Primary mental health care
Primary mental health (PMH) care is an integral part of services delivered by primary care teams. It encompasses health promotion, prevention, early intervention, and treatment for mental health and/or addiction issues.
PMH care is aimed at those with mild to moderate mental health and/or addiction issues (estimated at 17% of the population). Primary care also supports people with low prevalence mental health and/or addiction issues, in conjunction with specialist mental health and addiction services.
As part of the Primary Healthcare Strategy, DHBs provide a general primary care response to the needs of people of any age with mild to moderate mental illness. In addition to this, access to primary mental health interventions are funded for the following specific population groups.
- The enrolled population focused on Māori, Pacific and/or low income. The expected outcome is increased access to psychological and psychosocial interventions for these at-risk groups.
- Youth primary mental health services, available to all youth in the 12 to 19 year age group (regardless of PHO enrolment) who require such a service. The expected outcomes are to enable early identification of developing mental health and/or addiction issues and better access to timely and appropriate treatment and follow up.
The aim of PMH services is to increase access to talking therapies and other psychosocial interventions and the specifically funded components include:
- extended general practitioner or practice nurse consultations
- brief interventions (for both mental health and AOD)
- individually tailored packages of care (which cover a variety of services such as cognitive behavioural therapy, medication reviews, counselling and other psychosocial interventions)
- group therapy.
PMH services are being delivered across all 20 DHBs (mostly through contracts with PHOs but some with NGOs and one DHB delivering directly). The population groups noted above have free access.
PMH services are based on a stepped care model. Stepped care is a model of matching interventions to need so that the most effective, yet least resource intensive, is delivered first.
In additional to these services, many Primary Mental Health coordinator roles have been established. These roles provide consult liaison and clinical assessment and support the delivery of primary mental health services across New Zealand.
Youth mental health
As part of the Prime Minister’s Youth Mental Health Project to improve the mental health and well-being of young people, primary mental health services have now been extended to all young New Zealanders aged between 12 and 19.
Services vary according to local priorities and needs and are available to all young people regardless of PHO registration. New and innovative approaches have been taken to ensure services are targeted to local needs, working in partnership with general practice, school-based services, iwi providers and NGOs.
SPARX was also funded as part of the Prime Minister’s Youth Mental Health Project. SPARX (Smart, Positive, Active, Realistic, X-factor thoughts) is a computer-based E-therapy programme, publically available at the SPARX website. It is an interactive fantasy game that delivers cognitive behavioural therapy (CBT) using evidence-based CBT skills.
An evaluation of both these initiatives has been undertaken by Malatest International Ltd and reports are available at the links below.