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Manager of the West Coast PHO mental health programme, Bev Barron, believes most people with mild to moderate mental illness already have the wisdom in themselves to make choices and decisions that are right for them, they just need a little help to take action.

“It sounds very basic when you put it like that but people are sometimes unsure how to put their wisdom into practice,” she says.

 “We assist them to get beyond those things so they can call on their wisdom to move forward and achieve what they want to achieve.”

"I remind people that they are the experts in their life, they’ve had more years learning about themselves than anyone else, but that some things are getting in the way. We assist them to get beyond those things so they can call on their wisdom to move forward and achieve what they want to achieve.”

The programme has no restrictions on the methods used to support participants. “The programme involves all the different therapies including cognitive behaviour therapy and mindfulness therapy. We don’t actually like to say that we use any particular technique,” Bev says. “It has more to do with the relationship that’s developed with the person. The techniques are secondary to developing the relationship and working with the person so they make the best choices,” Bev says. “We use whatever techniques are most appropriate for the person.”

The programme is obviously working because an evaluation of outcomes has shown that most people who participate in it show a marked improvement after five counselling sessions and that this progress is maintained after six months.

The programme uses the General Health Questionnaire (GHQ) to measure a person’s level of distress before they receive counselling. Typically, scores are around 26 out of 36 at this point. After five counselling sessions the GHQ score is measured again and has usually dropped to about five. A sixth session is offered as a follow-up six months later and GHQ scores at this point have usually only risen a little to about seven. “We’re really pleased because this shows that we don’t counsel for a particular event that’s just happened, we assist people to develop skills for life,” says Bev.

“We know we can support people to make changes in their lives in a few sessions.”

Bev is absolutely convinced six sessions are adequate to make progress in a counselling environment. Having experienced, professional counsellors who are flexible, adaptable and able to work quickly is crucial, she believes. They should be able to bring all their skills to the role to support people’s recovery. “We know we can support people to make changes in their lives in a few sessions,” she says.

GPs are given feedback at three points in the process - initial assessment, when the participant comes to the first counselling session and at the end of the five sessions. The participant is invited to write their thoughts on the programme to include in the third report. “They say things like ‘this has changed my life’,” Bev says.

“People take the learning they’ve had and share it with their husbands, their wives, their kids, their work colleagues or whoever, so they’re spreading the word about healthy living.”

Word is spreading about the programme’s success and the number of people using it is steadily increasing. So far more than 1000 people have benefited from the programme. “One guy recently said ‘I’ve become like a born again Christian, I’m telling everybody what I’ve learned from you’,” Bev says. “People take the learning they’ve had and share it with their husbands, their wives, their kids, their work colleagues or whoever, so they’re spreading the word about healthy living.”

Originally from New Zealand, Bev was living in Melbourne and came home for a visit when she spotted a ‘situations vacant’ advertisement for a psychologist in the local newspaper. She didn’t think there were any openings on the West Coast so she was particularly delighted with her find. “After 20 years in Melbourne I really missed the New Zealand mountains, rivers and bush so it seemed meant to be,” Bev says.

Bev joined a steering committee comprised of the local DHB, a GP, iwi representatives and other interested people with knowledge of mental health issues to start the programme in March 2006. One of the first tasks was communicating the vision for the programme to GPs and gathering their ideas. “Right from the start I emphasised that our job was to make their job easier,” Bev says. “I think that’s been borne out by their feedback. We received feedback from one doctor who was here when we started then went to some other location in the North Island. We met up with her again when she came back to locum on the coast and she said what a big gap it was when she moved to a place that didn’t have this programme running.”

“The strength of the programme is that we’re not a separate service, we’re part of the general practice team. I think that is a big strength.”

Bev and her colleagues travel from their Greymouth base to places like Westport or Reefton. They each clock up about 450 km per week on average. To ease the travelling load, Bev worked out the number of enrolled patients in each practice and its percentage of the total population on the West Coast and divided time equitably across the various areas. “We go more often to the bigger practices with a higher enrolled population and to smaller ones we go on a proportional basis,” she says.

GP practices make rooms available for Bev and the other mental health programme staff to meet with participants. “In some practices we have a dedicated room, in others we take whatever is available. Sometimes when there’s no room available, I’ve sat outside under a tree with someone and that works,” Bev says. “We believe that as we go around the coast we actually become part of the practice teams and we are not a separate service on the coast. We’re actually supporting the primary health practitioners to support their patients so we are adding value,” Bev says.