Shelley McCabe joined Pegasus Health as the Mental Health Service Manager in 2017. With a background in secondary mental health as both a clinician and manager, Shelley was ready to shake up a system that was no longer fit for purpose or meeting the demands placed on it.
“When I came into the service as a manager, what I saw was that there were some excellent clinicians working here, but they all had a different approach. I thought, that’s not equitable. We need a more consistent model that fits with primary care and the demand that sits in our community.
“Our brief intervention clinicians now all use FACT which is Focused Acceptance and Commitment Therapy. It’s not focused on cognition so much as behavioural change. Often what people need is someone in the here and now to talk to and come up with a plan for how they can change things in their lives, to make things easier and help get them out of their head. It’s more around changing behaviours. We’re asking, ‘what can you do? What will lead you toward living a life that feels more aligned to your values?’
Shelley is also the Clinical Implementation Lead for Te Tumu Waiora across Canterbury. Te Tumu Waiora is a new model of primary mental health and addictions support that came out of the He Ara Oranga report in 2018. The model is based around new roles in the primary care workforce – The Health Improvement Practitioner (HIP) and the Health Coach. These two roles are based in general practice and ‘warm handover’ – a GP offering immediate psychological/wellbeing support for patients – is at the heart of the Te Tumu Waiora model. There is also a third role of a Support Worker, who offers a conduit between general practice and community resources.
“The focus of the HIP is to support people’s wellbeing. It’s moving away from a diagnostic clinical intervention towards normalising things for people. It’s encouraging people to feel like there’s no stigma when they need to get some support.
“Our HIPs also predominately use Focused Acceptance and Commitment Therapy. They’re not using diagnostic language around depression or anxiety, but normalising it and saying, well, there are times in our lives where we all struggle with mood.”
Pegasus Health was one of the first PHOs to trial the Te Tumu Waiora model in Aotearoa, before it was funded by the Ministry of Health.
“We’ve got about 35 practices across Canterbury who now have the model of care. They’re down as far as Ashburton and as far north as Pegasus town. We’re only funded for a limited number of FTEs, so we targeted our top 30 practices based on some key areas that we’re trying to address with this model of care around equity. We targeted practices with relatively high Māori, Pasifika and rainbow community populations, low socio-economic communities and rural practices where there are fewer resources available.
“We’re currently covering about a third of the total number of general practices across Canterbury and with more funding coming over the next wo years, we hope to extend this to about 60% of general practice”.