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Description: You have no doubt heard about the difficulty small towns and rural or northern communities face in recruiting and retaining doctors, but have you heard or wondered about whether this same issues plays out in relation to mental health and mental illness related services? In Canada over one third of psychiatrists (physicians specializing in treating mental issues and illness) practice in either Vancouver, Toronto, or Montreal. This along with the general finding that rates of mental illness increase with latitude (see references below) means this is an important issue. Think a bit about how this issue might be addressed and try and go beyond just providing Northern living allowances. Once you have your thoughts in order read the article linked below to see how your proposals line up with things that are currently being implemented in Canada.

Source: Canada grapples with challenge of drawing psychiatrists to small towns from big cities, Erin Anderssen, The Globe and Mail.

Date: January 20, 2020

Photo Credit:  Tumisu from Pixabay

Article Link:  https://www.theglobeandmail.com/canada/article-canada-grapples-with-challenge-of-drawing-psychiatrists-to-small-towns/

So, had you come up with northern recruiting and training, training rotations in northern settings or teletherapy as possible ways of addressing this issue?  In addition to those approaches did you note the mention in the article of the importance of team-based approaches to providing mental health care? Such teams can include individuals from a number of professions (including psychologists) in ways that both enhance care and treatment as well as reducing concerns over professional isolation. The idea of teletherapy as a standard part of all psychiatric (and perhaps also of clinical psychological) practices is intriguing though it would be good to know more about the efficacy of such approaches before advocating strongly for it becoming part of standard practice.

Questions for Discussion:

  1. What are some of the impediments to recruiting mental health professionals to work in northern regions?
  2. How might the impediments noted above be addressed (beyond just paying people more)?
  3. What sorts of things (research) would you like know about teletherapy before feeling comfortable with the suggestion that it become a standard part of all psychiatric and clinical psychological practice?

References (Read Further):

Saha, S., Chant, D. C., Welham, J. L., & McGrath, J. J. (2006). The incidence and prevalence of schizophrenia varies with latitude. Acta Psychiatrica Scandinavica, 114(1), 36-39. http://www.academia.edu/download/49344041/j.1600-0447.2005.00742.x20161004-25807-1k35nrw.pdf

Mersch, P. P. A., Middendorp, H. M., Bouhuys, A. L., Beersma, D. G., & van den Hoofdakker, R. H. (1999). Seasonal affective disorder and latitude: a review of the literature. Journal of affective disorders, 53(1), 35-48. https://www.rug.nl/research/portal/files/6657738/1999JAffectDisordMersch.pdf

Martin, A. C. (2013). Legal, clinical, and ethical issues in teletherapy. JS Scharff. Psychoanalysis online, 75-84. http://www.academia.edu/download/36268160/Psychoanalysis_Online.pdf#page=97

Tutty, S., Spangler, D. L., Poppleton, L. E., Ludman, E. J., & Simon, G. E. (2010). Evaluating the effectiveness of cognitive-behavioral teletherapy in depressed adults. Behavior therapy, 41(2), 229-236. https://henry-health.com/wp-content/uploads/2020/01/Teletherapy-Efficacy.pdf

Turgoose, D., Ashwick, R., & Murphy, D. (2018). Systematic review of lessons learned from delivering tele-therapy to veterans with post-traumatic stress disorder. Journal of telemedicine and telecare, 24(9), 575-585. https://www.kcl.ac.uk/kcmhr/publications/assetfiles/2017/Turgoose2017.pdf

Waska, R. (2015). Psychoanalysis Online: Mental Health, Teletherapy and Training. https://psychotherapy.psychiatryonline.org/doi/full/10.1176/appi.psychotherapy.2015.69.1.87

van den Berg, N., Grabe, H. J., Freyberger, H. J., & Hoffmann, W. (2011). A telephone-and text-message based telemedical care concept for patients with mental health disorders-study protocol for a randomized, controlled study design. BMC psychiatry, 11(1), 30. https://bmcpsychiatry.biomedcentral.com/articles/10.1186/1471-244X-11-30

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