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Your Choices...Your Health

Northland mental health programme improving lives


25 October 2007

A unique programme at the top of the country is helping Northlanders with mild to moderate mental health problems regain their health and stay well.

Te Pou Ora o te Piringatahi is run by the six Northland PHOs to help people who suffer from issues like anxiety, depression and grief.

Improving access and providing support


Central to the Primary Health Care Strategy, which in 2001 took New Zealand health in a new direction, was that there should be more and easier access to health services. The Strategy also focuses on supporting New Zealanders in staying well and encouraging people to look after their own health. Health providers co-ordinate the available services.

“We saw Te Pou Ora o te Piringatahi as an opportunity to support GPs who can spend between a quarter and half their time seeing patients with mild mental health issues,” said Chris Tipa, a former mental health nurse and the CEO of the PHO, Kaipara Care Integrated. “We identified a gap in the care of patients with these more ‘everyday’ issues. While these patients don’t necessarily get referred to hospital, these mental health issues have a huge impact on their lives and the lives of their families.”

Top diagnoses and causes


More than 2,000 people have been referred to the pilot programme since it began in July 2005 and an evaluation of data gathered about those referrals shows that depression, stress and anxiety were the top three diagnoses. The top three background causes of those conditions were relationships, finances and having other medical conditions.

Assessing patients and matching them with services


Co-ordinators – who are mental health nurses or social workers – assess someone who has been referred to the programme by a GP, and work out, in conjunction with the patient, what will help them. They know what is available in the community and can match patients with the services that best meet their needs.

“For many people, counselling is all that is needed to help them get well,” said Chris Tipa. “Previously, counselling fees were paid directly to the patient and would have to compete with living costs like groceries or the power bill. We secured funding for a package of six counselling sessions that a patient can use only for counselling. Interestingly, the average number of sessions patients have attended is about four – many of them do not need to use the full number of sessions.

“Other things that can help patients is joining a walking group or art activities, aerobics or other existing community activities. Other interventions might include discussing problem behaviours which may not be helping their situation, or getting some expert help with an alcohol or drug problem.”

The programme uses a standard health questionnaire, with the responses collated to produce a “score” giving the co-ordinators an idea of how distressed the patient may be. A score below 15 is considered to describe a stress level that people might expect when life is going well, while a score above 15 and up to 35 is a measure of increased distress brought about by underlying problems.

A follow-up questionnaire given to patients who have been through the programme indicates that almost 90-percent of people reduced their stress-level score by an average of 14 points.

Robust data


“We keep very robust data which is important with a pilot programme. Because of this we know that 36 percent of the people going through Te Pou Ora o te Piringatahi are Maori which reflects the proportion of Maori in Northland’s population. That is hugely gratifying to us because it shows Maori are more confident about seeking help from these new primary mental health services,” said Chris Tipa.

Collaboration and feedback


Some co-ordinators work within Māori Health Provider teams. GPs are also now aware of the new services and are making referrals.

Chris Farrelly, the CEO of Manaia PHO, said the feedback from clients had been overwhelming.

“We have been moved by comments such as ‘I wouldn’t be alive now if it wasn’t for this service’ and Northland doctors have been equally enthusiastic, telling us it is the most significant thing in terms of enhancing patient care they have experienced in their careers.

“Prior to this, there was no scope for addressing those mild mental health issues in a primary care setting. There is no doubt this is a standout programme.”


Related links
Mental Health - Useful Links

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Page last updated: 7 November 2007


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