Te Whatu Ora Counties Manaukau’s Rehabilitation Service

Te Whatu Ora Counties Manukau’s Community Rehabilitation Service include the PHQ-4 as part of the initial IDT assessment. It used to be recorded on a separate form, but they found that incorporating it into the initial assessment form prompted staff to do it routinely. Before implementing the PHQ-4 into routine practice, their psychologist provided training about how to ask questions and score responses and gave information about what would trigger a referral to psychology. The PHQ-4 is supported by a wide-ranging initial assessment which prompts providers to explore people’s general well-being and to ask about carer stress and well-being, and by providers’ observations of the person and their whānau. Staff use a range of strategies to adjust screening for people with aphasia or significant cognitive issues. These include joint sessions with the SLT, use of Talking MatsTM resources to aid understanding and expression, and use other communication supports such as whiteboards to write key words and to help people communicate their responses. When working with Māori stroke patients, staff involve whānau in screening. These initial screenings are discussed at the regular IDT meeting. The template for the meeting also reminds staff to identify people’s cultural needs and to discuss sex and intimacy with the person.