Better Sooner More Convenient Primary Care - New Zealand Doctor

lack of clarity in regard to roles of Primary Mental Health Co-ordinator has led to
duplicate assessment processes provided by both primary and secondary mental health
services
lack of assistance for patients who need ongoing psychosocial support for a period of
time but neither qualify for secondary services, nor are suitable for brief intervention
counselling
Māori in primary care do not have access to Māori mental health support workers; Māori
in secondary services do not receive the option of having a Māori Psychologist
lack of primary care involvement in discharge planning
lack of information for GPs from secondary mental care on the patient‟s mental health
management plan and medications, eg. difficulties arise when GPs are asked to provide
repeat prescriptions
lack of information for GPs from secondary mental care on the patient‟s management
plan and medications eg difficulties arise when GPs are asked to provide repeat scripts
no processes in place for shared care between primary and secondary care prior to
discharge from secondary care (except for methadone programme)
limited promotion of self care activities, eg. web based support programmes.
The recently released guidance paper, Towards optimal primary mental health care in the new
primary care environment 54 , provides a helpful guide for the further development of primary
mental health services. It makes a case for the importance of integrating mental health into
primary care:
“The World Health Organisation (WHO) and World Organisation of Family Doctors (Wonca) list seven
central reasons for integrating mental health into primary care (WHO and Wonca 2008). These
include:
1. Th e b urd en o f m en t al d isord ers is gr eat
2. Men t al an d p h ysical h ealt h p r ob lem s are int er w o ven
3. Th e t r eat m ent gap f o r m ent al d isord er s is en or m o us
4. Pr im ar y care f or m ent al healt h en h an ces access
5. Pr im ar y care f or m ent al healt h p r o m ot es resp ect of h um an r ight s
6. Pr im ar y care f or m ent al healt h is af f o rd ab le and cost ef f ect ive
7. Pr im ar y care f or m ent al healt h generat es good h ealt h o ut co m es”
This paper describes an optimal service user pathway in primary care as follows:
54 Ministry of Health. Towards optimal primary mental health care in the new primary care environment. MoH,
Wellington, 2009.
Business case appendices V12 AC 25Feb2010 Page 90