Crystal Degenhardt noticed that there were some mental health patients stuck in a cycle of hospitalization when they didn’t need to be. She wanted to find a way to prevent this cycle and thought a job opportunity at the newly formed Edmonton Southside Primary Care Network in 2005 could hold the answer.
“It can’t always be prevented but some of these patients were not getting their needs supported by their family physician, which was who we relied upon as a system when we discharged the patients from the hospital to provide the majority of the follow-up care,” explains Crystal.
“We have excellent health care in all aspects but family physicians are relied upon for mental health services and family physicians are turned to look after virtually everything. I believe mental health is seen here mainly because lack of stigma attached when you go to a family doctor’s office.”
The mental health program, now called behavioural health, was the first program started by Edmonton Southside. Crystal would receive referrals from family doctors to see their patients and meet wherever was comfortable for them – a coffee shop, a meeting room or a park.
“The kids would play and wouldn’t know what mom was talking about, which was helpful for her. We’d meet the patients wherever it needed to be to make it more accessible,” she says.
Family doctors helped bridge the relationship between Crystal and patients.
“By the fact that the physician, a trusted medical provider, had already referred them to us made it very easy to have the patient open up when they were ready,” she says.
The first four mental health coordinators covered 13 clinics and received four referrals in their first month in October 2005, which grew to 100 referrals per month within a year.
In 2008, a workshop called Changeways® was introduced to the PCN that focused on providing coping strategies for depression and anxiety.
“Depression and anxiety are the top two reasons for a referral for mental health assistance. For the majority of us, cognitive behavioural therapy, which is the therapy base of Changeways®, is the most appropriate form of treatment for patients to develop coping strategies with their mood,” says Crystal.
She adds patients are most likely to engage in coping and learning strategies within a group.
“It takes down the stigma that they are on their own. It shows that there are others out there so they are not feeling so alone. They can listen to the answers of others, go home and try the strategies on their own. They also have a safe place to discuss the strategies they’ve tried and have honest feedback from others who have also had the same barriers,” says Crystal.
Since the PCN was established, she has noticed an improvement to mental health services.
“Now I see the system is responding more to the need of mental health services to be more accessible. We take more of a behavioural focus on how we can help patients participate in the changes that need to happen to maintain and stabilize their health,” she says.