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My name is Max Buxton, and I am a family physician in the Ottawa Valley. Like many other primary care providers, I have at times felt overwhelmed by patients seeking help for depression and anxiety. The problem is not uniquely rural, but the lack of services available to rural patients provides an additional barrier to addressing the problem.
A relatively new service that I have found very helpful, and that my patients have come to appreciate is BounceBack.
BounceBack provides cognitive behaviour therapy through an online program, with the help of a coach who contacts your patient directly via phone or email, and guides them through a series of CBT exercises.
The program is funded by the Ontario Ministry of Health and requires a referral from a registered nurse practitioner or family physician.
Feedback from my patients to date has been universally positive, and it has given me something to offer people who may have no access to a psychiatrist, no coverage for psychologic services, and limited ability to travel.
The referral process is simple. Forms can be downloaded from bouncebackontario.ca, along with a brief screening questionnaire for the patient to complete. The referral can be faxed, emailed or submitted directly through some EMR’s. BounceBack has helped my patients with anxiety and mild to moderate depression. Maybe it can help your patients too.
The Province has rolled out new mental health resources that are proving to be very valuable in the Primary Care Sector. Many mental health problems present first in the primary care setting and Big White Wall and Bounce Back are evidence-based resources that will help support primary care patients on their path to recovery.
Big White Wall is a guided self-help peer community that supports the recovery of individuals with moderate depression and/or anxiety. The resource utilizes highly trained “Wall Guides” to moderate your patient’s experience and has demonstrated significant improvements for patients who have used the resource. While many publically funded resources have significant wait lists, this resource is immediately available to anyone with an Ontario postal code simply by signing up for the resource. Big White Wall is accessed directly by patients at https://www.bigwhitewall.com/v2/Home.aspx
Bounce Back is a coaching Intervention that is available through a Primary Care Practitioner’s referral. Developed in the U.K. and established in York Region two years ago, the program has been used by more than 80% of the physicians in the York region. Bounce Back will contact your patient within five days of referral and will deliver an intervention of telephone coaching sessions supported by workbooks developed for the patient’s specific goals. Your patient’s Telephone Coach will set up a schedule of sessions and will assess your patient’s risk and improvement at each session. Bounce Back will also link back to you to ensure the intervention is complementary to other treatment you may be providing.
You may access Bounce Back by visiting the website at http://ontario.cmha.ca/bounce-back-ontario/
Aquired Brain Injury (ABI) is an injury to the brain that occurs after birth. There are a variety of injuries that can cause ABI, and knowing what resources are available can be helpful in moving past the injury.
Living with an acquired brain injury
The brain controls everything we do—it’s the computer for our whole being! Imagine how you would feel if you sensed something was wrong with your own brain. A devastating feeling! Now, imagine you just suffered a brain injury. What would you do? Who could you talk to? The number and severity of problems resulting from a brain injury varies from person to person because each individual’s brain injury is different. A widely perceived myth is that a brain injury is simply a type of intellectual disability. People who acquire a brain injury usually retain their intellectual abilities but have difficulty controlling, coordinating and communicating their thoughts and actions.
Can the brain heal from an injury?
The healing brain has intense neuroplasticity. It is able to reshape and rebuild itself in ways we are only beginning to understand. While the initial intensity does gradually slow as healing progresses, it does not stop. With the right help, people with ABI can improve the way their brain functions, and they can often reclaim the portions of their lives that were affected by the injury. Years after brain injury, survivors are still passing incredible milestones.
Introducing Suzanne McKenna
Suzanne McKenna is a trusted and accomplished Acquired Brain Injury (ABI) System Navigator for the Champlain Community Care Access Centre (CCAC). She provides a single point of access for both individuals and caregivers living with an ABI. Suzanne also has first-hand experience as a caregiver for her 26-year old son who has lived for the last eight years with a traumatic brain injury. People living with acquired brain injuries can feel overwhelmed without the proper supports. Suzanne helps them and their caregivers to deal with difficult issues to improve their quality of life. Suzanne shares information about her role and offers hope for those with an ABI.
How can someone with a brain injury get help?
Please call the Champlain CCAC at 613-310-2222 to speak with Suzanne McKenna. You can also browse the ABI resource guide at www.champlainhealthline.ca. This guide brings together all of the ABI service providers, services and organizations available in the Champlain region into one user-friendly resource.
reposted from the Fall 2015 Health Matters magazine
After being in denial about it I hit the guilt stage. Now because I have cystic fibrosis I don’t think I will ever get over the guilt I feel. Looking at the parents of these girls I can’t help but feel guilt. Guilt that I’m still alive while their daughters were taken from them. Then came the anger stage. This stage still comes and goes in my life. The depression stage lasted a few months. Every time I felt some sort of joy the guilt would kick in that I was still here while Lisa and Jessica were not. The guilt would then put me into depression mode. It wasn’t till about 8 months later that I could fully accept that they were gone. I accepted that I could never have them back and I accepted that I would have to continue on this CF journey alone. BUT for some reason I kept going back to anger. To this day I’m still so mad. I know there’s nothing I could have done to bring them back but I couldn’t remain silent about this loss that I had. There is this empty space that will never be the same. This made me angry. I was so mad at the fact that nothing more could be done. I was mad I didn’t get the proper goodbye I would want. My mother helped me realize that I could say goodbye 104 times to these girls and it still wouldn’t be enough. Like I said before I still feel guilt. The anger is still there as well. So I decided to take my anger and use it to my advantage.
Channeling anger to make change happen
I wanted to use the anger I had and make a change. Not just for me and not just for CF patients everywhere. But for Jessica and Lisa. So I slowly started to raise my voice. I spoke publicly about CF and what it does to a person not just physically but emotionally. I was tired of people asking “WHAT IS CF” the more I heard these words the angrier it made me. So I would go on to speak more about not just CF but patient care. Some people don’t know that happiness and being healthy go hand in hand. If you have a strong attitude and a positive mindset you will see a difference in your health. Maybe not today or tomorrow or 5 weeks from now. But I know firsthand that the happier you are the more you tell your mind “I can do this” or “its ok my body is working as hard as it can” you will see a change.
For some reason my anger motivates me. My anger encourages me to speak up not just about cystic fibrosis but about all patients dealing with any illness. The reason I even got involved in patient advocacy was not for me. It is for Jessica and Lisa. It is for all CF patients. It is for all patients with any illness. It’s to recognize that every patient has a voice and a story. Not every patient will speak up. I didn’t speak up for the longest time. I thought no one would listen. The day Jessica died and 8 days later when Lisa died that was when my anger had to be dealt with. Anger towards their death. Anger towards my health. Anger towards every patient fighting every day just to have a life. I needed to do something. I could no longer sit back and watch people fall through the cracks. I took my voice and my struggle with my anger it flipped it. I flipped it to use it to my advantage.
I am at a point in life where I no longer want to watch the clock for the day I pass. I want to change the way patients and their families deal with their care. Depression is an invisible illness that more than 50% of people with an illness deal with. Some may see this as weakness. At age 14 I was diagnosed with depression. My body now depends of anti-depressants. I’m not happy about it. But it’s just another struggle that I will continue to fight with. Once again the anger towards all this motivates me. Rather than sit around being mad at the world I want to educate the world. I want to educate families, patients, doctors, nurses and anyone else dealing with health care. In a way losing my 2 friends made me a stronger person. Some days I break down. I lose sight of why I do what I do. I have to remind myself to take the anger and guilt and move forward be stronger louder more courageous than the Cystic Fibrosis. I will always have bad days. I will always have good days.
The bottom line is I write these posts and give these speeches to avoid anyone EVER being in my position. I know there will another like me someday but I want to avoid them going through the guilt and anger. I want to see patients happy even though they have an illness. Everyone deserves happiness. Especially when you are battling for your life every day.
This is dedicated to Jessica Forsyth & Lisa Lawrenson. CF warriors.
Motivational Interviewing can be an effective tool employed by health practitioners to help patients come to their own decisions and plans about quitting smoking
This webinar, provided by the Smoking Cessation Leadership Centre, in collaboration with the American Academy of Family Physicians, will:
- Describe how the “spirit” or underlying perspective of motivational interviewing can be applied to smokers
- Explain how to speak with smokers who may not be ready to quit
- Describe how to elicit “change talk” from tobacco users
Date and Registration
The webinar will take place on Wednesday, July 22, 2015 from 2 pm to 3:30 pm EDT.
To register or learn more, visit the Smoking Cessation Leadership Centre website.
There are now 8 Walk-in Counselling Clinics offering free access to therapy in Cornwall, Deep River, and across Ottawa.
New clinic locations now offer services in the following languages at these Ottawa-based organizations:
- Somali Centre for Family Services (Somali, English)
- Ottawa Community Immigrant Services Organization (Arabic, French, English)
- Ottawa Chinese Community Service Center (Mandarin, Cantonese, English)
The Walk-in Counselling Clinic provides immediate relief and professional help for people struggling with a variety of life challenges. The core service consists of a single-session, solution-oriented therapy with a professional therapist or social worker.
These services are operational seven days a week, including evenings and weekends. No referrals and no appointments are required.
For more information about this service or to request information cards for your patients, call 613-722-2225 ext. 431 or email the Coordinator at email@example.com. You can also visit the website at www.walkincounselling.com.
The Walk-in Counselling Clinic provides quick access to therapy and timely help to individuals, couples and families on a first-come, first-served basis.
This is a FREE service and is operational seven days a week, including evenings and weekends. No referrals and no appointments are required.
The core service at The Walk-in Counselling Clinic is a single-session, solution-oriented therapy with a professional therapist or social worker. The duration of the single session is between 75 to 90 minutes. People in distress who feel that they need more assistance may return for another session or can be referred for ongoing counselling.
Funded by the Champlain Local Health Integration Network, there are currently 7 clinics operating in Ottawa, Cornwall and Deep River, and more will be opening soon.
The Walk-in Counselling Clinic provides immediate relief and professional help for people struggling with a variety of life challenges: mental health issues, addiction, anxiety, depression, personal or work-related stress, crisis situations, trauma, grief and loss, separation and divorce, anger, sexual abuse (both men and women), family conflicts, intimate partner violence, relationship issues and parenting.
Research and evaluation from Ontario’s 33 walk-in counselling clinics show that:
- They provide professional help for people when they are most in need and when they are most open to change: at least 50% of clients attending single-session walk-in counselling clinics required no further services and 68% of clients reported improvement in their presenting concerns (Bhanot, Livingstone, & Stalker, 2010).
- After attending one walk-in session clients reported a reduction in stress, negative symptoms related to the problem and negative coping. They also identified increased knowledge of the problem, confidence to address the identified problem, positive coping and knowledge of resources: 91% of clients reported that they “felt hopeful after the session” and that “the session helped them to develop a plan to address the problem” (Bhanot, Livingstone, & Stalker, 2010).
- Walk-in counselling clinics have been instrumental in reducing pressure and wait times on primary and emergency care in areas of mental health and addiction services. Research at an existing walk-in counselling clinic shows that there has been a 19% client diversion from EDs and an 8% diversion from GPs offices. (Family Services Ontario, July 2011)
Learn more about The Walk-in Counselling Clinic at www.walkincounselling.com.
For more information about this service or to request information cards for patients, call 613-722-2225 ext. 431.