25 Victoria Shared Care

5th National Conference on Shared Mental Health Care: 

5th National Conference on Shared Mental Health Care June 4, 2004 2:00 pm – 3:00 pm W1d – Victoria Shared Care Initiatives: Langford Presenter: Dr. R. Weinerman (Victoria, British Columbia)

VICTORIA SHARED CARE INITIATIVES: 

VICTORIA SHARED CARE INITIATIVES What can be done with few resources and a few good people

2 PROGRAMS: 

2 PROGRAMS INDEPENDENT VIHA 1 psych each -Langford -Saan Pen -Aboriginal -Dtn Faith Community -2 psych-Salt Spring Island CHRONIC DISEASE INITIATIVE DEPRESSION Federally funded 1 psych/1 therapist each -Langford -Downtown

Staff from Urgent Short Term Assessment and Treatment (USTAT) Service: 

Staff from Urgent Short Term Assessment and Treatment (USTAT) Service Medical Director- Rivian Weinerman .2FTE Coordinator-Bob McKechnie MSW Psychiatrists- Drs. Helen Campbell, Mia Korn, Rif Kamil, Mike Kovacs, Nick Sladen-Dew, J. Sacamano- .1FTE each or more Therapists-for Health Transition Fund, Chronic Disease Initiative-Chronic Depression-Jan Stretch, Hersh Kline, Magee Miller - .1FTE each TOTAL- Medical Director and Coordinator Psychiatrists .7-1.0 FTE Therapists .3 FTE

LANGFORD: 

LANGFORD Resources -one psychiatrist -one clinic with 30 family docs -one board room with a phone situated on the second floor of a 3 story clinic -only 2 other family docs were interested that did not belong to clinic

Slide6: 

Process -needs assessment meeting was held -residual anger at 5 yr earlier loss of satellite clinic quite intense-unresolved -wanted on site help, but angry at overhead expense not paid by psychiatrist, angry at request for space, angry at not being paid to talk with psychiatrist -left meeting with no resolution -after a few months, letter sent out asking who might be interested still

Slide7: 

-about 8 docs responded, most at St. Anthony’s clinic -luncheon arranged paid by Lilly -6 St. Anthony docs came --wanted one time consults --wanted some telephone availability --wanted some drop in consultation --wanted report as soon as possible --pts would be sent down with chart report would be typed on my laptop that day put on disc and handed into office

Slide8: 

-all agreed they would cover costs of board room to be place where patients seen -sheet passed around for names which would then be the rota -I sent a schedule to each office for MOA to post outlining the parameters of responsibility as well-what it was and what it was not

Slide9: 

Problems -Communication between docs and their MOAs varied -Therefore, sometimes there was no patient called and sent for the appointment - 5% Puzzles No one telephoned during the 1 hr available -only 2 drop ins and these from docs who had not yet signed up

Slide10: 

Successes -95% of time slots filled -patients covered non psychotic spectrum -patients were complex and requests were at point family doc had reached end of the road -evaluations were 100% positive, not wanting the service to end, appreciating the consultation, liking that their patients avoided stigma, and did not have to travel long distance,

Slide11: 

Puzzles -no telephone inquiries -no drop ins -on evaluation drop ins still wanted -on evaluation none felt they had learnt anything much new except perhaps a better understanding of the particular patient, and help for that particular pt, but nothing to extend to others in particular.

Slide12: 

Future plans -continue service condensed into one half day a week -same number of patients to be seen -6 more docs have joined - having watched the traffic and wanted some of the help -issue of VIHA changes - change happens