Image: Registered Nurses Natasha Real (left) and Sarah Garrity test out equipment for the new healthcare clinic in the Wairarapa.
We know that physical and mental health are interrelated, and that changes in both need to be monitored over time. But it was during research for a quality improvement initiative that Registered Nurse Natasha Real had the idea to bridge a gap in care for rangatahi in the Wairarapa.
“I audited referrals to Wairarapa Child and Adolescent Mental Health Services (CAMHS) as part of my Expert PDRP, and found that only one quarter had relevant, up-to-date physical health observations attached,” she says.
“I knew we needed to set up a clinic.”
After discussions with her team lead and colleagues, she started taking steps to set up a pilot of an in-house nursing clinic, together with fellow Registered Nurse, Sarah Garrity.
Rangatahi attending appointments at the Wairarapa CAMHS team base are given the opportunity to be booked into an additional appointment for physical health screening, which has the benefit of being in a familiar place, and with people they know.
“The clinic offers top-to-toe screening of the physical things that we know impact mental health, carried out by nurses on the team,” says Tash.
“That includes recording baseline observations like blood pressure, height, weight, and pulse, but also discussing alcohol and drug use, vaping and smoking, and sexual health screening.”
The baseline data is then on file to help the treating team observe any changes over time, while any health issues detected can be flagged with the Case Manager or GP as needed.
The clinic also offers the opportunity to deliver health education. “A lot of young people don’t know they need to be watching their weight, for example,” says Tash. “If they don't know things like that - how can they advocate for themselves?”
The goal is to see an improvement in physical health data. If the pilot goes well, there may be the potential to roll out similar projects in other locations.
While the clinic has only just opened, Tash notes a benefit at being able to offer new rangatahi a bespoke package of care, with the option to come and see the nurses to discuss their physical health needs.
Tash says there is a large appetite for quality improvement in Wairarapa CAMHS. “There are lots of other projects going on. It’s partly out of necessity, being in a small team in a rural community, but it’s also a supportive environment, in which people feel safe to bring up ideas.”
