Te Hikuwai: Resources for wellbeing

Te Hikuwai: Resources for wellbeing is a brief intervention resource that has been developed by Te Pou o te Whakaaro Nui to support primary health services to deliver effective talking therapies to adults, using a stepped care approach. 
 
The resource is designed to be used alongside opportunistic screening tools such as PHQ 2 or 9, or Kessler 10, for psychological distress, and early problems with alcohol and drug misuse among adults (such as AUDIT). This relates to indicator 37 in Aiming for Excellence: The Royal New Zealand College of General Practitioners standard for New Zealand general practice (2016). 
 
The resource includes 20 topics related to mental health and addiction problems. Each topic includes printable wellbeing prescriptions and self-help resources.
  • Wellbeing prescriptions are designed to look like and be used by GPs as a prescription, to recommend appropriate web-based self-help resources to patients. A wellbeing prescription may also link a person to a community resource such as Citizens Advice Bureau. One of the prescriptions also offers a face to face session with a practice nurse, where needed. 
  • Self-help resources can be printed for patients to take away and use ‘free standing’ – without needing online access or to be referred elsewhere.
  • Topics include anxiety, depression, grief, crisis, stress, work stress, sleep, relaxation, alcohol, cannabis, methamphetamine, smoking, gambling, family and whanau of people with addictions, chronic pain and fatigue, exercise, problem-solving, wellbeing, advice, and face to face sessions.

Access to Te Hikuwai

A direct link to Te Hikuwai is being made available to primary care clinicians on request, and can be incorporated into clinic patient management systems such as Medtech 32.
 
For more information or to request access to the online resource, please contact Emma Wood

Consultation pathway

Te Hikuwai: Resources for wellbeing consultation pathway (flowchart).

Background

Te Hikuwai is part of the Let’s get talking project, developed by Te Pou o Te Whakaaro Nui to support primary health services to deliver effective talking therapies using a stepped care approach. The Let’s get talking toolkit consists of seven tools to support services to achieve this goal. Te Hikuwai forms part of the Let’s get talking toolkit and derives from the assessment tool which provides information on matching therapy to a person’s needs. 
 
The aim of Te Hikuwai is to support the capacity and capability of primary care to deliver brief interventions to adults presenting with early signs of mental health and/or addiction problem(s) at levels 1 and 2 of stepped care. This would normally be in services such as GP practices, NGOs or other primary health and social services. 
 
Stepped care model.
 
For further information on stepped care, watch the introductory video of the Let’s get talking toolkit.

About brief interventions

A brief intervention describes a range of approaches that, in the main, primary health practitioners can provide for people, who have been identified through screening as potentially having early signs of, or mild presentations of mental health and/or addiction problems (level 1 and 2 of stepped care).  Brief interventions aim to deal with the problem to enhance the person’s wellbeing and to prevent it from becoming more serious. Brief interventions support a first response to problems.
 
Low intensity therapy is usually delivered for mild to moderate mental health and addiction problems (level 3 of stepped care). People presenting at level 3 are referred to a PHO mental health co-ordinator or service for face to face therapy. This may be with a PHO, NGO or a psychological health practitioner in the community.
 
High intensity therapy (levels 4 and 5 of stepped care) addresses more severe and complex presentations.  These are referred to appropriate services such as PHOs, and secondary mental health and addictions services, in line with the GP practices clinical care pathway.  

Te Hikuwai trial 

An early version of Te Hikuwai was trialled with a PHO and selected GP practices in 2016. This trial was evaluated and a report is available on request. Outcomes from the trial have been used to inform further work in this area.