A new model of integrated primary mental health and addiction services (IPMHA) is being implemented across New Zealand by the Ministry of Health. This model of care is a part of suite of services being developed to expand access to, and choice of, Primary Mental Health and Addiction support.
The aim of these new services is to:
- Increase access and equity of access
- Increase choice in addressing people’s holistic concerns
- Reduce wait times for mental health and addictions support
- Improve population health and equity outcomes
This service is for anyone who is enrolled in the practice whose thoughts, feelings or actions are impacting on their health and wellbeing. There are no barriers to accessing this support, no referral criteria, no wait time, no cost to the patient and services are designed to ‘flex’ to meet the identified population health needs.
There are ‘key components’ of the service which will look similar across New Zealand. All services will be accessed via the general practice with priority given to Maori and Pacific peoples, youth and those people living in rural and remote locations. Some services may choose to use a locally relevant name for their service, however in all cases new staff will join the practice team and become integrated within the practice. The key components of the service include:
- Health Improvement Practitioner (HIP) - an experienced and registered mental health clinician who will provide assessment and brief intervention therapy as needed
- Health Coach (HC) – a trained support, peer or cultural worker who will support the individual to manage their health through a range of personalised interventions
- Support Worker (SW) who will provide access to cultural and social supports within the local community
- A confident and competent general practice team
- Effective links and coordination between primary and secondary services
The IPMHA model includes an evidenced based approach to providing behavioural health support within general practice. The IPMHA model has been adapted, piloted and provided in various regions in New Zealand since 2017. The HIP and HC work as a part of the practice team to provide brief intervention focused on strengthening self-management strategies. Their notes are written directly into the practice-based PMS and ‘warm handovers’ ensure that the practice team members can make an introduction when the need arises and are kept updated with patient information. Additionally, the HIP also supports the practice team through psycho-education, consultation and identifying patient pathways to increase access to behavioural support.
Te Tumu Waiora is just one of the iterations of the programme that is being rolled out across New Zealand. Te Tumu Waiora is a holistic model, supporting and addressing the physical, emotional, and social needs of the person. The model is based on a pilot initially conducted by urban Auckland DHBs and expanded to 5 additional DHBs across the country. Elements of the model include new roles in enhanced GP teams (such as, health improvement practitioners, health coaches, and mental health credentialed primary care nurses); increased access to NGO community-based support services and enhanced interface between primary care and DHB services.
Further information on Te Tumu Waiora is available at: Te Tumu Waiora. https://www.tetumuwaiora.co.nz/