Call to action: Interprofessional mental health collaborative practice in rural and northern Canada.

Abstract

Shared within health care is needed in rural and northern Canada where residents are challenged with greater social and health disparities. Compared to their urban counterparts, Canadians in these areas experience lower socioeconomic status; higher rates of disability; higher rates of unemployment; higher mortality rates; difficulty with transportation, thereby limiting access to essential health services; and higher rates of chronic illness (Barbopoulos & Clark, 2003; Canadian Institute for Health Informatics, 2006). Downsizing of hospitals in rural and northern areas is causing outmigration of health care services to centralized urban areas, forcing rural Canadians to travel greater distances to access health care services (Canadian Collaborative Mental Health Initiative [CCMHI], 2006). A lack of access to health care is frequently noted as a key issue facing rural and northern residents (Donato, 2015; Haggarty, Ryan-Nicholls, & Jarva, 2010; McIlwraith & Dyck, 2002; Ryan-Nicholls, 2004). Shortages of mental health professionals in rural, northern, and Aboriginal communities in Canada are well documented (Kulig & Williams, 2012; McIllwariath & Dyck, 2002; Pawlenko, 2005).Interprofessional mental health collaborative practice (IMHCP) is an emerging and vital response to meet the mental health-related demands in rural and northern Canada and is an enhancement of the current Canadian health practice of Interprofessional Practice (IPP; (CCMHI, 2006; Coffey & Anyinam, 2015; Commission on the Future of Health Care in Canada [CFHC], 2002; Haggarty et al., 2010; Heath et al., 2015). IPMHC involves developing and maintaining effective interprofessional working relationships with professionals, paraprofessionals, students, mental health consumShelley ers, families, and communities to ensure optimal health outcomes (Canadian Interprofessional Health Collaborative [CIHC], 2010). Effective collaboration requires individual professionals to reframe their views from the traditional 'we know best' mind-set to a holistic approach (CCMHI, 2006; Coffey & Anyinam, 2015; Petrie, 1976). Pearce and Sims (2001) define shared as leadership that emanates from members of teams, and not simply from the appointed leaders (p. 115). It is the authors' contention that psychology must fully embrace a shared role in IMHCP in rural and northern communities, not only within clinical practice but also within professional psychology associations and regulatory bodies. We discuss the opportunities and challenges this may create and how the scholarly literature can guide our next steps.BackgroundThe Romanow Report (CFHC, 2002) continues to be one of the most influential documents in modern health care delivery in Canada. Over the past decade, recommendations from this document have led to systemwide advances in IPP and interprofessional education (IPE). In response, provincial and territorial directives have been targeting collaborative practice as one of their priorities in streamlining quality health care (Canadian Health Services Research Foundation, 2011; Coffey & Anyinam, 2015; Health Professions Regulated Advisory Council [HPRAC], 2006; Province of Nova Scotia, 2014). IPP is now an explicit expectation within most standards of practice for self-regulated health care professions in Canada and is mandated by their respective regulatory bodies (Human Resources Professionals Association, 2015). National organisations specifically designed to promote awareness and education in this field, such as the CIHC (2010), are also emerging. As well, IPE is expanding within universities across Canada, supporting multimodal opportunities for clinical simulations in IPP (Church et al., 2010; Cornish et al., 2003; Curran et al., 2012; Dalhousie University, 2015a; Donato, 2015).Yet within rural and northern communities, there remain challenges with efficiently implementing IMHCP because these large, isolated geographic areas are being serviced by low numbers of health professionals representing a small number of disciplines. …