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Regional Report: Nova Scotia

09 Jul 2015 2:08 PM | CAGP (Administrator)

The Geriatric Psychiatry Program at Dalhousie’s Department of Psychiatry has had an active year.

One major highlight was receiving accreditation by the Royal College of Canada for our Geriatric Psychiatry Subspecialty Training Program.  All of the Geriatric Psychiatrists at Dalhousie participated in the process, with substantial contributions made by: Dr. Keri-Leigh Cassidy, the Clinical Academic Leader of the Geriatric Psychiatry Program, Dr. Janya Freer our new Program Director, Dr. Mark Bosma, Departmental Postgraduate Director and appointed Chair of the Royal College Geriatric Psychiatry Committee and Dr. Cheryl Murphy, member of the Royal College Examination Committee.  Our accredited Dalhousie Geriatric Psychiatry Program is a two-year residency, with the option of completing the first year during the five-year general psychiatry residency. There are only five such training programs in the country at this time.

Dr. Meagan MacNeil completed her Fellowship year, and joined the Geriatric Psychiatry team. Clinically Dr. MacNeil now works with our interdisciplinary outreach and outpatient service out of the Nova Scotia Hospital, and provides cognitive therapy through Dalhousie’s Enhanced Group CBT Program for depressed and anxious seniors. Dr. MacNeil contributes to capacity- building through the Nova Scotia Seniors Mental Health Network, and is actively involved in teaching and research as well.

Dr. Vanessa Thoo received the CAGP Resident Research Award, and completed a clinical and research elective in Geriatric Psychiatry, under the supervision of Drs. Keri-Leigh Cassidy and Janya Freer. Through the provincial Fountain of Health Initiative for positive aging, Dr. Thoo project involved developing a seniors’ mental health promotion tool for use by clinicians, and evaluating the material through the NS Seniors Mental Health Network. She has submitted her paper to an academic peer- reviewed journal, and she presented her work at several different conferences: CAGP, Alzheimer Society Conference, and upcoming Atlantic Provinces Psychiatric Association Conference. Dr. Thoo has also been accepted to the Geriatric Psychiatry Training Program in Toronto.

Provincially, we have undergone significant restructuring from nine to two districts, and have been engaged in the Nova Scotia Dementia Strategy.  Under the work of the newly formed Care by Design Mental Health Committee, Dr. Sameh Hassan has provided leadership this past year in developing an acute response protocol for long term care, including recommended medication approaches to managing challenging behaviours. The Care by Design Mental Health Committee will continue its work to develop a sustainable model for long term care, aiming to connect these recommendations with those that emerge from the Provincial Dementia Strategy.

Dr. Keri-Leigh Cassidy was the recipient of the CAGP Regional Contribution in Geriatric Psychiatry Award. Dr. Keri-Leigh Cassidy has been contributing to regional efforts as the Co-Chair of the Nova Scotia Seniors Mental Health Network over the past decade. Dr. Cassidy and the members of the Nova Scotia Seniors Mental Health Network also received the R. Wayne Putnam Award for Outstanding Contributions to Community Continuing Professional Development.  Dr. Cassidy was appointed to the Advisory Committee of the Nova Scotia Dementia Strategy, and has been providing leadership in seniors mental health promotion as co-Chair of Fountain of Health Initiative. This year, the Fountain of Health Initiative received a $25,000 grant from New Horizons to implement senior-lead positive aging courses in the community, and a $10,000 grant to increase mental health promotion activities by Nova Scotian family physicians. The Canadian Coalition for Seniors Mental Health has begun to collaborate with the Fountain of Health Initiative on a national seniors’ mental health promotion effort.

In terms of the current clinical and educational offerings by our collaborative, multidisciplinary Seniors Mental Health Team, we place a high priority on quality the educational experience of our students, and on service to patients and families.  A major clinical goal of our team is not only to intervene in a crisis but to anticipate and circumvent problems before they arise. As a recent clinical example (patient details changed for anonymity), a 76 year old woman with Parkinson’s being cared for at home by her husband with in-home support had recently declined from mild to moderate dementia with care needs now beyond what was feasible at home. Avoiding a breakdown of the situation, or need for acute care services, our team members functioned to anticipate her future care needs, provide a proactive competency assessment, support and educate the family, and communicate closely with primary care and community partners and services. As a multidisciplinary team, we are proud of what we accomplish together. We are equally proud that our service is consistency rated positively by students citing the strength of our multidisciplinary team work, and the rich learning environment provided by our team.

Nova Scotia has the oldest population in Canada with a senior population that will double over the next 20 years from 15 to 35% of the NS population. As the only tertiary Geriatric Psychiatry service in the province, we are acutely aware of the need sustainable provincial system that can meet the needs of our aging population. Our team envisions the need for a paradigm shift from being a clinical service to increasingly being utilized as a provincial resource for education and community capacity building. We have begun that process on many fronts, include through the Healthy Living program, the Nova Scotia Seniors Mental Health Network, and through our involvement in local and provincial strategies as described above.  We envision that a sustainable future must also include a paradigm shift toward greater seniors’ mental health promotion and upstream prevention--  or a “Positive Psychiatry of Aging” that highlight the psychosocial aspects of successful aging. Drs. Keri-Leigh Cassidy and Janya Freer and multidisciplinary members of our Healthy Living program, are actively providing provincial leadership in seniors’ mental health promotion through the Fountain of Health Initiative. For more information about the Fountain of Health Initiative for positive aging, please visit http://www.fountainofhealth.ca.

PLEASE NOTE: The CAGP cannot provide patients with the names of physicians providing care to patients. The Colleges of Physicians and Surgeons in most Canadian provinces and territories maintain a website for patients to find a physician by specialty. A list of these governing bodies is available on the Federation of Medical Regulatory Authorities of Canada’s website.

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