Addictions and Mental Health Integration: Focus on Shared Care Discussions Project

For primary care providers and mental health and addictions specialists, that feeling is the same. Often, primary care providers are unsure where to send referrals to help their patients receive support. Specialists in the community are often overwhelmed with numerous referrals that have been shared with multiple services, but lack enough information to help easily identify which service or support is best positioned to help move the referral forward.

Despite a high desire to offer the best care , providers often  feel frustrated and overwhelmed by a system that is siloed and not efficient. To help address this system issue, provide a new way of delivering more connected care and facilitate access as part of the work of the Frontenac, Lennox & Addington Ontario Health Team (FLA OHT), the Addictions and Mental Health Integration Group has been focused on creating Shared Care Discussions that will be in place with all interested Health Homes.

Through Shared Care Discussions, primary care providers and addictions and mental health specialists come together at a regularly scheduled meeting to review details of a patient’s situation. Together, they collaboratively determine which service is the best fit.

“With Shared Care Discussions we want to break down barriers between providers and specialists in the community and build awareness, trust and collaboration to help ensure we are connecting the right resource to the right person,” says Dawn Downey, Project Manager of the Addictions and Mental Health Integration Advisory Group. “Essentially, we want to move away from the current system of relying on multiple paperwork referrals and instead replace that with good conversation with everyone involved in a person’s care.”

Already, Shared Care Discussions are being rolled out across the FLA OHT region. From the practices that have begun implementing these discussions, the feedback has been positive.  

“I feel that the Shared Care Discussions are extremely beneficial and embody the essence of collaborative care.  Through direct communication, I believe we are providing a stronger network of support for clients and their families.  As such I believe we are improving quality and efficiency in terms of service provision,” says one primary care provider.

The feeling of transparency and network building is echoed from the mental health and addictions specialists who participate in these discussions.  

“These meetings have felt invaluable in creating a collaborative network of primary care providers and mental health service providers. I have found the lines of communication with other mental health agencies and with family medicine specialists/nurse practitioners to have opened considerably, and I can only attribute this positive change to the relationships being built through regular Shared Care Discussions. This opportunity to brainstorm together and navigate the system on behalf of our most vulnerable and high needs clients feels like a great step toward reducing barriers and has felt very rewarding and encouraging.”

Shared Care Discussions last up to an hour and are held virtually. They are attended by representatives from Kingston Health Sciences Centre – Hotel Dieu Hospital site, Providence Care, Addictions and Mental Health Services – KFLA, Maltby Centre and, depending on the organization that is participating in the discussion, social workers from the Rural Frontenac Lennox and Addington Allied Health Team.

Each of the discussions are facilitated by trained clinicians who developed relationships with providers and other mental health and addictions specialists and is part of a community of practice that is committed to holistic person and family centred care, respect, equity, inclusiveness and privacy.

“We’re helping to make meaningful connection,” says Gord Unsworth, a Shared Care Discussion facilitator and Community Team Manager at Providence Care. “Through our discussions we increase awareness for providers who may not know about a patient that is receiving our support already; we’re also helping the primary care providers know about what resources are available and which one is most appropriate for a particular patients need and can often do immediate follow up for that patient after our discussion. We’ve also been able to create truly collaborative relationships with the community services and increase awareness of which of us is best positioned to support any particular referral.”

In fact, just prior to the conversation held with Gord for the purpose of this article, he was contacted by a primary care provider who had a time-sensitive need for a patient and wanted to have help before their next planned Shared Care Discussion. This is a situation that likely would not have occurred before the introduction of Shared Care Discussions.

“Now that we’ve started the discussions at this practice, the provider knows who I am and has a better understanding of the services I’m able to provide and we have that relationship established where they can reach out directly to me instead of sending referrals to multiple services,” says Gord. “I’m now going to be able to contact my colleague at another agency who will also be able to help address a particular need of this situation because I’m now familiar with who the right contact is and what they are also able to provide.”

Now that the framework for Shared Care Discussions has been set, the Addictions and Mental Health Integration working group is focused on continuing roll out across the region, sustainability and standardizing a consistent approach to how facilitators are oriented to the role.

If you are interested in learning how you can include Shared Care Discussions into your practice, please contact Gord Unsworth at 613-530-2400.