Activities and initiatives database

Bryan Geer is the first point of contact for people accessing the West Coast PHO mental health programme. Bryan meets with each person and determines the most appropriate next step for them; would they benefit from the brief intervention counselling offered in the programme or would it be more appropriate to refer them to an alternative service provider? This programme targets those who are motivated for change and who have a clear rationale for what they want to achieve.

GPs send him ‘requests for service’. They’re not called referrals because he and his colleagues in the programme are seen as part of the GP practices, rather than as a separate service. Requests for service also come from district health nurses, schools and child and adolescent mental health services. Requests for service may also come from external providers such as drug and alcohol services and some non-government organisations. Bryan does, however, encourage external providers to strengthen GP/patient relationships by referring people to their GPs in the first instance.

During the initial appointment, Bryan performs an assessment using the General Health Questionnaire (GHQ) and then determines the best course of action. The opportunity to participate in the programme’s brief intervention counselling is only one option Bryan considers. Other alternatives might be ACC funded counselling, an employee assistance programme, private counselling, anger management, relationship services or the women’s health centre. “It’s about raising self awareness and helping them consider the opportunities that are there for them,” Bryan says. “Some people are able to invest $600 in private counselling while others simply cannot afford to pay. Those are the people who are targeted by the mental health programme.”

Bryan meets once a week with the three brief intervention counsellors involved with the mental health programme. They decide together which counsellors will be allocated to each participant. Bryan points out that the three counsellors involved with the programme are experts and it doesn’t make much difference which of them does the counselling; however having a mix of gender and ethnicity in the team is beneficial to the programme.

An initial assessment usually takes place within a week of a request for service being received. Some participants may then wait a further two or three weeks to start brief intervention counselling. Bryan says a lot depends on where on the West Coast participants are from. “Westport utilisation of the service is higher than some other areas, which can result in a delay between assessment and the start of counselling” Bryan says.

Feedback from the general practice team has been positive. Buller Medical Centre GP Dr Paul Cooper says the programme has been a great innovation. “The overall response of people who go through the programme is that it was a useful thing to have someone they could talk to. They say they have learned a lot about themselves and about ways of being more in control of themselves. I think people feel a sense of empowerment and feel they can understand their problems, strategies to address them and when to ask for help. It seems very useful in terms of people getting to know themselves and how to help themselves,” he says. “Certainly being able to access counselling which is funded is valuable, particularly in a population which may be struggling to pay private counselling fees.”

Having the mental health programme counsellors available in the GP practices is also valuable, he says. “It is quite useful being able to pop in and have a talk to them about people that have been discussed or letters I have received from them, or problems that I have encountered and they suggest how to approach things.”

Dr Cooper gives high praise to a resource book produced by the mental health team. It contains information about issues such as depression, anxiety and stress, with printed handouts as well as a list of counsellors and website links.

Educational workshops organised by the mental health team are also well received by GPs. “It helps us look at the way we interact, the way we communicate and some of the problems we have in terms of communication, and allows us to see how things could be run better. Having good teamwork is an important part of working well together,” he says. “My experience has been extremely positive. We get really positive results so I’ve got nothing but praise for the scheme.”