Tag: psychiatric services

Reading of the Week: The Future of Psychiatry – Part I of II

December 2, 2016 /

From the Editor

Should mental health clinicians embrace measurement-based care? Or is mental health becoming too technical (and forgetting patients as a result)?

The future?

When we speak about the future of mental health, we often think in terms of biomarkers and genetically-tailored drugs. And while they may be part of the distant future, can we improve clinical work in the near future?

Over the next two weeks, we will mull the future of psychiatry in terms of practice and measurement-based care. Measurement-based care has been defined simply by Scott and Lewis as “practice of basing clinical care on client data collected throughout treatment.”

This week, measurement-based care.

Next week, the end of the art of care?

While these two Readings were published in two different journals, they seek to address the future of the field, perhaps in somewhat contrasting ways.

This week, we look at a new paper published in the Psychiatric Services that offers a review of measurement-based care studies.

DG Continue reading

Reading of the Week: First Episode Psychosis and Access – The Anderson-Kurdyak Paper, and More

October 20, 2016 /

From the Editor

“If your son or daughter had cancer or diabetes, do you think it would be reasonable for them to wait? I don’t think it’s any different for mental illness.”

Access. It’s one of the biggest problems with mental health services.

How big is the access problem? What can be done about it?

This week, we consider a new paper looking at access and first episode psychosis. Dr. Paul Kurdyak, a CAMH psychiatrist and a program lead with the Institute for Clinical Evaluative Sciences, made the above comment to the CBC when discussing this new paper. In it, Kelly Anderson and Dr. Kurdyak find that 40% of patients didn’t receive physician follow-up in the month after diagnosis. Imagine – tying back to Dr. Kurdyak’s comment – if 40% of young patients with leukemia didn’t have physician follow-up in a month after their cancer diagnosis.

We also look at the discussion around a new federal-provincial accord with an op ed written by Michael Wilson, the chair of the Mental Health Commission of Canada – particularly timely as the ministers of health met this week with an eye on a new accord.

DG Continue reading

Reading of the Week: What’s New in Psychotherapy – Paul Garfinkel’s Book

October 6, 2016 /

From the Editor

What’s new in psychotherapy?

Psychotherapy is an area of psychiatry transformed over the past years.

Dr. Aaron Beck: not a Freudian

Last week, we looked at a major new paper on IPT. This week, we return to Dr. Paul Garfinkel’s book – the source of two past Readings – for an excellent chapter on psychotherapy.

Last week. A major new review of IPT.

This week. An overview of psychotherapy developments.

This chapter describes the evolution of psychotherapy, and its importance. It also notes the excellent opportunity for the mental health field – to embrace evidence-based treatments and to offer better care for our patients.

DG Continue reading

Reading of the Week: Kurdyak’s New Paper on Access

September 22, 2016 /

From the Editor

As medical school classes have grown, the supply of physicians has increased across the country. Has this helped address access issues in psychiatry?

How have practice patterns changed over time?

This week’s Reading seeks to answer some basic and important questions around physician supply and access in psychiatry. Following up on a major paper written in 2014, Kurdyak et al. have written another important and relevant paper.

The long and the short of it: there are significant problems with access – and they aren’t getting any better with time.

DG Continue reading

Reading of the Week: Hospitalizations and Ethnicity (and Stigma)

August 25, 2016 /

From the Editor

Younger and sicker.

This week, we look at a new paper published in The Journal of Clinical Psychiatry considering ethnicity and hospitalizations. Drawing on Ontario data, researchers looked at psychiatric hospitalizations for people of Chinese and South Asian descent, finding that they were younger and more ill at the time of admission.

Hospitalizations, ethnicity… and access

Lead author Maria Chiu of the Institute for Clinical Evaluative Sciences told the Toronto Star:

Cultural factors play a big role in these findings. While Asian people tend to have stronger family support, they are also faced with a higher level of stigma and it prevents people from seeking help early. Families may try to cope and keep the illness within the family until there is no choice but to go to hospital.

This paper is well designed. It’s also important, speaking to larger issues about access, stigma, and ethnicity.

DG Continue reading

Reading of the Week: Dr. Kurdyak’s Paper on Psychiatry and Practice

April 16, 2015 /

A few months ago, a patient walked into my office and immediately broke down. He explained that he had waited so long to see a psychiatrist that he was overwhelmed to finally meet me. For the record, he had never spoken to me before and knew nothing about me – except that I was a psychiatrist and that he needed to see one.

The surprise is that anyone would be surprised by such a story.

Patients often face long wait lists in our health care system. The wait for psychiatric care seems particularly long. But here’s the question: do we have a shortage of psychiatrists in Ontario – or do we have a shortage of creative thinking on how psychiatrists practice in Ontario? The week’s Reading asks this important question, with a surprising conclusion: “increasing psychiatrist supply will have little impact on patients’ access.” Continue reading