Primary Mental Health Initiatives (PMHI)

Primary Mental Health Initiatives (PMHI)

All Primary Health Organisations (PHOs) receive funding for primary mental health services, with $23.765 million of funding provided for these services in 2011/12. This funding has increased progressively from $5 million in 2005/06. 

The main target group is patients with mild to moderate mental health and/or substance abuse problems.  Because of the limited funding available, these services are targeted to high needs populations such as Maori, Pacific and high deprivation.

A key aim of these services is to increase patients’ access to talking therapies and other psychosocial interventions.  Components include:

• extended consultations with a general practitioner (or practice nurse)
• assessments, brief interventions, and/or counselling sessions provided by primary mental health clinicians or counsellors/psychologists
• packages of care for patients, which cover a variety of services such as cognitive behavioural therapy, medication reviews, counselling and other psychosocial interventions.

In additional to these services, around 120 Primary Mental Health clinical roles have been established since 2005.  These staff provide a significant clinical assessment role in the delivery of primary mental health services across New Zealand. 

The Ministry recommends the primary care sector adopt a stepped care approach to service provision.  Stepped care is a system of delivering and monitoring treatments so the treatment that is most effective, yet least resource intensive, is delivered to patients first.  Adopting this model will help provide patients with the most effective mental health care at the lowest cost.

The models of care for primary mental health initiatives differ around the country and not all the components are offered in all PHOs – to find out what services are offered in your area please contact your General Practice or your local PHO.

How effective has Primary Mental Health been in New Zealand so far?

The first 26 primary mental health initiatives were evaluated in the 2009 Evaluation of the Primary Mental Health Initiatives: Summary Report.

This report showed very promising results, with eighty percent of patients showing positive improvement and expressing satisfaction with the care provided.  There was no control group, but several studies suggest it would be reasonable to expect between 35 to 50 percent of patients to improve under ‘care as usual’ conditions and fewer under ‘no treatment’ conditions.  The 80 percent improvement rate shown through the evaluation is therefore highly meaningful in a clinical sense.  These benefits were maintained at a six month follow-up.