Chair, Division of General Psychiatry Western University
The largest division in the department, the DGP is primarily based out of the London Health Sciences Centre, is the academic home of acute care psychiatry, and to an increasing extent involved in continuing mental health care, spanning a broad range of services, as described under Clinical Programs / Services. The primary clinical catchment area for the divisional activities is the London-Middlesex area; though we have expanded regional mandates in several areas.
The DGP has the responsibility to provide the core educational experiences required by medical students, psychiatry residents, as well as those from family medicine and other specialties, in addition to trainees in related health disciplines. As such, the division’s influence extends beyond producing competent general psychiatrists.
It has been a very productive academic year for the Division. DGP faculty organizes and delivers much of the department’s undergraduate, postgraduate, and continuing medical education/continuing professional development. Once again, Dr. Praful Chandarana organized the nationally acclaimed UWO Psychiatry Exam Preparation Course, which is taught by many divisional members. Dr. Chandarana is now developing a succession plan so that younger members can “carry the torch” into the future. Similarly, our research productivity has increased as can be attested to in the research section. A major educational endeavour planned for the upcoming year involves working with SWOMEN/Windsor partners to foster undergraduate and continuing education/CPD, and the special project of developing a freestanding affiliated residency program in General Psychiatry continues to progress. A new contribution for divisional/departmental CPD and PGME was the complimentary membership for the online psychiatric resource, Global Medical Education, which we were able to secure, with the kind assistance of Dr. Amresh Srivastava.
On the clinical front, with access to inpatient beds so often an issue; there has been much attention to the Emergency and Inpatient services. Our Centralized Emergency Psychiatric Service (CEPS), Inpatient and Ambulatory programs are engaged in developing and implementing solutions to the problem of admitted patients waiting for inpatient beds in the Emergency Department. These include the development of community-based crisis services and crisis beds, mobile crisis service, regular monitoring of length of stay and re-organization of the ambulatory care program. Working with City of London Crisis Services and the LHIN, we are pursuing a plan to house the community-based and operated integrated crisis services on the campus of Victoria Hospital. We were also successful in being awarded P4R funding to support a full-time psychiatrist on site with CEPS during the weekday working hours. This initiative will be evaluated over the next year. More recently we have also developed an escalation plan for various levels of access problems through the Emergency which includes opening Mental Health Surge beds on a separate inpatient unit, when under extreme access pressure.
Ambulatory care development remains a focus as well. Based on a review of our ambulatory systems there has been a realignment of new referrals being more appropriately triaged to a team-based model of care. As well, our Day Treatment Program has been redesigned moving away from a fixed 6-week modular program to a more patient needs centered one which will provide stepped down or up care, respectively, from in- or outpatient care. We commenced work on two major funded ambulatory initiatives in conjunction with colleagues from the LHSC Child and Adolescent Program, in which we received over a million dollars for each of these projects. With RBC support, we will create an At-Risk Centre to coordinate and develop services for new Canadians, with a focus on prevention and early intervention mental healthcare for children and families who have escaped from traumatic backgrounds. The LHSC Auxiliary awarded us with a major grant to enable us to develop a Transition Age Project, which will focus on developing accessible, coordinated assessment and early intervention tailored for people aged 16 to 25 years who have mental health difficulties. Lastly, at the end of the academic year, on June 21, 2013, the Mental Health Services at LHSC and at St. Joseph’s Health Care London completed a leadership retreat, with a major focus on improving access and flow through the ambulatory services.
The DGP continues to maintain strong collaborations with our Neuropsychiatry Group regarding brain imaging studies, particularly with the following clinical services: PEPP – Schizophrenia, FEMAP – Mood and Anxiety Disorders, and Traumatic Stress Service – PTSD. The PEPP and FEMAP services as well are at the forefront of producing high impact clinical outcomes and health services research. Other examples include how the division continues to be very active in SMART e-health technology research, and is a hub site for the multi-sited evaluation of the Transitional Discharge Model. Additionally, psychopharmacological research remains an important part of the DGP’s mandate, with researchers active spanning the range from the provincial population level (ICES) to the individual genome.
For an overview of the division’s varied programs along with individual goals for the next academic year, written in conjunction with the respective medical leaders, please visit, the London Health Sciences Centre Psychiatry Based Services and the St. Joseph’s Health Care – Psychiatry Based Services on the DGP’s area of the website.