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Te Tumu Waiora


To head towards wellness

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Te Tumu Waiora


To head towards wellness

Contact us

 

Te Tumu Waiora - te reo for ‘Towards wellness’ is a new model of primary mental health and addictions care and support.

It aims to provide all New Zealanders experiencing mental distress or addictions challenges with access to convenient, high quality, integrated and person-centred care and support.

Read the Te Tumu Waiora overview document here

 

the mental health challenge


the mental health challenge


We have a mental health epidemic in New Zealand. One in five people experience mental illness or significant mental distress each year; as many as three quarters of New Zealanders will experience some degree of mental distress or addiction challenges, or both, at some point in their lives.

There are significant social and cultural risk factors. Poverty and deprivation, poor housing, family violence or neglect, social isolation and ethnic background are key determinants of mental distress and addictions issues and of poorer outcomes.

He Ara Oranga, the Government inquiry into mental health and addictions and the subsequent Government response has set the direction for future services.

The Inquiry noted ‘the striking degree of consensus, from most parts of New Zealand society, about the need for change and a new direction: an emphasis on wellbeing and community, with more prevention and early intervention, expanded access to services, more treatment options, treatment closer to home, whānau- and community-based responses and cross-government action’.

transforming mental health services


transforming mental health services


The $1.9bn investment committed to mental health services in the 2019 Budget will change lives and communities and allow people who need support to access it when they need it.

This includes investment of $455m to develop new frontline primary mental health services accessed through general practice, iwi health providers and other community agencies over the next five years, providing support for an estimated 325,000 people by 2023/24.

These people, in the ‘mild to moderate’ category of mental health need, identified by He Ara Oranga as ‘the missing middle’ are not unwell enough to meet the threshold for access to specialist mental health services, but often have needs that are too complex to be managed within the day to day resources of a conventional general practice team.

Existing supports for this group are often limited, ad hoc and vary across the country.

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About


About


Primary care organisations have been working with NGOs, DHBs, service users and international experts over the past fiveyears to develop a new way to provide convenient, personalised care and support for people experiencing mental distress or addiction challenges.

The Te Tumu Waiora model of care is the culmination of that work.

Based on international evidence and local co-design, the new model of care provides rapid, targeted brief intervention to people who are experiencing mental distress and connects them quickly to the social and specialist supports they need.

This service is accessed through general practice and is based around two new roles in the primary care workforce – the Health Improvement Practitioner (HIP) and the Health Coach. Based in the practice, these new members of the team provide advice and support to clients based on individualised goals, connecting them to other services as needed and promoting self-management.

Someone presenting to their general practice who is experiencing mental distress or addiction issues can be seen in the same location quickly – often immediately – by the HIP. A support plan is developed, with follow up as needed, tailored to individual circumstances.  Follow up may be by text or email or with subsequent appointments with the Health Coach or others in the practice team. For some people the initial session is enough to provide the emotional or behavioural support needed.

The HIP and Health Coach also act as a specialist resource, enhancing the confidence and competence of GPs, nurses and other members of the team.

A community support work role is a key part of the model where local community NGO support workers and peers support people in distress to increase their wellbeing.

You can read the full Te Tumu Waiora overview document here.

Te TUMU Waiora In practice


The model of care was first piloted in a small number of Auckland general practices in 2017 by a collaboration of ProCare Health, Total Healthcare, local DHBs and NGO partners, and with support from the Ministry of Health. Following successful evaluation, the model was extended to 23 practices across New Zealand by mid-2019.

Below are some first hand accounts of the difference this approach is making.

Te TUMU Waiora In practice


The model of care was first piloted in a small number of Auckland general practices in 2017 by a collaboration of ProCare Health, Total Healthcare, local DHBs and NGO partners, and with support from the Ministry of Health. Following successful evaluation, the model was extended to 23 practices across New Zealand by mid-2019.

Below are some first hand accounts of the difference this approach is making.

Dr Tim Hou talks about Te Tumu Waiora and the positive impact it has for patients. The programme provides immediate, easy and free access to support for mental health and social issues affecting someones wellbeing at a convenient place in their local community, their family general practice.

Alysha Simonsen is a health psychologist working as a health improvement practitioner in the Te Tumu Waiora programme at Auckland University Student Health. Here she reflects on one year working as a Health Improvement Practitioner.

Following Alysha, Dr Peter Woolford, a GP at Health New Lynn one of the Te Tumu Waiora pilot practices, talks about the impact of this innovative mental health support programme and what it is like for general practice to have mental health specialists as part of the general practice team.


Awhi Ora – Supporting Wellbeing, is a key part of the model where NGO support workers and peers walk alongside people in distress supporting them in increase their wellbeing in their local community. A clip explaining this approach is below


I was nervous, she put me at ease. It was easy to talk about everything. Life, family, money; I put it all on the table.
— Patient

Te tumu waiora collaborative


Te tumu waiora collaborative


 Following the success of the Auckland pilot, seven organisations have come together to form a national collaborative, committed to implementation of the Te Tumu Waiora (TTW) model.

The member organisations - Northland DHB; Mahitahi Hauora; ProCare Health; Total Healthcare; Pinnacle Midlands Health Network;Tu Ora Compass Health; and Pegasus Health - together provide health services to 2.4 million New Zealanders, more than half the New Zealand population.

Initial implementation is underway in all regions, with the TTW model being provided in 23 general practices in July 2019. Each region will build, tailor and sustain the programme and the workforce based on local needs, while having access to national learning, evaluation and improvement and peer support.

The Collaborative aims to ensure provision of accessible, integrated and high quality primary mental health and addictions services and improved health outcomes for their populations. It will co-ordinate implementation of the TTW model of care, providing leadership, infrastructure, learning and improvement support and workforce development.

The Collaborative is working in partnership with service users, their family/whanau and with NGOs and Maori providers and workforce development organisations on rollout and future development of the model.

Impact


Impact


An independent evaluation of the initial phase of implementation of the model in a small number of practices in Auckland was undertaken in 2018. This evaluation showed the programme was achieving the objective of offering quick access to talking therapies and other supports and achieving positive outcomes and high levels of satisfaction from service users.

Read the Synergia evaluation following the first six months of the pilot here.

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I think I’d gone to see my doctor, and he’d said about this (anxiety), we’ve got like this service now at this clinic, where you can see this lady, (name). And then, I said, oh that sounds great, and so he said I think she actually has a place like now, like in half an hour or something. So I actually went to see her, the day I went there to get some help, or get some advice or something. That was really good, I just went straight in there and had my first session.
— HIP client