Over the past number of years there has been a concerted effort across Primary Healthcare Organisations, District Health Boards and Non-Government Organisations to re-imagine how people’s mental health and wellbeing can be supported in primary care. This work resulted in the publication of a number of key documents such as Closing the Loop (2016) and the Fit For The Future co-design report (2017) which provided guidance on what support was possible for a transformed primary care holistic model, supporting and addressing the physical, emotional, and social needs of a person and their family.

To test these possibilities, ProCare Health Ltd., in collaboration with the three Auckland DHBs, NGOs, other PHOs, and with support from the Ministry of Health, has been testing a new model of care approach for mental health and wellbeing that has the potential to be implemented nationwide in Aotearoa.

Te Tumu Waiora was launched in July 2017 with services initiating in December 2017. This programme brought together a range of promising approaches such as Awhi Ora (NGO support workers available in primary care to walk alongside people in addressing their wellbeing in the community), general practice based Behavioural Health Consultancy and Health Coaching, Psychiatry Liaison and referral based talking therapies.

The programme has been running in five ProCare general practices across the three DHBs of greater Auckland; at Mangere Health Centre, Peninsula Medical Centre, Health New Lynn, University of Auckland Student Health Services and Turuki Healthcare Panmure. The programme is also running in practices supported by Auckland PHO and East Tamaki Healthcare. It is due to run until June 2019.

The aim of the programme is to deliver 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, as well as to connect social and specialist support across one continuum of care.

The pilot has been producing successful results so far with:

  • 57 – 70% of patients are seen for therapy on the same day as disclosing distress to their GP (compared to 3 – 5% for conventional service)

  • 75% seen for talking therapy within five days (less than 17% in conventional services)

  • Significantly improved equity of access across Māori, Pacific, Asian and European populations with no significant difference between rates of conversion of referral to appointments across ethnicities

  • 74% of Māori clients report improved wellbeing (compared to 72% European, 74% Asian, 71% overall

  • 95% satisfaction rating from over 3,000 client surveys

  • Reduction in prescribing of medication in favour of a ‘skills before pills’ approach

Collaboration has been key in the success of the programme to date. The pilot stems from a strong collaborative base across local DHBs, other PHOs and NGOs, as well as nationally through Network 4 (ProCare, Pegsus, Tū Ora Compass Health, Pinnacle Midlands Health), and Northland DHB.

Funding for the pilot has come from a range of sources: 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.

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

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