When first surveyed in 2012, members of the VDFP identified mental health and substance use (MHSU) care as the top issue requiring attention and improvement. Since then, the Division has maintained MHSU care access as a strategic priority. In 2015, the Victoria Division, in collaboration with Island Health and the South Island Division of Family Practice, launched a comprehensive Shared Care initiative to take further action on priorities and solutions recommended by the working group. This initiative, which will run until at least the end of September 2016, is composed of four main strategies:
1. Improving MHSU care in GP offices: This strategy works to help GPs to better identify, diagnose and treat MHSU conditions in a regular office visit. Key activities have been a Learning Series in which people with lived experience, specialists, fellow GPs, and allied mental health professionals provide training to GPs on topics including addictions medicine, cultural safety, youth MHSU, and more. Click here to watch videos of a recent Learning Series event.
2. Cognitive Behavioural Therapy (CBT) Group Medical Visits (GMVs): Through this work we are developing a collaborative model of care where psychiatrists and GPs co-facilitate group visits teaching skills based in CBT. It both fills a service gap, providing people with mild-moderate depression and anxiety with low-barrier access to care, and supports collaborative practice between GPs and psychiatrists. As of June 2016, over 800 people have participated in the CBT groups, and early evaluation results indicate significant clinical improvement as well as strong individual satisfaction.
3. RACE: As part of a larger roll-out of RACE in the South Island, GPs can now have Rapid Access to Consultative Expertise with local (Victoria-based) adult and child & youth psychiatrists. Click here to learn more about RACE.
4. Island Health partnership: The MHSU care access working group recognized early in its process the necessity of partnering with Island Health (IH) MHSU to improve referral processes, collaborative care, and patients’ access to services beyond community-based primary care. GPs worked with IH to revise the referral form to adult MHSU services, and to contribute to the process of developing a South Island Crisis Service. At present, we are working together to determine how best to integrate the work of GPs and MHSU clinicians, and how to support GPs in the community to take on and care for patients with MHSU concerns.