates, and the risks and issues of each project.
The deep dive and Technical Review reflect a single point in time, shortly after the transition from the 20 District Health Boards to Te Whatu Ora, when the responsibility for delivering the 16 mental health projects also shifted to Te Whatu Ora. The challenges identified should be seen in the context of market conditions at the time, and the health reforms that were underway, which were designed in part to address concerns around how health capital projects had been planned in the past.
The reviewers acknowledged the value the MHIP has contributed to the projects it has been involved with, and saw no opportunities to materially accelerate the projects in the MHIP. All project-level recommendations have been completed or closed, and many of the Programme-level recommendations have already been implemented or are well underway.
The Programme-level themes and actions identified in the review were all consistent with what the IIG had independently identified. The establishment of Te Whatu Ora and Te Aka Whai Ora present significant opportunities to improve the way in which projects are planned, procured and delivered, and have begun to address the issues that were present when the projects that are in the MHIP were established.
The remaining themes and actions identified have been incorporated into the IIG’s operating model and will be addressed as the model is established ― through an integrated structure and strengthened national functions.
Notably, the deep dive found ample evidence of the value in building central capability and capacity in planning and delivering health infrastructure.
Some redactions have been made to the Technical Review, for instance to protect individuals’ privacy, or where issues are under active consideration or where free and frank advice has been given.
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