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Primary mental health update for Waikato


Updated September 2018

Primary mental health update

A message from Maree McCracken, GP liaison - primary mental health.

There is a lot going on in the Waikato so apologies for the long update! As always, please get in touch with me or Amanda Bradley, Pinnacle MHN Mentally Well programme lead, if you have any questions or concerns.

Brief intervention service (counselling and psychology packages of care) 

We've always received more referrals than we have had funding for - sadly this is nothing new. In the past, we have met demand by delivering services over and above the funding received. This is no longer sustainable, and we are now required to work within the available funding. We are meeting regularly with our providers to ensure services are maintained for all our communities, particularly rural ones. 

Our contract with Waikato DHB includes requirements which aim to ensure services are prioritised to those who need it most, namely high needs patients (M?ori, Pacific Island peoples, low income and youth). We're now meeting as a team each day to triage referrals so we can provide a more thorough response with suggestions of more appropriate services. Therefore we'll be requiring as much information as possible to make this assessment. We are also looking at changes to the BPAC referral to ensure we are capturing the relevant detail to best support you and your patients. We are contacting patients on the waiting list to reassess need and urgency.

There are other funding options available to support your patients, and our coordination centre will work with you to find alternative options when our service cannot assist.

Primary care psychiatrist / Waikato postgraduate medicine education event

Additional funding was negotiated to establish a primary care psychiatrist service to provide advice and support to GPs managing mental health conditions in general practice, and to give assistance with comprehensive patient assessments and management. Dr Andrew Darby is available to meet and discuss cases in your practice, and provide education and support around issues encountered frequently. Read more about this service further down this page.

The Bryant education evening on 11 October will be a chance to meet Dr Andrew Darby and Dr Lyndy Matthews the psychiatrist from Hauraki PHO. Working together in 0.6FTE roles Andrew and Lyndy coordinate to cover all week days. 

Integrated care for mental health patients

In 2017 we started working Waikato DHB to enable Waikato general practices provide 12 months of free care for patients discharged from Waikato mental health and addiction services. The goal is to remove barriers for these patients to access primary care, and to assist the patient to reach a stage where they are able to take care of their health independently (take personal responsibility for their health). 

Work is underway to increase the amount of people transitioning via this programme. We're aware you may have received initial information and contracts last year, but not yet worked with the service, so we'll be updating the information on our  website to support the increasing patient volumes expected. The practice support team are involved in this work, and will be your first point of call for any queries.

Updated July 2018

New service: psychiatrist in primary care

Pinnacle MHN is pleased to announce Dr Andrew Darby joined the primary mental health and addiction team in early July. Andrew comes with much experience, knowledge and connection with Waikato practices having worked in this region for many years.

Andrew will be available to provide telephone advice and support to GPs managing mental health conditions in general practice, and to give assistance with comprehensive patient assessments and management. Andrew will also establish an education plan to support primary care teams, and develop care pathways between secondary and primary to strengthen the capability and effectiveness of all mental health services.

GPs will also have the opportunity to have Andrew visit their practices to meet and discuss cases and provide education and support around issues they encounter frequently.

Andrew is in a 0.6FTE role, working Tuesday, Wednesday and Friday each week. He will be joined in September by a psychiatrist at Hauraki PHO, Dr Lyndy Matthews, also in a 0.6 FTE role. Andrew and Lyndy will work closely together supporting all Waikato GPs during normal business hours. Once Lyndy is on board Andrew's phone will automatically divert to her when he is unavailable.

This service begins on 17 July.

Important points to note

  • This service is during normal business hours only. It is not an urgent or crisis service.
  • Access the service by e-referral, or phone Andrew on 027 208 6316 (this number is also found on the e-referral).
  • When using the e-referral please write 'attention psychiatrist'.
  • If you phone for advice Andrew will request you (or your practice nurse) send a blank e-referral titled 'as per phone call attention Andrew Darby'. This will ensure we capture the patient details and Andrew can document the conversation. A copy of these notes will then come back to practice via BPAC.

Secondary care continues to be the referral destination for severe mental illness e.g. severe depression, psychosis, and mania. This service will continue to be accessed through the crisis team 0800 50 50 50, or the adult community mental health e-referral.


Primary mental health brief intervention counselling and psychology service

Across New Zealand there is greater demand for support for people experiencing distress than current services in the sector can support.

Waikato is no exception to this. Each day we receive on average nearly three times the amount of referrals than we are funded for.

We look forward to the outcome from the national mental health inquiry and the opportunities for more and/or better services, but we acknowledge any outcome from this process could be some time away yet.

At a primary care level we are working with N4 to find new solutions to the issues, for example the stepped care model as outlined in Closing the Loop.

At a local level we are working closely with Waikato DHB to seek new solutions - this is an ongoing conversation. Secondary services also continue to experience higher demand than they are resourced for. Please appreciate this is a very difficult situation for everyone.

We know the demand is high and the level of distress significant. In order to advocate for more funding for our service we need to measure this need in a demonstrable way. We would appreciate where possible GPs and practice nurses completing a Kessler 10 when referring for extended consult funding and or primary mental health service BIC or psychology. This helps build a case for additional funding to improve or extend the current service and achieve better support for patients and practices.

Fact: we cannot deliver interventions to the volume of referrals we are currently receiving.

We will need to:

We ask that you:

  • seek guidance/support from the psychiatrist in primary care service on a consult/liaison basis (see above)
  • remember the option of an extended GP consult if this appropriate for the patient
  • use the 1737 telephone counselling option
  • refer to other online self-help resources - these can be found on our itsmyhealth website which you can share directly with patients.

We remain committed to assisting our members to support patients with mental health needs. If there is ongoing unmet need and no other options available please get in contact with our coordinator by emailing primarymentalhealth@pinnacle.health.nz.


Changes to the e-referral

In the next few weeks you may notice some changes to the BPAC e-referral to allow referrals to be directed to our primary care psychiatrist and make it easier for us to collect the information we need. If a Kessler 10 is completed this will self-populate regardless of what the referral is for. The drop down diagnosis box under the specialty tab, will also now be mandatory for all referrals.


For more information

Amanda Bradley

Mentally Well programme lead

amanda.bradley@pinnacle.health.nz

027 598 5542

Maree McCracken

GP liaison, primary mental health

maree.mccracken@pinnacle.health.nz

027 485 7847

Mentally Well Update - Waikato, July 2018 PDF 173.66 kB

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