Despite decades of experience in both family medicine and GP psychotherapy, Dr. Patricia Barry modestly admits she doesn’t know everything. Sitting in one of the cozy rooms of her office with the afternoon light pouring in, she describes the tremendous benefits of belonging to a collaborative mental health care team and graciously speaks about those individuals whose problems have gone beyond her own expertise.
“I didn’t have the information that I needed to have to do that next level of care.”
In the past Dr. Barry would have had to refer individuals with unique treatment requirements to someone else. The referral system is something that many Canadians are familiar with, having been passed from expert to expert at one time or another for either diagnosis or treatment purposes. Dr. Barry explains, “What happened in most cases was that when in doubt you referred, because you didn’t want to do anyone any harm.”
In contrast, today Dr. Barry hardly ever refers clients and finds herself taking on conditions that she never would have considered treating before. She still may not know everything, but now she has a network that does.
A few years ago, Dr. Barry was asked by a colleague to join a new initiative called the Collaborative Mental Health Care Network – a network of mental health care professionals and family physicians. Each with their own skills and specialities, the network would provide a resource of information for the professionals involved, so that rather than referring, they could simply ask an associate for advice on how to handle a situation they were unsure of; which would ultimately mean more personalized and appropriate treatment for their clients.
“It gives me the support in the community that I wouldn’t really have otherwise,” says Dr. Barry. “Before I had the network, I would feel that I needed help, meaning that I would have to either declare that person an emergency when often they weren’t…or get them on a psychiatrist’s waiting list and that could take months.”
The network came through in a big way when Dr. Barry was faced with what was clearly one of her greatest challenges. The court system called to ask her if she would treat a young individual who had been convicted of pedophilia.
Her first reaction was ‘no’.
“I have strong feelings about abuse to children”, and she didn’t feel she had particular expertise in this area. “But everyone was saying no” and she knew if the individual ended up in the system without treatment, the chances of getting worse were much greater.
“So, I said I would try.”
Through the network, Dr. Barry was connected with a specialist who treated pedophilia. She worked with the client while consulting with the specialist throughout the course of the treatment.
As to whether or not Dr. Barry was able to really help this individual she says “only the future will tell.” But she believes that her client did work hard in treatment and claims to have gained some controls over certain aspects. Without the help of the specialist, Dr. Barry strongly feels she wouldn’t have been able to provide the appropriate therapy.
“I would never have taken this on if I didn’t have the backup. I wouldn’t have wanted to take that on. I wouldn’t have been able to do it,” she says.
In this case, the network acted as a liaison, putting her in touch with a professional who had the particular skills she needed. But in Dr. Barry’s experience, the network has also acted as a replacement for traditional mental health care solutions, which often burden the system as well as do a disservice to the individual seeking help.
“I can see how [collaborative care] can supplement and complement family medicine in a major way and would help take some of the pressure off the health care system,” Dr. Barry proclaims.
And by helping the system be more efficient, it is ultimately the individual receiving the care who benefits most. They receive a more personal level of care through a single provider committed to providing appropriate care and who will seek out answers to any questions they may not have the answers for. In this way, individuals have better access to the care they need and are viewed as central to the collaborative process.
Dr. Patricia Barry’s office is a cozy place, complete with flower-printed chairs, an antique roll-up desk and the smell of potpourri. But the solace this creates shouldn’t be mistaken for solitude. Dr. Barry is certainly not alone. She has a team of professionals she can call on, in those rare cases when she doesn’t know everything.
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PHOTOGRAPH:
Dr. Patricia Barry (right) with her assistant Karen – the first face a client sees as they walk into the antique-filled red brick house that is Dr. Barry’s office.
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