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emain under the care and management of their general practices, thus allowing a more
holistic approach to well being with no stigma attached.
Secondary mental health services on the West Coast currently provide services to more
than 3% of the population. Services are mainly community based and include adult,
psychiatric emergency, child and adolescent, alcohol and drug, and Māori mental health
teams, with a small inpatient unit and family and consumer advisory services. There are
close linkages with Canterbury regional specialty services (youth inpatient, mother and
baby, eating disorders, detoxification services) and service users are able to access a
range of NGO provided residential and support services.
The Māori mental health team work alongside mental health service case managers to
provide cultural support to clients of mental health service and support clinical
processes to ensure they are delivered in a culturally appropriate manner.
“Recognising the integral relationship between cultural identity as Māori and Māori
wellbeing is a core element of a kaupapa Māori model of care. The term “Kaupapa Māori”
refers to the culturally derived philosophy that underlies and is woven into all aspects of
service delivery, with wellness for tangata whaiora Māori as the desired outcome 53 .”
To date there has been limited integration of primary and secondary care mental health
services on the West Coast because of the following reasons:
- they have been established, funded and operated in very different ways in order
to adhere to two distinct sets of criteria;
- shortages of psychiatrists to help develop shared care systems, shortages of
GPs with consequent lack of resource to take on a greater role;
- primary mental health co-ordinator role has focused on assessments and not had
capacity to take on a wider role;
- the current patient pathway is only established as a one way track i.e. primary
mental health team to secondary, no pathway back to primary mental health for
brief intervention counselling;
- current primary/secondary contracts add to the fragmentation of services due
to their distinction between mild and moderate/severe.
In terms of volumes, currently the adult community mental health services carry out 736
community adult assessments and admit to their service 636 new patients per year. This
excludes TACT team (449 assessments), inpatient (63), Alcohol & Drug Services and Child &
Adolescent Mental Health Services (382). The PHO Mental Health team assessed 414 patients
(aged 14 and above: 37 Māori) in 08/09 of whom 180 received Brief Intervention Counselling
(BIC) of up to six sessions per person.
Issues of current concern that may be able to be addressed as part of an initiative to better
integrate mental health services are:
lack of seamless entry for patients into the most appropriate pathways via a stepped
care approach
53 Te Haererenga mo te Whakaoranga 1996-2006. The Journey of Recovery for the New Zealand Mental Health Sector.
Mental Health Commission. Pg 157
Business case appendices V12 AC 25Feb2010 Page 89