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Primary Health Care
Shared Care for Mental Health
Working Together for Better Mental Health
Trillium Health Centre Launches New
Shared Mental Health Care Pilot
By Sheryl Farrar
Family physicians regularly provide mental health care for
their patients. In fact, evidence shows 35% of individuals
suffering from mental health disorders are treated by their
family doctors in a primary care setting. Yet many family
physicians report encountering difficulty in accessing services
and support to provide care for their mental health patients.
Consequently, when
the family physicians with privileges at Trillium Health Centre
indicated they would appreciate an innovative, integrated
approach to better care for their mental health patients,
Trillium welcomed the opportunity to pioneer a shared mental
health care program. Trillium had previously developed a shared
mental health care model with LAMP Community Health Centre,
located in west Toronto, which had proven quite successful.
Following discussions with other community organizations such
as St. Joseph’s Health Centre in Toronto, the HSO Mental
Health Program in Hamilton, and the Ontario College of Family
Physicians, Trillium developed a model to increase family
physicians’ knowledge and comfort in treating mental
health patients, provide patients with quick access to psychiatric
consultations, and improve mental health providers’
understanding of what is necessary to support family physicians.
Family physicians will also benefit from rapid access to consultation
services and support from a mental health team.
This pilot, which began in October 2002 and will continue
until June 2003, includes several family physicians and a
clinical team and is supported by Trillium’s Mental
Health System and the Primary Care and Community Health Initiative.
In the shared mental health care pilot, family physicians
are able to refer patients to a team of nurses, social workers,
and a psychiatrist for rapid consultation. Recommendations
made by the team are provided to the family physician and
the mental health team and the physician work together to
link patients to appropriate treatment. While patients remain
in the care of their family physician, the mental health team
is available to advise and assist with implementation of the
recommendations. Physicians will meet once a month with the
mental health team to discuss cases and learn about advances
in mental health such as new medications.
“This project will provide rapid access to consultation
for our patients and will provide back up for us to continue
to manage those patients”, says Dr. Cheryl Hewitt, a
family physician participating in the pilot. “It is
a great advantage to have that support as mental health care
providers and we look forward to working with the team.”
Dr. Suzanne Legault, Trillium’s Chief of Psychiatry
and the participating psychiatrist on the team, says offering
this service will enhance both primary care and mental health
services through better communication and learning opportunities.
Positive evaluation results based on patient and provider
satisfaction, patient outcomes, and physician knowledge and
comfort in handling mental health problems will result in
an effort to expand to all family physicians at Trillium in
the future.
The environment
to foster shared care at Trillium began in 2001, when the
Health Centre recognized the need to strengthen their focus
on supporting and promoting improvements in primary and community
care. A planning committee was struck to review supports for
primary care and the result was the creation of Trillium’s
Primary Care and Community Health Initiative. This initiative
consists of 26 action-oriented strategies to support the role
of primary care physicians, strengthen information and communications,
and improve how primary care and community care are provided.
Trillium’s Primary Care team is currently exploring
new methods of collaboration between primary care physicians
and specialists in several clinical areas including cardiology,
adult diabetes, and geriatrics.
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