Mental health roles fleshed out to add support in general practice

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Mental health roles fleshed out to add support in general practice

Virginia
McMillan
Photo by Nik Shuliahin on Unsplash
The contracts are aimed, in part, at building the general practice team’s confidence and capability in meeting the needs of people experiencing mental health and/or alcohol and drug concerns
It’s expected two extra full-time workers will be funded per 10,000 population in general practices in a territory where a contract is agreed He

Comments

Clearly another patchwork (?hotchpotch) approach where funding for Health Improvement Practitioners (HIPs) and Health Coaches (HCs) will go to selected larger practices.  Not everyone with mental health problems attends a large practice and many are not even enrolled in a PHO (or wish to be).  Whatever happened to David Clark's promise that health services were for "ALL" New Zealanders?

It would seem that a few in those practices will be able to access 30 minutes with a qualified "health professional" HIP and have access to a Health Coach with "lived experience" (but not any health education), while the practice and PHO face added contracts and presumably extra audits.  Is there any evidence to support this model?

But wait, here is a golden opportunity to set up a large comparison trial comparing outcomes from patients accessing the Kaupapa Māori Primary Mental Health and Addiction model, those referred to the HIP/HC model and those from smaller practices of similar demographic nature who are referred to psychologists and/or qualified CBT therapists, all controlled for severity, condition, gender and culture.

It probably won't happen as there appears to be a political agenda to force more people into larger practices and destroy traditional General Practice, whatever the consequences as well as an anti-science approach to mental health that excludes GPs, Psychologists and Psychiatrists.

Without good NZ based trials, a lot of effort and funding could be wasted on management, auditors and HIP/HC workers all earning more than many GPs do while wellbeing and suicide rates worsen in NZ.

 

Yes I’m not convinced this will do much to address the mental health needs of many of he types of patients we see in GP. We have seen a slide in mental health funding in the last 6 months with tighter restrictions on who qualifies for engage funding - but no decline in the number of people presenting with acute distress. Ideally we could access some funded counselling for them, but unless they tick certain severe boxes (but not too severe) then there are few options for referral that don’t involve the patient having to pay.  And it’s the cost that really is the biggest barrier for people. They come to us because they believe that with a referral they can get funded counselling. Even the NZCCP website states this! They are often disappointed to learn that this simply isn’t the case. I was hoping the well-being budget was going to give us access to more funded counselling options. This would have been a far more meaningful and useful use of the money!