Mental Health Matters
Kia ora tātou,The Primary Mental Health team have had a busy start to the year with lots of referrals to our service and our new MH Registered Nurse, Michelle Lowry, and Social Worker, Melanie Rundell, orientating and settling into their roles.
Demand for our service has been high, however we are stiving to contact people within a week of their referral to discuss their needs and options for support, we continue to prioritise our target populations.
As we process referrals routinely with our limited resources, it is very important that those requiring urgent intervention are referred to the appropriate service for support, such as the Crisis team, who can respond urgently.
Our funding for Individual counselling continues to be inadequate for our population, we continue to actively work with Te Whatu Ora regarding our level of resourcing. Within your practices your assistance in ensuring the people who most need our support are the ones referred, is most appreciated. If you have a HIP in your practice, please utilise their skills for the management of people who are presenting requesting mental health support in the first instance.
Our contract is for the provision of Brief Intervention, for those presenting with mild to moderate mental health issues, we cannot fund long term therapy or diagnosis, priority is given to those who have not accessed therapy previously.
If someone has already accessed therapy through our service on more than two occasions in recent years, please consider if it is time to refer to specialist services for support, outlining to them in your referral what services have already been delivered within primary care.
Our service is unable to provide support for people who already have counselling in place through ACC, or who are under the care of secondary services such as Community Mental Health.
Age for Referral to CPO Service
We have received several referrals recently for children as young as 7, please remember that we can accept referrals for those aged 12 years and over. We are unable to facilitate care for these children, they are outside the scope of our contract with Te Whatu Ora.
Matching to Appropriate Providers of Talking Therapy
Recently we have received several referrals where the referrer has advised the patient and advised in the referral that a psychologist is required. Please be aware the decision of who
your patient is assigned to for their talking therapy is a clinical decision, made within our service, based on many factors.
We have 64 different providers with a multitude of skill sets and qualifications. There are many counsellors and specialist counsellors who have exceptional skills as talking therapists. Our psychology resource is small and is kept for those presenting with most the complex clinical presentations, or when a first line treatment pathway is required. We need to manage our psychology resources carefully.
When people have been told they require a psychologist it can set us up for a difficult conversation with your patient, who comes in with an expectation re the qualification of who they will see. Many times, your patient may be better matched with one of our specialist counsellors, clinically psychology may not be indicated. This can also sabotage any relationship with the counsellor they are referred to.
Please advise your patient that we will discuss their needs and presentation, then match them to the most suitable provider avalible. All patients are advised to get back in touch with us directly, if they do not feel they are matched with the right provider after meeting with them.
Interface with Specialist Mental Health Services
We are receiving many referrals where the person has been referred to both our service and specialist secondary services simultaneously
No doubt it can be tempting to concurrently refer patients to both WBOP PHO and Te Whatu Ora mental health services simultaneously, to try to minimise waiting times, however this can have the opposite effect for people.
Due to contractual issues, the PHO is unable to accept a referral until the DHB has triaged and graded it, and in fact a dual referral can lead to delays. We cannot accept referrals for those already receiving treatment from secondary services.
The information contained in the DHB triage and specialist letters is sent to GPs only, and not accessible to the PHO Mental Health team. Our team can only access information regarding the progress of referrals to specialist services with the written consent of your patient, facilitating this for many people is difficult.
It would be helpful if referrals, for patients who you believe require secondary care level input, could be made to the DHB in the first instance, and only then to the PHO if the DHB referral is declined.
Please can you also attach the outcome of the DHB triage, and any relevant clinical documents to your referral to the PHO, as this information is not available to the PHO mental health team otherwise. The Primary Mental Health team is unable to access clinical information held by specialist service without signed consent of the patient, sourcing this information can lead to further delays for provision of service.
Group Programme
It is over a year since we paused our group workshop programme, due to the impact of Covid and limited demand. We have been monitoring the situation, to see if there is demand for this service to restart. In our conversations with people regarding their needs and options for support, accessing group psychoeducation has not been something that there has been interest in. We are also aware that some Health Improvement Practioners are facilitating group workshops in their practices, we would not want to replicate this. The group programme will remain paused at this time, however, offering this service will be considered if there is demand in future.
Extended Consultations
These claims are made through Halcyon. There are allocations to your practice according to enrolled population and identified high needs population
Claims over and above your allocation are reviewed, to ensure our targeted populations receive support, descretionary funding can be applied to the following target populations.
• Māori / Pacifika
• Youth >19
• Postnatal / Parenting
• Those declined at secondary /specialist services.
Please be aware we have no ability to review notes in your PMS, these must be in the Halcyon claim for us to be able to review. These notes are valuable in looking for descretionary criteria and being able to offer suggestions as appropriate for your patients.
We look forward to working with practices to meet the mental health needs of our enrolled population.
Ngā Mihi nui Naomi Malcolm Programme Lead Primary Mental Health Service