For the Fall issue of the newsletter, we have selected to focus on the theme of Mental Health and Addictions as it affects many of our clients and how we respond as providers of care. Many of you may be wondering why two such vast topics have been lumped together. Certainly the topics of Addictions and Mental Health deserve their own focus, but on the other hand, in real life, the two topic areas are often intertwined. Where addictions personally affects 10% of the general population (this is not counting the broader impact to those around them), mental illness is said to affect a staggering 20% of Canadians in their life time. Furthermore, the co-occurrence of the two conditions is also very common; the Centre for Addiction and Mental Health cites 20% of those with mental illness also have a co-occurring substance use problem (see following for some general statistics: CAMH website ). This is why it was felt that we ought to explore the two topics together. We hope that our readers will find interesting and possibly new, kernels of information and insights from the contributions of our various writers.
To start off this fall edition we have our regular President’s Update by Rosemary Graham, who offers her summary of executive activities, along with her vision for the future possibilities for NPs in our province. We are entering exciting times and hope that together, we can contribute to the development of fresh ideas for the goal of improved quality and access to care.
As a feature article, we have the pleasure of bringing to you a piece by Charlotte Jackson, a Registered Clinical Counsellor working in Mental Health and Addiction Services at the Downtown Eastside Community Health Centre. She has presented workshops extensively over the last while within Vancouver, on the topic of providing care to individuals with Personality Disorders utilizing a “trauma-informed” approach. Her thoughtful contribution may give readers a fresh perspective to engaging clients who carry the diagnosis (but also the stigma) of Personality Disorder.
We have also invited Robin Loxton from BC Coalition of People with Disabilities to give us a run down of the various provincial forms and income sources available to clients who face financial challenges due to their mental health or addictions issues. We hope that this article helps to answer questions you may have had about the BC benefits programs and how to strategize in order to ensure clients can access income supports and advocacy from organizations like BCCPD. This may mean creating informal networks of providers in your community or your practice setting so that barriers are minimized.
In this edition we also once again feature the thoughtful Practice Reflections. This time we have Jodie Foster, who works with two ACT teams (the Raincity ACT team and the Vancouver Coastal Health ACT team), as well as Karol Ghuman, who provides primary care services for mental health clients of Fraser Health in Surrey. We hope these reflections give our readers some insight into how some NPs put into practice the themes covered in the feature article, as well as what philosophy guides their day to day interactions with these populations.
Another regular feature is back with the review of two relevant research articles. Our education committee has reviewed two articles worth noting. The first article reviewed looks at conducting chart audits to address health needs for people with mental illness. As our education experts found, this article may offer ideas for NPs in practice for conducting similar chart audits as their annual practice review. The second article is one which reviews the various service delivery models for working with injection drug-using populations. In addition to offering insights on various care delivery models, this review gives readers the chance to reflect on elements needed for evaluation of services. Furthermore, to complement these article reviews, with the assistance of our Vancouver Coastal Health library services, we have compiled a list of articles and abstracts related to the topic area, which we would be happy to share upon request. Please do not hesitate to contact us by leaving a comment after the newsletter or through the BCNPA general contact.
We are also excited to welcome back Esther Sangster-Gormley who will continue exploration of the steps needed in tackling research while balancing front line work. In this issue, she focuses on reviewing how to find and evaluate studies which are meaningful to practice, so that we may become more proficient at integrating evidence into our practices. She provides excellent resources to use and bookmark in our technical assistive devices.
As always, we invite readers to respond to us with comments or feedback, and hope that this issue can be a starting point for healthy dialogue between NPs and other health providers to reflect on the care provided to those afflicted with mental health and/or addiction issues. Thank you for reading!
Gwyn McIntosh & Wendy Bowles
Erratum from previous Spring issue: on Pg 5 of the printed Newsletter, the practice reflection was by K. Pikksalu with R. Lehal.
Following are some useful web links to review:
Region-Specific information for BC
- Fraser health Overview of services: http://physicians.fraserhealth.ca/media/MHSU%20Services%20Guide.pdf
- Portal for primary care providers, Fraser Health Authority: http://physicians.fraserhealth.ca/resources/mental_health_and_substance_use/
- Vancouver: http://www.vch.ca/locations_and_services/find_health_services/
- Interior Health: http://www.interiorhealth.ca/YourCare/MentalHealthSubstanceUse/Pages/default.aspx
- Vancouver Island: http://www.viha.ca/mhas/
- Northern Health Authority: http://www.northernhealth.ca/YourHealth/MentalHealthAddictions.aspx
General Guides for Mental Health and Addictions
- Aboriginal-specific resources for mental illness: http://www.reachingfamiliesproject.org/cgi-bin/dada/mail.cgi/archive/aboriginalfamily/20120501161055/
- The Physician’s Guide to Depression, Anxiety Disorders , Early Psychosis and Substance Use Disorders: http://www.health.gov.bc.ca/mhd/physicians_guide.html
- Link for crisis service (for patients) : http://www.crisiscentre.bc.ca/about-us/
Centre for Addictions and Mental Health (CAMH) in Ontario offers various resources
- Introductory information for patients and families on topic of addictions: http://www.camh.ca/en/education/Patients-Families-Public/public/mental_health_and_addiction_101_series/Pages/mental_health_and_addiction_101_series.aspx
- Information geared toward primary care providers: http://knowledgex.camh.net/primary_care/toolkits/addiction_toolkit/Pages/default.aspx
- Trauma informed care toolkit: http://www.trauma-informed.ca/traumafiles/Trauma-informed_Toolkit.pdf
Peer Support/Patient Advocacy Resources
- Canadian Mental Health Association of BC: http://www.cmha.ca/branch_locations/british-columbia-division/
- From Grief to Action provides family information and supports: http://www.fgta.ca/