More than 80 people from around New Zealand turned out to a mental health workshop last week (Thursday 5 April) to hear early stage learnings from the implementation of ProCare’s stepped model of care for mental health.

Held at the Holiday Inn at Auckland Airport, the event attracted attendees from the Ministry of Health, members of the Government’s mental health enquiry, District Health Boards, NGOs, universities and PHOs from Auckland and around the country.

The new model of care is currently running across five Auckland general practices covering a population of 60,000 enrolled patients. The two-year pilot, which started in December 2017, gives patients access to focused support, including health coaches and health improvement practitioners (mental health clinical generalists) conveniently available as part of the general practice team, as well as NGO community support workers, traditional referral-based talking therapies and shared care with DHB specialist teams connected with the general practice team.

ProCare has trained a mental health nurse, health psychologists, clinical psychologists and a general practitioner to work as Health Improvement Practitioners in the pilot programme, which is based on the Behavioural Health Consultancy model from the United States. ProCare has also collaborated with East Tamaki Healthcare on the health coaching element of the model.

Dr Patti Robinson, who supported ProCare with training in the Behavioural Health Consultancy approach for the new model, shared her more than twenty years of experience implementing the approach within large US-based health systems including Kaiser Permanente and the United States Army.

Dr Robinson highlighted the many benefits of the approach such as improved patient access and patient outcomes. In the United States, practice-based mental health clinicians see between 8-12 patients per day, mostly on same day referrals, with 15-20% of a practice’s population being seen every year. The model has also been shown to increase practice visit capacity by 10-15% and to reduce demand on specialist services from primary care. Improved patient outcomes are proven with significant and sustained clinical and functional outcomes demonstrated within 2-3 brief sessions.

ProCare is also working closely with its local DHB and NGO partners to ensure better integration between services as part of the new model of care. Auckland and Waitemata DHBs have been developing the Awhi Ora programme which offers wellness support to practices through mental health and addiction NGO support workers. Counties Manukau has also been innovating in primary care through the development of the Integrated Locality Care (ILOC) teams, which are specialist multi-disciplinary mental health teams that work closely with general practice on a locality basis. Both of these innovative programmes are being integrated into the model of care piloted by ProCare. 

The majority of the project funding for the programme has been provided by ProCare with Waitemata DHB providing funding through their Our Health in Mind primary care programme; Counties Manukau through providing flexibility in their Primary Mental Health Initiative programme, and from Auckland DHB through their Ministry of Health Fit for the Future programme.

ProCare CEO, Steve Boomert, says “general practices have long term trusted relationships with many patients and frequent interactions making it a logical place to expand capability and access.

“We are hearing, only four months into the pilot programme, 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 comfort and support.”

Johnny O’Connell, ProCare’s General Manager of Patient Services is pleased with the reaction to the workshop.

“We wanted to share as much information as we could with other organisations and agencies dealing with mental health issues. We have been working to develop this approach over the past five years, through the development of Closing the Loop and all of the subsequent cross sector collaborative development that followed.  

“The model shows how primary care can better support patients, and to see the results so far and the reaction of everyone at the workshop, we still believe we are on the right track,” says Johnny.

Ian Soosay, who was the final speaker at the workshop, said the programme aligned with the new Government’s focus on primary care and mental health, adding that the programme was showing a great deal of promise and that he was looking forward to seeing the evaluation.

The stepped care for mental health pilot will run until June 2019 and is being evaluated independently by Synergia. It is currently being piloted in five ProCare practices; Peninsula Medical Centre, Health New Lynn, University Health and Counselling Service, Turuki Health Care Panmure, and Mangere Health Centre. 

To review workshop presentations and more information on the stepped care mental health pilot please visit www.closingtheloop.net.nz/pilot