A pioneering telephone and digital counselling service – Puāwaitanga, meaning to bloom or grow – is demonstrating that designing services for Māori mean better results for everyone.
Established almost two years’ ago, the 9am to 9pm, seven-day-a-week programme is run by social enterprise Whakarongorau Aotearoa. It offers clients who are referred a package of care for up to 12 months, with users selecting their preferred counsellor and session time via an online portal. Clients generally have their first session within a week of referral.
It achieved an 87 percent Māori conversion rate from referral to engagement in the last year; a figure unrivalled in the mainstream health sector. Māori make up 25 percent of its client base. Other service users include New Zealand European (54 percent); Pasifika Peoples (six percent); Asian (seven percent) and other European (five percent).
Whakarongorau Aotearoa CEO Andrew Slater says the programme was specifically designed by Māori with a holistic, te ao Māori lense.
“We know from experience that what works for Māori, works for everyone. We also know that Māori, who are over-represented in most negative health statistics, can find it difficult to navigate mainstream systems. We set out to reverse this situation and are really pleased that Puāwaitanga has achieved such success for all ethnicities using the service.
“Many of our clients are first-time users of a mental health service. We’re connecting with those ‘hard to reach’ members of our community, who are often the ones in need of acute intervention.”
The service is proving popular nationwide.
“We have more than 30 trained counsellors offering their time in some 15 different languages. We are currently recruiting to increase our team,” says Puāwaitanga’s service delivery manager Melissa Grant (Ngapuhi).
“Our team comprises registered psychotherapists, psychologists, occupational therapists, counsellors, mental health nurses, social workers, addiction practitioners and ACC registered therapists, and they all have at least 5 years’ face to face counselling experience,” she says.
“One of the biggest advantages of the programme is that it reduces barriers for access. It operates outside normal office hours – including weekends – so no one needs to miss work; there are no transport issues and it reduces the need for child care arrangements.”
Ms Grant also says many clients like the anonymity of the service. “Many of our clients present with severe anxiety, with some having trouble leaving their house. Phone sessions are one of the only ways this group can get help. Some clients say they can talk about things that they wouldn’t have been able to if they’d been seen face to face.
“Puāwaitanga is not designed to replace face-to-face counselling.
It focuses on the here and now for clients who receive an average of five sessions. We sometimes do three-way sessions with the client, their GP and the counsellor and we also refer on for more complex issues.”
Ms Grant says Māori feel safe to use the service. “As soon as Māori see a service that has a name that they can recognise and that they feel a connection to, they are going to be drawn to that. It’s also the reason why we get a strong selection of Māori candidates for interview.”
Outcomes for all clients are positive with the average DUKE Score* increasing by 43 percent for Māori clients and by 39 percent for all other clients since it was established in 2018. Two external evaluations carried out by AUT and Synergia since Puāwaitanga’s inception have shown that its results are the same, if not better than face-to-face counselling. Service users’ DUKE scores are assessed before treatment begins, at the end of treatment and again after three months since following counselling ending.
*The Duke Health Profile (DUKE) is a technique for measuring health as an outcome of medical intervention and health promotion. It is a 17-item generic self-report instrument containing six health measures (physical, mental, social, general, perceived health, and self-esteem), and four dysfunction measures (anxiety, depression, pain, and disability). Items were derived from the 63-item Duke-UNC Health Profile, based upon face validity and item-remainder correlations.
For interview enquires and further information please contact: Penny Hartill – consultant 021 721 424, firstname.lastname@example.org
Puāwaitanga grew from a pilot study called eTalk initiated by the Canterbury District Health Board in 2011. It was designed to reduce waitlists for mental health services following the devastating earthquakes in the region. It was externally evaluated by AUT and further developed by a co-design panel led by Melissa Grant. Clients are referred to Puāwaitanga by GPs, primary health organisations, universities, district health boards and government agencies, who pay for the service. Clients of 19 years’ and over are accepted. https://www.homecaremedical.co.nz/en/puawaitanga
Whakarongorau Aotearoa is a social enterprise providing New Zealanders with innovative health and mental health services across digital channels. It runs the National Telehealth Service (NTS), providing New Zealanders with access to free health, wellness and injury advice, support and information, 24 hours a day, seven days a week across seven digital channels including Healthline, the COVID-19 Helpline, 1737 – Need to Talk and Depression.org.nz. Homecare Medical also runs services independent of the National Telehealth Service including Employer Advice Line, the national sexual harm helpline Safe to talk, Puāwaitanga, the cervical and bowel national screening coordination centres, and General Practice After Hours services.
Our team of more than 600 includes registered nurses, mental health nurses, psychologists, psychotherapists, psychiatrists, counsellors, doctors, Poisons Officers, Health Advisors, paramedics, sexual harm professionals, and emergency triage nurses working from contact centres in Auckland, Wellington, Christchurch and Dunedin and from their homes all over New Zealand.
Whakarongorau Aotearoa is owned by ProCare and Pegasus Health. It is co-funded by the Ministry of Health, ACC, the Health Promotion Agency, Ministry of Social Development, and the Department of Corrections. www.whakarongorau.nz