The Globe and Mail looks at businesses, services and other projects in British Columbia that aren't often talked about because they actually work.
Medical officials at the University of Victoria are bringing the race-car "pit crew" model to mental health, ensuring students see family doctors and psychiatrists at the same time as part of an innovative program that has cut waiting times for counselling services in half.
Dr. Marilyn Thorpe, who oversees the psychiatry unit at the university, says the project, which began as an experiment with 40 students in 2014, brings the family doctor, psychiatrist and patient together to talk about diagnosis, medication and other treatment.
"Instead of making patients go from one professional to another," Dr. Thorpe says, "we should descend on the patient like a pit crew in a race and treat the patient together and make decisions together."
Dr. Thorpe was inspired by a 2012 TED Talk by Dr. Atul Gawande to create the Psychiatrist-led Interdisciplinary Team, or PIT. The original 40 students were on the university's wait list for mental-health services. In only three weeks, 36 of the students saw a psychiatrist and the remaining four were identified as needing additional psychiatric evaluation.
Before the PIT experiment, the average wait for a full psychiatric consultation at the University of Victoria was 43 days, with some patients waiting as long as nine months.
Half of the patients sitting on the wait list didn't require a full psychiatric consultation, which includes an evaluation of their medical history and their family's history.
"You don't need all of that if your problem is, 'I know this person's depressed and this medication isn't quite doing it,'" Dr. Thorpe says.
Now, the wait time has been reduced to 23 days for a full psychiatric consultation and 11 days for a PIT team appointment.
During a PIT appointment, the psychiatrist and the family doctor meet briefly to review the file before being joined by the patient for a 20-minute appointment where all three collaborate on a treatment plan.
"It's way more comfortable for patients," Dr. Thorpe says. "Patients feel like there's a team looking after them and they feel more a part of something as opposed to when you come to see a psychiatrist and you're scared out of your mind."
Dr. Thorpe says it saves time for everyone involved. Because most patients don't require a full psychiatric consultation, psychiatrists are freed up to see more patients. They also benefit from the family physician's knowledge of the patient's medical history. Dr. Thorpe says the integrated approach gives physicians insight into how to provide mental-health treatment to their patients.
She says it's also a huge cost-saver. The cost of a 30-minute PIT appointment is half that of an hour-long psychiatric consultation. The psychiatry unit was able to put the funding they received from a joint committee of Doctors of BC and the provincial Health Ministry toward a full-time mental health nurse and additional short-term therapy."
It's been a morale booster for everyone involved.
"There's high job satisfaction and it has really built a team," Dr. Thorpe says. "There's a lot more talking back and forth and a lot more get our heads together and figure out what we can do."
Joel Lynn, the director of student services at UVic, thinks the new approach will help students even after they graduate.
"We have a role to play in helping students discover what mental health might mean for them, especially those that have acute needs," Mr. Lynn says. He says when students arrive at university "they will be discovering for the first time what resources they might need to be successful as a student and beyond."
Maxwell Nicholson learned about the PIT crews' success about a month ago. As the director of campaigns for UVic's student union, he's now focused on raising awareness of the mental health services offered at the university.
"There is a problem with mental health and with stigma," Mr. Nicholson says. "We can play a role as a student society in highlighting the resources."
Dr. Thorpe says it's a model that can be brought to other universities and to provincial health care but there are a few policy roadblocks in the way.
In British Columbia, family doctors who are not salaried are only paid for four 30-minute counselling sessions a patient a year. There would have to be a change in the billing code for family doctors to take on more counselling responsibilities when a psychiatric consultation is not needed.