Specialized training and support in mental health

Issue: BCMJ, vol. 51 , No. 7 , September 2009 , Pages 309 GPSC

Latest PSP module to launch across BC in September—open to all GPs

A new Practice Support Program (PSP) module is set to launch across the province this fall. The mental health module—much more clinically oriented than other PSP modules to date—has been specifically designed to meet the needs of general practitioners and their medical office assistants, all of whom are on the front line of mental health care in BC.

“Family physicians screen, diagnose, and treat about 85% of the province’s mental health patients and the issues are often complicated,” says Liza Kallstrom, BCMA lead, change management and practice support. “The complexity of the symptoms often makes them difficult to recognize or attribute to mental health issues.”

Despite the challenges, the GPs and MOAs who enrolled for facilitation training on the module have reported that they learned more than they thought possible, and they’re enthusiastic to share the information with colleagues, having seen first hand the difference it can make.

A unique feature of the module is the support of specialized clinicians and psychiatrists. Dr Rivian Weinerman, site chief of psychiatry, Vancouver Island Health Authority, and her colleague, Dr Helen Campbell, developed the CBIS (cognitive behavioral interpersonal skills) manual with the Shared Care Team at the USTAT clinic in Victoria together with Janet Stretch, RPN, nurse therapist, and Magee Miller, MSW, clinical therapist. Many of the specialists also attended the train-the-trainer sessions along with GP and MOA facilitators and the PSP coordinators.

“The module introduces common screening scales, a tool for organizing patient issues, a cognitive-behavioral skills program—Bounce Back—consisting of telephone coaching for mood management, and a patient self-management workbook,” says Ms Kallstrom. “And of course it is underpinned by the PSP module approach, which involves learning sessions interspersed with action periods to test new skills and knowledge.”

Behind the module’s success to date—and its anticipated future success—is rigorous evaluation every step of the way, including a pre-evaluation of the train-the-trainer program and assessments of each of those sessions.

A prime recommendation from the physicians involved in the evaluations was to describe the module in an algorithm that would then have electronic hyperlinks to all resources in the module. Local referral forms for local mental health services were also added electronically to allow family physicians to connect their patients with the community services they need in a timely way.

“It was clear that with each successive evaluation the GP and MOA trainers were gaining more confidence and enthusiasm,” says Ms Kallstrom. “At the end of the train-the-trainer sessions they received practical and useful tools and skills to help their patients with mental health care.”

Regional health authority PSP coordinators involved in the train-the-trainer sessions also evaluated them positively, indicating they are ready to “start spreading the news” to GPs in their communities.

A national 12-hour Mental Health First Aid program, licensed by the National Mental Health Commission, is being offered in addition to the module for MOAs who are working with physicians taking the module. The course provides explanations of common mental health problems and information that helps reduce the stigma of mental health and the difficulties of accessing professional help.

Module participants can look forward to enhancing their skills and confidence in the screening, diagnosis, and treatment of mental health conditions while increasing patient satisfaction and engagement in self-management of mental health concerns. Most importantly, the diagnostic assessment interview is now so comprehensive that physicians will be able to catch conditions that previously were masked by other symptoms.

The PSP module, which supports incentive payments introduced last year to acknowledge the efforts of family physicians in caring for their mental health patients, is being piloted—and further evaluated—this summer in all health authorities. It launches in September and aims to meet the needs of about 700 GPs across BC.

PSP is a program of the joint BCMA-Ministry of Health Services General Practice Services Committee (GPSC). For more information on the mental health module, visit practicesupport.bc.ca.

—Greg Dines
Senior Program Advisor
BCMA Professional Relations

Greg Dines,. Specialized training and support in mental health. BCMJ, Vol. 51, No. 7, September, 2009, Page(s) 309 - GPSC.



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