More than half of patients are being seen by a mental health practitioner the same day they disclose their distress to their GP, early data from an Auckland pilot shows.
The data was to be shared with Health Minister Dr David Clark and associate health minister Jenny Salesa during his visit to the Mangere Health Centre today to learn more about the mental health support programme Te Tumo Waiora.
The pilot started in December 2017 in eight general practices serving 80,000 people. It aims to offer brief, targeted mental health interventions on site by expanding the general practice team to include the new mental health roles of health improvement practitioners (registered health professionals trained to follow a role similar to the United States’ behavioural health consultants) and health coaches.
The pilot practices are spread across three district health boards. ProCare, which supports five of the eight practices, including Mangere, says its data from the first six months shows that 50-70 per cent of clients are being seen on the same day as disclosing distress to their GP, compared with 5 per cent referred to conventional talking therapies services.
It also shows that 90 per cent of people are taking up a pilot referral compared with 70 per cent referred to conventional therapies. About 75 per cent of people seeing health information practitioners or health coaches have appointments of 30 minutes or less.
Dr Tim Hou of Mangere Health Centre says the new model gives the practice team the flexibility to provide different options of care for different patients.
“We now have something that is not a one-size-fits-all approach. With our fully expanded team our patients can easily access psychology support and psycho-social support, they weren’t able to so easily do this before.
He said it has also enabled it to explore new flexible options for patients, like outreach home visits or group sessions for those with long term conditions such as diabetes.
ProCare Clinical Director Dr Allan Moffitt says as general practices had long-term, trusted relationships with many patients it was a logical place to expand mental health capability and access. “We are hearing, only six months into the pilot, that this model can change lives for our patients”.
“Patients having the ability to access comprehensive support from within their general practice not only reduces wait times and travel costs, but can provide immediate support right when it is most needed.”
The pilot also seeks to help people address social issues impacting on their health and wellbeing, through access to NGO support workers in the community, and building general practice team capability. Improving coordination and integration with specialist mental health services delivered by District Health Boards is also being worked on.
The first evaluation report from the pilot, which will run until June 2019, is due soon. Funding for the pilot has come from a range of sources, including ProCare Health, Waitemata DHB’s Our Health in Mind primary care programme; Counties Manukau Health’s Primary Mental Health Initiative programme; and Auckland DHB’s Ministry of Health Fit for the Future programme.
Key components of the programme, which is adapted from a similar US model, include:
- ‘enhanced’ general practice teams
- health coaches (may be health professionals or peer support workers who support patients find the resources and support they need)
- health improvement practitioners (registered health professionals trained to take on a similar role to American behavioural health consultants)
- ‘confident and capable’ general practitioners and practice nurses
- self-management support (e.g. self-help resources, e-therapy)
- referral-based talking therapies
- increased access to NGO-delivered community support workers
- enhanced integration and co-ordination with DHB mental health and addiction services.