For some physicians, learning new skills to treat patients can be a game changer. That’s the case for Kelowna family physician Dr Jim Ketch. Learning how to more effectively treat patients with mental health issues has definitely changed his practice for the better.
Dr Ketch gained valuable skills through two learning modules from the Practice Support Program (PSP): the Adult Mental Health and the Child and Youth Mental Health (CYMH) modules, which enable physicians to screen patients more thoroughly for mental illness and to diagnose conditions that can be difficult to detect.
A joint initiative of Doctors of BC and the Ministry of Health, the PSP is a quality improvement program for physicians and their MOAs that is designed to improve clinical and practice management and to support enhanced delivery of patient care.
“The more I use it, the more I am using it,” says Dr Ketch of the Adult Mental Health module. “I’m not prescribing medications as much. I’m educating my patients to cope with depression and anxiety with tools they can use.
The module tools and resources include common screening scales, a diagnostic assessment interview tool, a tool for organizing patient issues, a cognitive-behavioural skills program, and a patient self-management workbook.
The CYMH module offers similar screening and assessment tools designed for children and youth. Module training, tools, and resources encourage and support collaboration of the various practitioners—the multi-sectoral team—who provide care for these young patients. Family physicians who complete the CYMH module training learn how to work together with child and adolescent psychiatrists, pediatricians, child and youth mental health clinicians, and school counselors in their local communities.
“Before I took this training, I had nothing,” says Dr Ketch. “Now when school counselors refer children to me, I have tools. I can assess them and figure out what to do with them. These mental health tools can be used by my patients their whole lives. So now they can be empowered to change the way they cope with life stressors and reduce their anxiety and depression.”
PSP learning modules typically involve three half-day group-learning sessions, offered locally in communities throughout the province. Each group session is followed by an action period of eight to12 weeks during which PSP participants try out what they’ve learned in their own practice. During action periods, participants receive in-practice support to ensure they get as much benefit as possible from the learning sessions, and have the guidance they need to incorporate newly acquired tools and processes into their practices.
Dr Ketch notes that adults and youth approach him differently for mental health issues. “Both modules are great, but with adults it often takes more convincing to get them to use some of the tools. At first, adults may want pills to make them better, and they’re less receptive. But once we get into it, they feel much better using the techniques they learn. With adolescents, their brains are mouldable at this age, and they can take control of their thoughts and emotions. I can show them some ways of dealing with them, and they can see the successes. But for all of my patients, these are tools they can use for the rest of their lives.”
Dr Ketch is also an instructor at UBC’s School of Medicine, working with family practice residents. He teaches them many of the lessons he learned through his PSP training.
“I’ve incorporated the Adult Mental Health and CYMH training and tools into my program in behavioural medicine, so the residents have exposure to the modules, he says. “I teach them how to screen for mental health, how to use the module materials, and even how to take care of themselves using the same tools. This way they are better able to show patients how to use them.
Dr Ketch says these treatment techniques are changing the way physicians think about many of their patients. “It’s changing the paradigms. We have to teach old docs new tricks. Both modules will give doctors more confidence, more tools to use to treat patients other than just medication. The treatment approach is not for every patient, but those who are open to it get lots of success.”