ProCare, New Zealand’s largest Primary Health Organisation (PHO), responsible for the health of more than 800,000 New Zealanders, welcomes the release of He Ara Oranga, the report following the Government Inquiry into Mental Health and Addiction in New Zealand.
ProCare’s patient services general manager Johnny O’Connell, says “We congratulate the inquiry panel on the work they have carried out and thank the thousands of New Zealanders who attended meetings and made submissions. We are really pleased to see the report endorses the direction ProCare has been travelling for the past few years. General practices have long term trusted relationships with many patients and frequent interactions, which makes it a logical place to expand capability and access to support for mental health and addiction issues.
“We’ve been working really closely with our sector colleagues to develop new models of care so people have easier access to quality support in a timely manner. In the past 12 months we’ve implemented Te Tumu Waiora, an innovative mental health pilot programme, in five general practices’ across Auckland, which gives people immediate access to dedicated mental health and addictions support at their local General Practice. This model has been developed as part of the Fit for the Future programme, and incorporates a range of innovative approaches such as health coaching, behavioural health consultancy and Awhi Ora which are all aligned around an integrated primary and community approach to mental health and wellbeing.”
Early data1 from the pilot suggests this is the right approach, with services reaching up to three times as many people as conventional services, and 50-70% of people seen on the same day for talking therapy (compared to 5% for conventional talking therapy services). Most importantly the new approach is closing equity of access gaps across all ethnicities, including Māori and Pacific.
1 Synergia report: Fit for the Future - Evaluating Enhanced Integrated Practice Teams, a report for the Ministry of Health, 1 October 2018.
ProCare also welcomes the report’s recognition of the need to increase the access target to 20%, from 3%, to better match the numbers of people needing access to mental health support in Aotearoa.
ProCare Clinical Director Dr Allan Moffitt says, “We know that for some GPs, the percentage of patients presenting for mental health-related issues can be significant. It is therefore critical that we find ways to develop our General Practices to expand their teams so they have the ability to offer patients ‘skills before pills’ support, a crucial part of early intervention.
“We really hope that there will be a commitment to fund Te Tumu Waiora in the 2019 budget to support its expansion nationally,” comments Dr Moffitt.
Te Tumu Waiora - Overview
Te Tumu Waiora has been designed as a holistic model, supporting and addressing the physical, emotional and social needs of patients. The programme delivers a small amount of targeted, brief intervention to a large number of people as opposed to a large amount of therapy, to a small group of people. The programme gives patients access to focused mental health support from mental health clinicians, known as health improvement practitioners (HIPs) in the general practice setting. HIPs can be clinical psychologists or other health professionals with a mental health qualification. HIPs provide brief intervention talking therapy when someone is referred to them directly from the GP or practice nurse. It is as simple as the Doctor or Nurse walking with a patient down the corridor of their practice to be introduced to the HIP. The programme also provides access to health coaches to support self-management and to community workers who can link people to community resources to address any social issues.
The pilot has been implemented by ProCare with partners across the three DHB areas inclusive of DHBs, mental health and addiction NGOs and other PHOs. The pilot is currently running in the ProCare supported practices Mangere Health Centre, Peninsular Medical Centre, Health New Lynn, University of Auckland Student Health Services and Turuki Healthcare Panmure, as well as in the East Tamaki Healthcare practices in Glen Innes and Dawson Road and in the Ngāti Whātua-o-Orākei Health Clinic supported by Auckland PHO.