GP learning session focuses on improving care for adolescent depression

Issue: BCMJ, Vol. 52, No. 2, March 2010, page(s) 96 GPSC
Liza Kallstrom

The General Practice Services Committee’s Practice Support Program (PSP) held a pilot learning session in Vancouver in December on methods for identifying and treating depression among youth. 

The session presented learning materials from the PSP’s new Child and Youth Mental Health learning module and was well received by the 58 participants, who included 15 general practitioners and five high school counselors involved in an East Vancouver project focused on the needs of youth with depression at Killarney High School. The session’s learning materials included a tool kit to support GPs in identifying, diagnosing, and treating adolescent depression. 

According to a participant from the Vancouver School Board (VSB), the PSP’s Child and Youth Mental Health module represents an important step toward improving care for youth with depression. Jackie Farqu­har, a social-emotional learning consultant with the VSB, is involved with both the steering committee and working group for the module. 

“I have a lot of respect for the BCMA’s willingness to include a wide range of organizations involved in youth mental health as part of the development process for this training module” says Farquhar. The module has also engaged representatives from the BC Ministry of Children and Family Development, Vancouver Coastal Health, and other organizations. 

Farquhar says Vancouver’s high school counselors are pleased to see GPs becoming more involved in youth mental health and it’s “absolutely es­sential” to have a strong working relationship between school counselors, doctors, and mental health teams to ensure effective care for youth with mental health issues. She says GPs play a key role because some families go straight to their family physician about issues such as teenage depression, as their doctor is a health professional they already know and trust. 

Response to the pilot learning session from participants was very positive, says Dr Lloyd Oppel, chair of the Child and Youth Mental Health working group. One participant, who claimed to have attended all PSP learning sessions to date, described the youth mental health session as the best one yet and called the quality of materials and presenters “excellent.”

The session provided an introduction to clinical assessment tools and to a variety of therapeutic techniques for treating youth with major depressive disorder (MDD). A postsession survey showed that most participants found all topics presented at the session both relevant to their work and valuable. 

The participant survey also asses­sed the confidence of GPs in dealing with youth mental health issues, both prior to and after completing the learning session. The survey asked GPs to rate their confidence level on a range of activities related to youth mental health using a four-point scale, with “1” indicating “very confident” and “4” indicating “not at all confident.”

For every item on the survey, the average confidence rating of GPs was higher following the learning session. For example, the average postsession rating among GPs on their ability to identify youth at risk for MDD was 1.4, compared with a presession group average of 2.7. Similarly, the average postsession confidence level among GPs for treating MDD in adolescents was 1.9, compared with a presession group average of 3.0. 

Although all family doctors have received mental health training, Dr Oppel says the Child and Youth Mental Health learning module helps physicians enhance their capacity and comfort in treating youths with mental disorders. Providing them with additional training, specialized tools, and dedicated financial incentives makes it “more realistic” for family doctors to engage in mental health care, says Dr Oppel. 

The need for improving GP skills in the area of mental health care for youth is driven in part by statistics that show 6% to 8% of adolescents (inclu­ding youth up to their mid-twenties) are affected by MDD, and that most people who develop the disorder experience their first episode of depression in adolescence. There is also evidence to show that early identification and treatment of MDD can reduce short-term morbidity and im­prove long-term outcomes for patients with the disorder. 

The PSP’s Child and Youth Mental Health training module will be expanded to include other areas of mental health in addition to MDD before it is finalized. The training module is expected to be ready for rollout to GPs province-wide before the summer.
—Liza Kallstrom
Executive Lead, Practice Support Program
Professional Relations, BCMA