Five years ago CAMH partnered with Trillium Health Partners, Sick Kids and the University of Toronto to improve access to better care for patients living with both mental and physical illnesses. The partnership is known as the Medical Psychiatry Alliance (MPA). We spoke with the Director for the MPA & Collaborative Care at CAMH, Athina Perivolaris about how this collaboration is transforming health care.
Q. The Medical Psychiatry Alliance has been around for 5 years. What has been the real benefit of that partnership?
A: An important benefit of the MPA partnership is the elevated awareness and dialogue around the importance of treating both physical and mental illness simultaneously. Over the past five years the partners have worked hard to implement innovative projects to provide care to patients and to train current and future health-care professionals. Lessons learned will help guide future projects and approaches to improve care for these patients.
Q: What has the MPA partnership meant for CAMH and our patients?
A: CAMH is implementing four projects that are helping accelerate how staff better manage both physical and mental health issues of our patients.
Through the PARTNER’s project we are studying the effectiveness of a mental-health coach — a unique and innovative role in Canada — who calls patients with depression, anxiety and at-risk drinking, the most common mental health problems in primary care. The Partners Project, is meant to bridge primary-care providers and the larger mental-health services community.
To date, the Project has received almost 800 referrals through collaboration with over 170 health care professionals, including solo providers and 13 primary care teams, at 19 sites and seven solo providers spread across urban, suburban, and rural Ontario. We have reached our target of enrolling 500 patients and will begin data analysis in May 2019.
With MPA support, CAMH expanded and enhanced Telepsychiatry services through their partnerships with Family Health Teams and other health providers across Ontario. Consultations increased by 13 percent over the last year. Consultations are done with live video conferencing to enable real time patient consultations between mental health experts and primary care providers. The service is also actively engaged with Aboriginal services and other outreach providers throughout the province to integrate psychiatric, cultural, and contextually relevant approaches in service delivery.
CAMH is also developing and delivering simulation training for faculty and building research and scholarship relating to simulation in medical psychiatry. In 2017/18 327 learners were trained from various professional backgrounds.
The Technology Enabled Collaborative Care Program (TECC) is studying interventions to address the physical health needs of youth 16 to 29 affected by First Episode Psychosis. The project is a collaboration with CAMH, Sick Kids and Trillium and will study the effectives of online, interactive modules to help this patient population quit smoking, stay active and eat well. TECC is actively recruiting participants for the study, and will continue recruiting until October 2019.
Q: How has your work with the MPA guided your clinical work over the last few years?
A: As a nurse I have always recognized the importance of attending to peoples multiple health needs including their physical and mental health. In Ontario, 1.3 million people suffer from co-morbid physical and mental health illness. In many cases, treatment of these patients fails because our health care system is designed to focus on either physical or mental illness but not both at the same time.
Many patients experience symptoms of mental illness that can serve as a barrier to accessing care. So I am passionate about the MPA work that guides my approach and aims to build capacity in other health care providers to meet both the physical and mental health needs of patients and families. I am quite optimistic about the benefits of integrated collaborative care in addressing the needs of this patient population. Symptoms associated with mental illness and stigma must not serve as barriers to meeting physical health needs. We need to identify new approaches to care for patients who have both physical and mental health needs.