Featuring:

• Caitlin Hand, CCPA - PA in Inpatient Psychiatry at Ontario Shores

• Katrina Pullia, CCPA - PA in Paediatric Mental Health in Ottawa, ON (twitter: @katrinaccpa)

Resources Discussed:

• Diagnostic and Statistical Manual of Mental Disorders (DSM)

• Canadian ADHD Resource Alliance (CADDRA)

• Centre for ADHD Awareness, Canada

• SWITCH Rx - Free membership SwitchRx aims to provide healthcare professionals with the most current and useful information to guide their clinical practice when adjusting their patient's psychotropic treatment regimens

• PsychoPharm - an App: interactive versions of medication decision support trees of psychopharmacology.

• Canadian Armed Forces Clinical handbook on Suicide Prevention

• BC Mental Health Clinical Practice Guidelines

• Practical Guide to Mental Health and Law - put together by lawyers to discussing navigating mental health and the law.

CME:

• UptoDate

• University of British Columbia CPD websites: mental health, suicide risk assessment, psotpartum

• Psych Refresh: offered by University of Toronto, and targeted towards psychiatry residents preparing for exams, but is very helpful. The 5-day course offers a comprehensive review of psychiatry today, with some of the field's leading experts presenting the most relevant and up-to-date material.

• UofT City Wide Psychiatry Grand Rounds - Replays available online

About Caitlin Hand, CCPA:

PA in Inpatient General Psychiatry

​I graduated the McMaster PA program in 2013 and began working at Ontario Shores Centre for Mental Health Sciences upon graduation and have been there since. I work on two inpatient general psychiatry wards with four supervising psychiatrists.

Our hospital services individuals with complex mental health challenges, with a large portion of our patients having a treatment-resistant psychotic illness. Ontario Shores is also a teaching hospital, so I usually take a handful of PA students each year for their psychiatry rotation.

Outside of teaching and clinical roles, I am involved in various working groups aimed to improve adherence to quality standards and developing bundled care models for the treatment of mental illness. In my spare time, I love to spend time with my family and dog, and also love to bake!

About Katrina Pullia, CCPA:

​PA in Paediatric Mental Health in Ottawa, ON

Katrina Pullia is a Canadian Certified Physician Assistant (CCPA) with a keen interest in mental health research.

She is a two-time alumnus from McMaster University, completing both her Bachelor of Health Sciences (Physician Assistant) and Bachelor of Science (Biology & Psychology) at the institution. Katrina’s passion for research started with the completion of two undergraduate thesis projects during her first degree. To enhance her research skills, Katrina worked as a Research Assistant and Clinical Study Coordinator in the Department of Psychiatry at McMaster University prior to entering the McMaster PA Program in the fall of 2016.

After graduation, Katrina moved to Winnipeg, Manitoba to join a team of six PAs working in Crisis and Emergency Psychiatry. She had the opportunity to engage in a wide range of research opportunities with the rise of virtual care during the Covid-19 pandemic, as well as support and mentor physician assistant students.

Since the spring of 2021, Katrina has returned to her home province of Ontario and is practising in Pediatric Mental Health in Ottawa, Ontario where she continues to have an active role in a variety of ongoing clinical research studies.

In her spare time, Katrina can be found spending time with her cat Roscoe or playing board and video games.

You can find Katrina on twitter @katrinaccpa.

What is the Specialty of Psychiatry?

Psychiatry and Mental Health is a specialty dedicated to the diagnosis, prevention, study, and treatment of mental disorders. These disorders can include a wide range of issues affecting mood, behavior, cognition, and perceptions. Psychiatry as a field encompasses various modalities of treatment, including medication, psychotherapy, and a range of other therapeutic interventions aimed at improving or stabilizing mental health.

Key Aspects of Psychiatry and Mental Health:

• Diagnosis: Psychiatrists are trained to evaluate patients through comprehensive clinical assessments that may include interviews, physical exams, psychological testing, and coordination with other medical specialists. Diagnosis is based on the patient's reported experiences, observed behavior, and, when applicable, laboratory tests or imaging studies.

• Treatment: Treatment in psychiatry can involve a combination of modalities:

  • Medication: Psychiatrists prescribe medications such as antidepressants, antipsychotics, anxiolytics, and mood stabilizers that target the biological aspects of mental disorders.

  • Psychotherapy: Also known as talk therapy, this involves therapeutic conversations and interventions aimed at understanding and changing problematic behaviors, thoughts, emotions, and patterns.

  • Other Therapies: This can include electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS), and lifestyle counseling, among others.

  • Prevention: Psychiatrists work on the prevention of mental disorders through early intervention, education, and public health measures. This can involve screening at-risk populations and providing interventions that can reduce the severity or even prevent the onset of mental illnesses.

  • Research: Psychiatrists may also be involved in clinical and basic research to understand the causes of mental disorders, develop new treatments, and improve existing treatment modalities.

  • Education: Part of their role includes educating patients, families, and the public about mental health issues, treatments, and wellness strategies.

  • Mental Health Advocacy: Psychiatrists often advocate for the improvement of mental health services and policies, work to reduce stigma associated with mental illness, and ensure access to mental health care for all segments of the population.

Subspecialties within Psychiatry

Psychiatry includes several subspecialties, each focusing on a particular aspect of mental health, such as:

• Child and Adolescent Psychiatry: Specializing in the mental health of children and teenagers.

• Geriatric Psychiatry: Focused on the mental health of elderly populations.

• Addiction Psychiatry: Concentrating on the treatment of substance use disorders and related mental health issues.

• Forensic Psychiatry: Involving the interface of psychiatry and the law, including evaluations for legal cases and the treatment of individuals in the criminal justice system.

The Role of PAs in Psychiatry and Mental Health

Physician Assistants (PAs) in Psychiatry and Mental Health play a critical role in addressing the growing demand for mental health services. They work under the supervision of psychiatrists and in collaboration with a multidisciplinary team that may include psychologists, social workers, psychiatric nurses, and other healthcare professionals. PAs in this specialty are involved in various aspects of mental healthcare, providing comprehensive services that range from diagnosis to management of psychiatric disorders.

Here's an overview of their key roles and responsibilities:

• Patient Evaluation: PAs conduct thorough psychiatric evaluations, which include taking detailed medical histories, performing physical exams (when necessary), and assessing mental status. They are trained to identify symptoms of psychiatric disorders and understand their impact on patients' lives.

• Diagnosis and Treatment Planning: Based on their evaluations, PAs contribute to the diagnosis of mental health conditions and develop treatment plans in collaboration with psychiatrists and other team members. They consider various factors, including the severity of the condition, patient preferences, and co-existing medical issues, to devise comprehensive care plans.

• Medication Management: PAs prescribe medications for the treatment of psychiatric disorders, under the supervision of a psychiatrist. They monitor patients’ responses to medications, manage side effects, and make adjustments to treatment regimens as needed.

• Psychotherapy: While their scope of practice in psychotherapy may vary by region and training, some PAs provide supportive therapy, psychoeducation, and counseling to patients and their families. They help patients develop coping strategies, improve communication skills, and address behavioral issues.

• Patient Education: PAs educate patients and their families about mental health conditions, treatment options, and lifestyle modifications that can improve mental health outcomes. They provide guidance on managing symptoms, medication adherence, and preventive measures to avoid exacerbation of psychiatric conditions.

• Coordination of Care: PAs often serve as a liaison between patients and other healthcare providers, ensuring that mental health care is integrated with overall health management. They collaborate with primary care providers, specialists, and community resources to coordinate care and support services for patients.

• Crisis Intervention: In settings such as emergency departments or psychiatric crisis centers, PAs may be involved in assessing and managing patients experiencing acute psychiatric crises, providing immediate intervention, and facilitating referrals for ongoing care.

• Advocacy and Mental Health Promotion: PAs advocate for the mental health needs of their patients, working to reduce stigma associated with psychiatric conditions and promoting access to mental health services.

• Continuous Learning and Research: Given the rapidly evolving nature of psychiatry and mental health, PAs engage in continuous education and professional development to stay updated on the latest treatments, research findings, and best practices in mental health care.

PAs in Psychiatry and Mental Health fill a vital gap in healthcare systems, providing accessible and effective mental health services. Their role is especially important in regions with a shortage of psychiatrists, contributing significantly to expanding the reach of mental health care and improving the lives of patients with psychiatric disorders