Northern Exposure

By Jennifer Parraga, BA’93

Since 1981, Schulich Medicine & Dentistry’s North of Superior Program (NOSP) has been providing outreach psychiatric services to people living in the North of Superior region. Today, four faculty members, who are dedicated to specific sites, and physician residents use a creative approach of telepsychiatry and in-person visits throughout the year to provide care. “Northern communities face huge challenges with access to care and for years, Western has been there for us; I can’t imagine where we would be without it,” said Mr. Jocelyn Bourgoin, North of Superior Counselling Programs board member and former President & CEO, Manitouwadge Health.

“This partnership supports the foundation of the delivery of care. Without it, suffering would increase.” — Dr. Giuseppe Guaiana

Dr. Giuseppe Guaiana begins the first of his three in-person visits to northern Ontario for the year at the London airport. During the next few days, he’ll travel 1,083 kilometres north to Manitouwadge with an overnight stay in Thunder Bay and a full day of appointments in Nipigon. His passion for rural medicine is palpable and inspires him to continue serving as the Clinical Director of NOSP, a role he has held since 2012. “NOSP not only provides care to underserviced areas , it also offers physician residents an opportunity to receive a training experience they wouldn’t get elsewhere,” Dr. Guaiana said.

The North of Superior Counselling Programs is the agency partner to NOSP. It is a non-profit, accredited community-based mental health and addictions agency that was founded in 1983. Through the Programs, counsellors provide ongoing counselling and support to local residents in five different locations, including Nipigon, Schreiber/Terrace Bay, Greenstone, Marathon and Manitouwadge, and work collaboratively with psychiatrists to provide care. “This partnership supports the foundation of the delivery of care,” said Dr. Guaiana. “Without it, suffering would increase.”

Upon arriving in Nipigon, Dr. Guaiana meets with Shannon Cormier, Executive Director, North of Superior Counselling Programs. Together, they oversee the intricacies of this partnership, strategically plan how to meet its day-to-day needs, develop enhancements and determine how to best deliver services using resources in the most efficient way.

Katie Freeman (right) is an adult counsellor and social worker who has been working with the Programs for two years. This morning she is meeting with Pamela (left), a client, prior to their session with Dr. Guaiana. “As a counsellor, my role is really essential in creating a supportive care environment and providing continuity of care to clients in between and during appointments with the psychiatrist,” said Freeman.

“The beautiful thing about it is the opportunity to learn in such a
different way than you would in an urban centre. Working here, you are really challenged to expand your learning and enrich your practice.” — Shannon Cormier

Working as a team, Dr. Guaiana and Freeman meet with Pamela and her husband, John, who have travelled for more than an hour for the session. “The access to mental health services is even more challenging in rural areas, and through NOSP, we are bringing essential services to people,” said Dr. Guaiana.

Originally from Manitouwadge, Cormier has spent her career working in rural practice and is a strong advocate for rural communities. “Rural practice is who I am, and it is where my heart is,” she said. “The beautiful thing about it is the opportunity to learn in such a different way than you would in an urban centre,” she added. “Working here, you are really challenged to expand your learning and enrich your practice.”

Marathon, Ontario is located just off the Trans-Canada highway and hugs the rugged coastline of northern Lake Superior. It serves as one of the main sites for NOSP and a psychiatrist, who is often accompanied by a resident physician, is dedicated to this community.

On the second day of his trip up north, Dr. Guaiana meets with the care team in Manitouwadge. He’ll spend the next two days working with Karen Barclay, Regional Manager of the Program for the communities of Marathon, Schreiber/Terrace Bay and Manitouwadge (centre), and Darcie Donaldson, Adult Mental Health Counsellor (right). “The collaboration that happens with this team is essential and so important to our delivery of care,” said Dr. Guaiana. “Working together, we can better help our patients to achieve wellness.”

“The collaboration that happens with this team is essential and so important to our delivery of care. Working together, we can better help our patients to achieve wellness.” — Dr. Giuseppe Guaiana

Resident physician Dr. Sheena Ghodasara spent two days in Marathon providing care and working alongside a faculty member. “The psychosocial situations and difficulties that individuals who live in remote areas face, as well as culture and way of life, really stood out to me as they were quite different than those I have been exposed to in a larger city. This forced me to assess their situations from a different angle, one I had not previously experienced,” she said.

In between appointments, Donaldson and Dr. Guaiana connect with Jamie McLellan, the Program Assistant who manages the daily schedule for them. In addition to those people with appointments, the clinic accepts walk-ins for people who are in immediate need of care.

Sara and Vivian are just two of the clients that Dr. Guaiana and the team see during two busy days of appointments in Manitouwadge. “Our focus is on adult patients, and right now the wait time is relatively short to see a psychiatrist,” said Dr. Guaiana.

“I have a real passion for organizing these services, and I very much enjoy working in rural or remote areas. When I’m here, I really feel like I am making a difference for the people in these communities.” — Dr. Giuseppe Guaiana