Page 65 - 2017-2018 Department of Psychiatry Annual Report

1. Establishing appropriate clinical clinical exposure across the spectrum develop a plan for flow out of our
oversight at intake: The intake team of psychiatric conditions, and peer- service to manage our growing
at all clinic sites will include a triad peer learning. In addition, we have patient cohort. Via a joint effort
of clerical staff, clinical staff, and restructured the senior resident between R&I psychiatrists and
psychiatry. shared care rotation to include managers, we created discharge
provision of telehealth consultative planning guidelines to benchmark
2. Implementing open psychiatry services (under the supervision of which patients could be transitioned
booking: Each FTE psychiatry Dr. Brian Burke) to the EZ and NZ back to primary care and in turn, a
position will provide a minimum of CMH&A programs. Together, our five process for them to return should
three static weekly calendar blocks clinic sites provide clinical teaching they again become unwell. We also
for new assessments to the intake placements for nursing students, undertook a clinical review of all
team. psychology students, social work patients to better define their clinical
students, occupational therapy needs. This revealed that the needs
3. Coordinating psychiatry job plans: students, medical students, family of about 20 per cent of our patients
Psychiatry new assessment blocks medicine residents, as well as junior could be equally well met in primary
will be reviewed each quarter as and senior psychiatry residents. care, or with a community mental
part of each team’s job planning to We would like to thank the Bayers health clinic. We have begun to
allow coordination of psychiatry and Road, Dartmouth City, Cole Harbour, meet and work with colleagues in
clinician schedules to facilitate greater Bedford/Sackville and West Hants community mental health to open
clinician-psychiatry collaboration.
Teams for their flexibility, effort, time up lines of patient flow between our
Despite our own resource challenges, and dedication to student teaching. two services. It is anticipated that the
psychiatric resource shortages current shortage of family physicians
in other zones have become a Recovery and Integration in Nova Scotia will make the transfer
serious access and equity issue Recovery and Integration (R&I) of patients back to primary care
for patients and families across the continued to provide recovery difficult.
province. In response to the need focused clinical care and A decision was finally reached late
for psychiatric consultative services psychosocial support to people living this fiscal year about how the unused
in rural areas, Central Zone CMH&A in our community with a persisting beds at Simpson Landing could best
is partnering with the Eastern Zone psychotic disorder and functional be utilized. Originally designed for 40
(EZ) and Northern Zone (NZ) CMH&A impairment. patients, the unit has only used 15-20
Programs to provide psychiatry beds for several years. The other half
consultative services via telehealth During the past year our of this facility has been effectively
from the Bayers Road CMH&A Clinic. psychological services team mothballed awaiting government
One component of this initiative, continued to grow and flourish. We approval of a proposal to redeploy the
led by Dr. Brian Burke, includes were able to provide psychological excess human resource and space.
one-time psychiatric consultative assessments, individual Cognitive More than three years ago we asked
services to family physicians or nurse Behavioural Therapy (CBT), and for approval to use this facility to
practitioners within EZ or NZ who group interventions focusing enhance our outpatient service and
are available to provide ongoing care on hearing voices, anxiety, and offer community-based psychosocial
and monitoring for the patient before resilience. Two of our patients that support to more patients. The
and after the consultation. Another participated in the hearing voices decision has been made to move the
component of the initiative, led by Dr. group at Connections now co-lead a addictions unit into the unused side
Anand Natarajan, includes psychiatric peer-led hearing voices group in the of Simpson Landing. This should
consultation to patients with severe community. In total about 130 patients offer opportunities for enhanced
and persistent mental illness followed have accessed these services which access to addictions expertise for
by the NZ CMH&A team. Both represents 20-25 per cent of all the both Simpson Landing patients and
components of the initiative are being patients we follow. Late in the year staff. It is still unclear whether we will
embedded within a sustainability we lost our primary therapist to a be able to use the excess nursing
framework within the Bayers Road research job, affecting capacity, resource at our outpatient services.
package of MH&A services. although we have begun to train two
other clinicians from the service in The availability of this resource would
In collaboration with the postgraduate CBT. allow us to move forward with the
education office, we have reorganized new clinical model we developed 18
student clinical placements in For the past several years we months ago.
CMH&A to maximize the opportunity have put effort into creating good
for learners to benefit from direct transitions into the R&I service. This
psychiatry clinical teaching, increased year the biggest challenge was to

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