Practice Support Program – working together for better mental health services for children and youth

Focusing initially on family doctors and their medical office assistants, the Practice Support Program (PSP)is increasingly involving the broader community and patients.

The PSP provides doctors and clinicians with tools for improvement in a number of areas, ranging from office efficiency to end-of-life planning and a range of other topics (see GPSC summary below). They are currently finalizing a training module for doctors in coordination with specialist services and schools to help better address child and youth mental health disorders including depression, ADHD, and anxiety.

“We’re recognizing that if you want to tackle a problem you can’t just focus on the family physician and practice staff – you need to go much broader,” says Liza Kallstrom, Practice Support Program Lead. “The vast majority of mental health conditions have their onset when the brain is still developing, and they can respond to treatment with positive long-term outcomes. We have a real opportunity to change the trajectory of mental health in the province.”

The module was introduced to family doctors, clinicians, school counselors and members of the Ministry of Child and Family Development (MCFD) at a “Train the Trainer” session in October. Four PVN members attended the two day session, one of whom was Judy of Victoria. Judy deals with child/youth mental health issues on a daily basis, so when the call went out for a patient perspective on this training module she made sure to respond.

“Having the schools there was pretty innovative,” says Judy. “Instead of the doctor being the centre of care, the patient is the centre. The modules help the doctor identify other people in the child’s life who are to be able to help as part of a team.”

Since the module focuses on mild to moderate conditions, the General Practice Services Committee (which operates PSP) hopes that one positive outcome of this module will be to alleviate pressure on the specialty services provided by MCFD. By treating mild to moderate cases effectively in the family doctor’s office, this can decrease wait times for conditions that are more severe.

“Any school counselor will tell you there isn’t anywhere to refer students besides the MCFD,” says Liza. “And family physicians say they are not trained in managing mental health conditions in the primary care office.”

“There aren’t a lot of specialists that work in child and youth mental health. It’s tough getting referred to the right place,” adds Judy. “This is a good first step to have a resource so it’s possible to start working on a comprehensive basis.”

The training module development was led by Dr. Stanley Kutcher, an expert in the area of child and adolescent mental health, and a national and international leader in mental health research, advocacy, training, policy, and health services innovation. Prior to the October session, a portion of the module content addressing teen depression was tested in Killarney Secondary School in Vancouver.

“They had phenomenal support from the school counselors and about 12 physicians who got to try the tools and evaluate them,” Liza told us. “It was a small prototype but very successful. They ended up meeting all the needs of the school.”

Participants in the session praised organizers for the level of interaction and encouragement to collaborate between disciplines. Attendees were encouraged to talk about what they currently experience in their community and how they envision things being improved.

“The way its organized and developed by their peers is actually really useful for doctors and a  practical tool to have in their office. It’s very friendly,” says Judy.

Once the content for the training modules has been finalized, physician mentors and practice leaders will be trained to deliver the module in any community around the province, supported by PSP coordinators. For more information on these and other PSP initiatives, visit the PSP and GPSC websites.

The Practice Support Program is an initiative of the General Practice Services Committee, which is a partnership between the BC Medical Association and the Ministry of Health. For more information about the PSP and its learning modules, visit the GPSC's website.