The Te Tumu Waiora integrated mental health and wellbeing service has been up and running in general practices in Taupō and Tūrangi since July 2019. The response from practices and the community has been overwhelmingly positive.
Health improvement practitioners (HIPs) have specific skills in assisting with mental health concerns, however they also see people requesting help for a range of health conditions. GPs, community organisations and other services can refer people to HIPs, who see 8-10 individuals or whānau groups a day, in brief sessions of up to 30 minutes. They are situated in the general practice and available to see people on the day they need support, or for booked appointments.
Clinicians and patients appreciate the ease of access - right here, right now. Whānau say they find the service very helpful, and the majority of sessions receive high helpfulness ratings. People say they are grateful for how helpful such a short session has been, and the focus on what is important to them and their whānau - “We talked about what matters to me”.
The format, ease of access and helpfulness has vastly improved the level of service to these communities. Previously the primary mental health service for Taupō and Tūrangi saw around 150 people per year. Wait times were long, at up to 12 weeks. In contrast, the team of HIPs delivered 1,000 sessions in the first seven months of the service (around 150 per month), and 60 per cent of people were seen either the same day or the day after.
There has also been a positive impact on general practice teams. Having appropriate support available within the team to help with urgent mental health concerns has been really helpful for both GPs and patients. People with severe distress and at high risk of suicide have been able to access better support and follow-up, more quickly, and from their general practice.
Within a month of the service starting, powerful feedback about its impact started coming in. "As a result of what you did, we as whānau have been able to wrap around and support our young person, and I can tell you, you saved a life that day."
GPs have commented that having ready access to support from HIPs has reduced the number of medications they are prescribing for sleep and common mental health concerns such as depression and anxiety. "I'm prescribing less because people can get the help they need now," says one GP.
The HIP team also helps practice teams by offering them general wellbeing support and bite-sized education sessions to improve their expertise in managing common mental health concerns. Rural practices are often frantically busy, so they really value this support which helps sustain them in delivering the same high level of service every day. Another GP reports, “This change has had the most impact of any primary care innovation we've had in a number of years.”
The service seamlessly integrates with the philosophies of Health Care Home, a model of care that supports general practice to be the health care hub and care coordinator for its enrolled patients.
When COVID-19 alert level 4 was announced the team quickly adapted the model to virtual delivery. HIPs have continued to offer support to practice teams and people presenting with distress during this time. The adaptable, flexible approach has ensured practice teams and the community have remained connected to this essential service at a time of great need.
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