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TaPasefika PHO chronic care management (CCM) depression module

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posted by sebastian on 20 August 2010

“I am so impressed with Epenesa, Philip (clinical psychologists) and Siale (psychiatrist). We are very privileged to have that skill here.”
– TaPasefika PHO general manager Siobhan Matich.

Chronic care management (CCM) has been such a successful model in areas such as diabetes, chronic heart failure, cardiovascular disease and chronic obstructive pulmonary disease (COPD), TaPasefika PHO decided to also use it with depression.

The PHO, based in Papatoetoe, has two providers of primary health care working with the CCM depression programme – Bader Drive Healthcare and Mangere Family Doctors. Of these two, the programme has seen most success at Mangere Family Doctors.

TaPasefika PHO general manager Siobhan Matich says in its early stages the initiative has attracted high numbers of people needing help with depression.

When two psychologists were employed, the programme thrived.

“They had a massive growth phase and it’s quite well imbedded there,” Siobhan says.

The PHO serves a huge Pacific population representing Cook Islands, Samoa, Tonga, Niue, Fiji and others. Many live in poverty with poor housing being one of the biggest issues.

Having the psychologists, Epenesa Olo-Whaanga and Philip Britz, co-located in the doctors’ clinic has been helpful to overcome trust issues. Pacific people use the service because it’s in the same place as other services with which they are already familiar. However, it’s a slow process to change the community’s beliefs about mental health and overcome challenges such as accessibility, language, having an appropriately skilled workforce, and IT infrastructure to deliver an effective primary mental health programme.

A psychiatrist, Siale Foliaki, is also on site for two hours on alternate weeks.

“I remain optimistic,” Siobhan says. “I am so impressed with Epenesa, Philip and Siale. We are very privileged to have that skill here.”

Siobhan says Mangere Family Doctors also has a GP, Dr Peter Woodward, who she describes as a “clinical champion” for the CCM depression programme.

“He is a mainstream (not Pacific) doctor but one of the few primary mental health champions I have come across. He is one of those enthusiasts and quite transformational,” she says.

Dr Woodward’s positive attitude to developing the primary mental health initiative is something Siobhan hopes will rub off on other TaPasefika PHO providers so the CCM depression initiative will expand to reach more in the community.

Siobhan says doing group work with people whose depression is recurring or introducing a “virtual psychiatrist” may be useful solutions to the challenges being faced.

“TaPasefika has always been an early adopter of new things,” she says.

For a GP's viewpoint click HERE.

For a psychologist's view point click HERE.

Initiative

TaPasefika PHO chronic care management (CCM) depression module