Response to Evolution of Collaborative Mental Health Care in Canada: A Shared Vision for the Future

Abstract

Dear Editor: We believe that integration of mental health services within primary care is essential for the well-being of patients. We want to discuss our successful approach. As such, we, the members of the Edmonton Southside Primary Care Network (PCN), read the position paper entitled, Evolution of Collaborative Mental Health Care in Canada: A Shared Vision for the Future,1 with interest. As of May 2005, the Edmonton Southside PCN has been developing a model of collaboration, effective communication, consultation, coordination of care, co-location, and integration within primary care. These are all mentioned in the position paper. Below is an outline of some of the successes and continuing challenges within the PCN in the area of providing collaborative mental health care. Collaboration The mental health team consists of mental health coordinators (MHCs), family physicians, and psychiatrists. In addition, all primary care team members can be involved, including nurses, nurse practitioners, dietitians, and auxiliary staff. Effective Communication The MHCs ensure the family physician is aware of all referrals and services recommended to patients. This has improved care for patients as less is missed and it prevents the duplication of services on an already overworked mental health system. Continuity of care is maintained within this model. Consultation In 2007, the PCN added a psychiatric consultation service to the multidisciplinary team. While most mental health concerns are managed well by the family physician, the need for specialized services for some patients was recognized as beneficial in maintaining patient care within the primary care setting. An ongoing challenge is that patients who require ongoing psychiatric care continue to be referred in the normal way and wait times are still long. This is mitigated somewhat by the MHCs who can support the patient and the family physician while waiting for services, and by the psychiatrist who can advise the family physician regarding management in the interim. Coordination of Care and Co-location Coordination of care has been the main focus of the mental health team. It was recognized early on that improving coordination would benefit the patients, the family physicians, and the other mental health team members. The Edmonton Southside PCN is a decentralized model. Nurses, nurse practitioners, dietitians, and respiratory therapists are all placed in the family physicians' offices to provide care. When possible, the psychiatrists come to the family physicians' clinics as do the MHCs. …