Close-up of psychiatrist hands together holding palm of her patient. Courtesy: Getty Images
University of Alberta psychiatrists are offering training, resources and ongoing support so family doctors in Alberta can deliver more timely and effective mental health care, especially to rural and Indigenous patients.
The new Alberta Network for Community Health Outreach and Rural Mental Health is a 12-week training program for family doctors that includes interactive educational sessions, collaborative case conferences and ongoing support with tools and access to experts.
It is led by David Ross, chair of psychiatry, and Jeremy Weleff.
“The vast majority of individuals with psychiatric illness are going to be seen in primary care before they ever get to a psychiatrist, if they ever get to the psychiatrist,” Ross said.
“We don’t have nearly enough psychiatrists, and this problem is especially true for rural populations and in other underserved communities.”
The goal of the new program is to mitigate this shortage by allowing psychiatrists to collaborate with family doctors, who may each have a caseload of several thousand people.
“Family physicians are working incredibly hard. They’re being asked to treat patients who are very sick – individuals who need to see a specialist, but that may not be possible. So how can we help them cope as best as possible within the system we have?” Ross said.
Each week the doctors in the program attend a two-hour session.
The first hour emphasizes experiential learning through case-based scenarios, including treatment guidelines, scientific content and videos.
Topics range from how to navigate psychiatric illness during pregnancy to understanding and managing the biological consequences of complex trauma to new genetic testing available to diagnose autism.
During the second hour, the doctors bring cases from their practices to a collaborative discussion with psychiatrists who can help understand the complexity of the patient’s situation, guide treatment decisions, and suggest additional resources.
Sonya Regehr, a Calgary-based family doctor with the Alberta Indigenous Virtual Care Clinic, is one of the 80 physicians who have taken the program so far.
She appreciated the refresher on diagnosis and treatment of illnesses such as generalized anxiety disorder and major depressive disorder, which she often sees in her practice.
What really surprised her was the integration of new science around neuroscientific findings, including biomarkers, genetic testing and functional MRI.
“I think it results in empathy, because I now have a better understanding of what’s going on for patients at the neuronal level,” she said.
“I actually can see in my mind the image of the neurocircuitry of a person with borderline personality disorder or post-traumatic stress disorder, for example, just like I can imagine the atherosclerotic arteries in someone with high blood pressure.”
Once the course is finished, the doctors are invited to stay connected to the program through a Discord group where they can bring questions, discuss challenges and offer suggestions to colleagues.
The psychiatry team is tracking feedback from the doctors who have taken the course and is regularly updating the curriculum, with plans to offer the program to 80 more family physicians from across the province this year. They are also partnering to bring the program to specific communities in central and northern Alberta.
In early results, participants report increased confidence in screening for, diagnosing and managing psychiatric issues; increased comfort discussing mental health concerns with patients and families; and reduced stigma towards certain psychiatric conditions.
The team is working to develop tools to assess clinical outcomes for the family doctors’ patients.
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