Mental Illness: Teamwork in Service DeliveryIf you have a mental illness, you are not alone. There is hope and there is help.
Anxiety, depression, manic depression, schizophrenia, addictions, phobias, Alzheimer Disease, eating disorders--all are forms of mental illness, which are treated across the country by people who make up interdisciplinary health care teams. This team-based approach to service delivery is designed to ensure that you receive coordinated, quality care.
The team involves many people, depending on your needs and wishes. Along with you, the team may include family members and friends, the psychiatrist, the psychiatric nurse, the psychologist, the social worker, the occupational or recreational therapist, self-help, support, and other community groups.
The team will work together to provide treatment to control your illness and its symptoms. The plan should never make you dependent on your therapist, but should strive to maintain your individuality and personal autonomy.
The Treatment and Support TeamThe Person with the Mental Illness
The important thing to remember is that teamwork is essential in the treatment of mental illness. If you are ill, you will be the central player on the team. You will play a key role in your treatment and recovery, and you can participate actively in the decision-making process.
To do this, ask questions. Pay attention to how you feel. Be honest about your feelings. Other team members may not be aware of the meaning that you give to words or labels, so it is important that you let them know if you feel confused or offended by descriptions of your symptoms or treatment. Seek information from health care providers, self-help groups, support groups, or your library. Work with therapists governed by regulated professional bodies to ensure that you receive quality care. Know what the treatment options are and make your own informed decisions.
A person with mental illness has the right to choose a therapist who he or she trusts and with whom he or she can communicate.
The Family Doctor
The family doctor is most often the first person you will see. Your doctor will listen to you carefully and may start diagnosis and treatment. Or, he or she may refer you to mental health professionals and/or provide you with information about services in your community.
After treatment begins, the family doctor continues to act as a resource for you, your family members, and friends. He or she can also work with other members of the service delivery team and, in some cases, prescribe and monitor the ongoing use of medication.
A medical doctor who has specialized in psychiatry can be your primary therapist or act as a consultant to the treatment team. Some psychiatrists are generalists, while others specialize in the unique problems of children, adolescents, or the elderly. Psychiatrists may also choose to focus their expertise on specific conditions such as schizophrenia, addiction, and depression. They can provide many forms of help for mental illnesses, in different combinations.
Medication may be used to control symptoms in people with severe psychosis, balance moods in people with depression, or help people overcome phobias. Even when medication is the primary source of treatment, it should always be accompanied by some form of psychotherapy. Psychotherapy assists people with mental illnesses and is designed to increase their self-confidence and self-esteem.
The Psychiatric Nurse
The psychiatric nurse plays a strong role in coordinating patient care, whether it be in a hospital setting or in the community. He or she is able to assess your problems and provide nursing care and support.
Because of their close contact with people with mental illnesses, psychiatric nurses will often be key in helping you beyond the point of crisis to where you can live more independently.
The psychologist works with you, your family members, and friends to assess and treat mental illness. They can be well trained in a range of psychotherapies such as cognitive therapy and behaviour modification, which complement the skills and expertise of the psychiatrist.
When your treatment involves both psychotherapy and medication, the psychologist may provide the psychotherapy, but will refer you to a psychiatrist or family doctor who would be able to prescribe and monitor medication.
The psychologist has a community focus and works closely with other members of the team to provide effective mental health services.
The Social Worker
The social worker is a valuable member of the team, with special expertise in understanding people in their social context. They act as links among you, your family members, and community resources such as health care support, employment services, training programmes, and housing services. This link will help you reestablish yourself in the community or workplace.
The social worker also helps family members to achieve a better understanding of your needs, develop a more supportive social environment, and cope with their own emotions and concerns related to your diagnosis and treatment. It is common for both the person with the mental illness and the family members to go through a grieving process, and the social worker is equipped to help them through this difficult time.
The Occupational and Recreational Therapists
The occupational or recreational therapist forms partnerships with you and other members of the team to improve your quality of life. He or she promotes mental health by enhancing your ability to function in self-care or leisure activities, and at work or school.
The occupational therapist provides skills training, showing you different ways of coping with the demands of your daily routine.
The recreational therapist helps you develop leisure skills, promotes recreational activities, and plans programmes geared toward enhancing community mental health.
Family Members and Friends
Family members and friends who offer unconditional support to people with mental illnesses can be invaluable in the healing process. And, they are often in a good position to do this. While emotional support is critical, other forms of assistance such as helping you keep appointments or monitoring medication can be just as helpful.
Family members and friends can also offer health care professionals information that you may or may not be able to provide. For example, they can note changes in your behaviour or attitude, something that can be extremely beneficial in determining the effectiveness of the treatment approach.
By learning as much as they can about the illness from you, from health care professionals and other resources, family members and friends can become supportive team members.
Self-Help and Support Groups
Self-help and support groups are an important resource for people with mental illnesses as they move through the health care system. By helping you deal with the stresses in your life before they become overwhelming, self-help and support group members can prevent crises from developing. Acceptance and understanding from others who have had to overcome similar difficulties help in the recovery and healing process. More and more, people with mental illnesses are acting as advocates to promote their needs.
Working TogetherThe mental health care service delivery team does not work in isolation. Its success depends not only on each member, but also on the support it receives through a strong community infrastructure.
Hospitals are a part of this infrastructure and are sometimes necessary for people with severe mental illness. They can be particularly effective when you need a safe, structured, non-stressful environment for intervention and treatment.
Today, hospitals are getting smaller and are adopting more cost-effective, team-based approaches to service delivery. Doctors also have access to much more effective medication than they did many years ago. Because the overall number of hospital beds has decreased over the past ten years, the role of community-based care and self-help and support groups has become that much more important.
Although this shift has taken place with some growing pains, hospitals are now playing a more and more active role in promoting and cooperating with community services. These services encourage and reinforce the efforts of family members and friends, and support you during the various stages of treatment.
By emphasizing teamwork in service delivery, we make it easier for you and your family members to participate actively in decisions related to care, so that you can reach an optimal level of functioning, community integration, and quality of life.
We are all part of the solution. One in five Canadians will suffer from some form of mental illness during the course of their life. By knowing more about the people involved and the treatments available, we can all help to shed the stigma of mental illness.
Brochure produced through a health education grant from: Eli Lilly Canada Inc., Pfizer Canada Inc., and SmithKline Beecham Pharma Inc.