The Evaluation has reported that the initiatives have been very successful. They have facilitated effective interdisciplinary team work, created new roles and at least 80 percent of patients receiving the funded services showed positive improvement.
Key Results
OverviewClinically significant mental health problems are common in New Zealand. Many people, particularly those with mild to moderate conditions, are first seen in primary health care and general practice settings.
The Primary Mental Health Initiatives (PMHIs) represent a significant investment in primary care service delivery and infrastructure. The initiatives were delivered within a timeframe requiring a rapid evolution of service development, and were sustained over a two-year period.
A range of service delivery models was developed, offering choice to both service users and practitioners. All services were offered at no charge to services users. Every model contained some elements specific to local need.
The PMHIs were perceived as being efficient and responsive to consumer need, and were judged a success by both practitioners and service users.
It is unlikely that any single model could be universally applied as none contained all successful elements of an optimal model.
No service delivery model offered an inherently superior value for money, or an inherently more cost-effective service compared to others. The PMHIs provided services to address the needs of service users with a wide range of symptoms and problems. The ability to address undifferentiated and sub-threshold symptom complexes, as well as well-defined conditions such as depression and anxiety, was welcomed by service users. Up to 80% of service users benefited from the variety of interventions offered.
Although common, mental health disorders such as anxiety and depression are complex and it is not surprising that 20% of service users did not improve. Spontaneous remission (getting better without any treatment) is also relatively common.
Several studies suggest that it would be reasonable to expect anywhere between 30 and 50% of patients to improve under ‘care as usual’ conditions and fewer under ‘no treatment’ conditions. The 80% improvement rate therefore represents a significant and beneficial treatment effect, which was generally sustained at six months in those for whom data were available. Service users expressed satisfaction with the care given by the initiatives. Mental health needs arising from mild to moderate common mental health conditions, including those involving social complexity, can be addressed by primary care.