CPO Mental Health Funding 2022-23

July 2022 Tena Koutou, RE: CPO MENTAL HEALTH FUNDING 2022/23 You will be aware we are continuing to experience significant increased demand for primary mental health services, particularly for individual counselling packages of care.

Demand exceeds capacity for individual counselling in our region.

Please give consideration to engaging clients in e-therapy such as ‘Just a Thought’; https://www.justathought.co.nz or ‘Beating the Blues’ on Manage my Health or ‘The Journal’ or ‘The Lowdown’ (youth) on www.depression.org.nz, as a first option for treatment for depression or anxiety which can occur via a funded extended consultation.

If no improvement, then refer to the CPO Mental Health Programme.

Furthermore, the use of practice Health Improvement Practitioners (HIPS) and Health Coaches is recommended, as a first contact point for mental health support where possible. Other options for funding such as WINZ, ACC etc should also be explored prior to referral.

While there are no longer limited counselling allocations for each practice (instead clinicians can refer according to patient need), the funding remains capped and limited for these interventions, with some discretionary funding also available for target populations.

Clients who are presenting in crisis requiring urgent intervention, are not eligible for the programme. When a patient presents in severe distress, and with complex issues referral to secondary mental health services for support is recommended especially if you have trialled first line treatment (medication). It is important to understand we are not able to provide Crisis or Urgent intervention for clients presenting with active suicidality.

Clients with this level of distress requiring urgent input should be referred to the Crisis team or urgent referral made to Community Mental Health Services.

Please remind your GPs that Extended Consults are now claimed via Halcyon from 11 May 2022 and that practice allocations for this service remain. Your practice’s Extended Consult allocation balance can be viewed in Halcyon.

The discretionary criteria we apply to other aspects of the programme has been extended to include extended consultations.

There are two options for referral into our service via BPAC. 1. Social worker 2. Mental health support (this option is for Individual counselling and group workshops) Following the service changes communicated in May this year the Kessler is not mandatory.

There is provision for the referrer to advise which support they feel would most benefit their patient and give background information.

The MH team will contact the patient to complete the Kessler, assess their needs and make a treatment plan i.e., referral to group workshops, Individual Counselling sessions etc.

Please inform all GP’s that discretionary funding is available for extended consultations, individual counselling, or brief intervention counselling, if your patient meets the following criteria: ● Youth (12 – 19 years) ● High needs clients (Māori and Pacific Island) ● Referrals declined from secondary Mental Health Services (DHB and recommended suitable for PHO). ● Pregnant and postnatal women/ new parents.

The allocation of funding for Packages of Care (POC) is managed by the PHO MH team and allocated according to clinical presentation.

Please be aware there has been no extra funding for the programme so discretion is required before referral to ensure the service is not overwhelmed.

When a referral is required, please make the referral at that point. This way referrals are staggered across time. The service has noted a surge in referrals at the beginning of the new quarter which creates a process bottle neck. There are no longer quarterly allocations for individual counselling, so clinicians do not need to wait till the beginning of the quarter to refer.

Due to limited funding availability for individual counselling, priority will be given to people who have not previously received PHO funded counselling.

We are actively exploring avenues to increase funding available for delivery of service to our population. Please be aware the due to increased community demand and need many providers of therapy are currently managing waiting lists for access. This situation means there are sometimes delays in accessing treatment. Please advise your patients accordingly.

Referrers will receive a copy of non-contact or appointment letters sent to their patient, so they are aware of progress through the service. Final reports will continue to be processed as is for now.

Our Social Worker Violet Davidson is employed by the PHO to work alongside General Practice with clients who have mild-moderate psychosocial issues. Violet is a qualified health professional who is available to see people individually to support and assist with a range of social situations in relation to the person’s mental health.

We are looking forward to continuing to work with you to meet the needs of our people seeking mental health support. Please contact us if you require any clarification or support regarding these changes.

I look forward to working with you to provide a service that meets the mental health and addiction needs of the population of the WBOP. I am available to discuss or clarify any referrals or to visit the practice in relation to any mental health education requirements or clarification of any matters relating to the CPO Mental Health Programme.

Ngā Mihi Naomi Malcolm Registered Nurse CPO Mental Health Programme Lead naomim@wboppho.org.nz