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Vol 39  No 3
Sept. 21, 2006



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Rural mental health program to be launched

by Sharon Gray

After five years of planning and two pilot projects, the Rural Mental Health Interprofessional Training Program will be offered this fall in three locations.

Dr. Ted Callanan (Photo by HSIMS)

Dr. Ted Callanan, chair of the Discipline of Psychiatry and one of the project partners, said the program will start with on-site visits to three communities for the first two modules of the program followed by interactive videoconference sessions for the final four modules offered through 13 two-hour videoconference sessions held weekly over 10 weeks. The training team will be in Placentia on Sept. 26, in Harbour Breton Sept. 28, and in Port aux Basques on Oct. 4 for on-site visits. Another three programs will be offered starting in February 2007 in different communities.

“People in rural and remote regions often have little access to mental health services,” said Dr. Peter Cornish, director of Memorial’s Counselling Centre and a project partner. “The problem is made worse because the health care professionals in these areas often feel unprepared to manage the complex social, psychological and psychiatric needs of their communities and their isolated work environment can result in burnout and high staff turnover rates. Other professionals in the community, including teachers, clergy, paramedics, and police officers also feel unprepared and unsupported in their efforts to respond to mental health crises.”

Despite these shortcomings, the project team found that rural communities have natural strengths and respond effectively to community concerns. “Families tend to be supportive of each other through difficult times, natural networks exist in small communities, and health care professionals are open to working collaboratively,” said Dr. Cornish. Other project partners are Dr. Cheri Bethune, Family Medicine; Dr. Vernon Curran, director of Academic Research and Development in the Faculty of Medicine; Dr. Lynda Younghusband, University Counselling Centre, and Dr. Elizabeth Church, Faculty of Education, Mount Saint Vincent University. Dr. Olga Heath has been hired to work with the project, which is part of the overall Interprofessional Education Curriculum being developed by Memorial’s Centre for collaborative Health Professional Education.

Dr. Callanan explained that the rural mental health program consists of six modules. The first two, delivered on-site, are interprofessional collaboration and collaborative practice in mental health and building and maintaining productive relationships with patients. The modules offered by videoconference are on stages of change/motivational interviewing for substance abuse treatment, solution focused interviewing for working with adolescents and their families, cognitive behavioural interventions for depression and anxiety, and development interprofessional assertive community treatment and crisis management programming.

“Each session has a similar structure,” said Dr. Callanan. “At the initial session, participants are introduced to the skills and content for that area through interactive presentations and modeling. Experts present and discuss their own cases, and the participants are provided with opportunities to apply and practise the skills through small group interactive activities, such as role-playing. Following this introductory session, the emphasis shifts to encourage interaction and interprofessional collaboration. A small group format used for discussing prepared cases and the cases themselves are structured so as to promote the development of an interprofessional perspective. This provides participants with the opportunity to learn more of the roles and perspectives of their colleagues and the provision of collaborative mental health care. In the final session for each module, participants are encouraged to present their own cases.

The pilot projects for this program were delivered first in Twillingate and then in Bonavista. “Participants reported a high level of confidence in their ability to work collaboratively with other professions, to deal with situations of conflict, and develop interdisciplinary care plans for patients,” said Dr. Cornish. “According to pre- and post-testing, participants increased their belief that patients receiving team care are more likely to be treated as whole persons. Of the 18 mental health issues addressed, eating disorders, addictions, sexual assault and child sexual abuse saw the largest increase in participant confidence.”

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