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Faster access to urgent psychiatric care in Pictou County

Dr. Vienneau

Patients needing urgent psychiatric care in Pictou County can now be seen by a psychiatrist within two business days thanks to a new Urgent Psychiatric Care Clinic at Aberdeen Hospital.

The new Urgent Psychiatric Care Clinic, led by Psychiatry and supported by the Crisis Response Team, is embedded within the existing model of emergency psychiatry/Crisis Response Service. Emergency mental health concerns will continue to be assessed through the emergency department and/or Crisis Response Service. However, if patients do not need an emergency level of care but do have urgent mental health needs, the Crisis Response Service immediately refers the patient to the Urgent Psychiatric Care clinic for assessment and follow-up.

The new model was prompted in part by the closing of the inpatient mental health unit at Aberdeen Hospital in August 2015. Dr. Theresa Vienneau, Head of Psychiatry, Northern Zone (Colchester-East Hants, Cumberland and Pictou areas), along with local and provincial leadership, began to explore ways to support the citizens of Pictou County in light of the closure.

“Many of the patients we see and eventually follow will have their first presentation to an emergency department. They aren’t yet linked with mental health services; therefore it becomes incredibly important to ensure continuous follow-up from that point,” said Vienneau.

“Between the emergency department assessment and the treatment provided by traditional outpatient clinics, there really was no service in the middle where we could see people that have urgent needs. A service that provides rapid access to psychiatric assessment and treatment was seen as important to explore.”

Vienneau looked at the literature to see what models existed. “We wanted to get it right. It had to be aligned with best practice and aligned with what the literature tells us in terms of evidence-based care for patients experiencing a mental health crisis.”

The model of an urgent psychiatric care service embedded in a crisis response service emerged as a front-runner.

Working closely with her co-lead, Robert Graham, Director of Mental Health and Addictions for Northern Zone, “We hired an independent consultant to do a thorough review so we’d be able to identify the vital elements of a crisis response service,” said Vienneau. The consultant’s report supported having an urgent psychiatric care clinic embedded within a crisis response service.

Planning for the service began early in 2016. The clinic began seeing patients on February 6, 2017. Appointments are available every day from Monday to Friday. Patients referred from the Crisis Response Team are interviewed by a psychiatrist, with crisis clinicians present as well. These clinicians can also follow up with telephone check-ins, telephone coaching or additional appointments.

In addition to being timely and responsive, “It’s a patient-centred recovery approach that also includes involvement of family and support members,” said Vienneau. Patients are encouraged to bring their family or support members with them to appointments.

Vienneau sees the greatest benefit of the clinic as bridging patients “between that very difficult time that they seek help for a mental health crisis until the time when the crisis is resolved. It supports the person to the point where they can take over aspects of their own functioning and feel adequately supported through traditional outpatient follow-up, a family doctor or other supports.”

The clinic recorded 14 visits in February, 35 in March, 26 in April and 34 in May for a total of 109 visits so far. The service is tracking data about the number of patients, characteristics, time to be seen, and referral source. They also ask each patient to complete a satisfaction questionnaire to gauge experience and help inform future improvements.

While the group hasn’t yet completed a formal review of questionnaires, Dr. Vienneau said, “Patients have been incredibly grateful.”