If you have depression, help is closer to home than you may think.
Sun Country Health Region (SCHR) staff participated in the Saskatchewan Health Quality Council's Chronic Disease Management Collaborative that enabled practitioners to become better equipped to assist patients affected by depression in the region.
Sheena Grimes, chronic disease management facilitator for the health region, explained the collaborative. "The Health Quality Council of Saskatchewan has a chronic disease management collaborative that started in 2009 and it was on depression and COPD [Chronic Obstructive Pulmonary Disease]. We had four practices from within Sun Country Health Region who participated in this collaborative." These practices included practitioners from Carlyle, Maryfield, Lampman and Radville.
"One of the reasons why Health Quality Council decided to focus on depression is because caregivers are under-equipped to be able to support people who have depression and that was proven. So this has been a really great initiative of improving that care."
"The collaborative ran from November of 2009 and it just wrapped up at the end of March this year. But we are continuing throughout the region to spread all the great work that has been done into all of our practices. There is the depression working group that was formed so we are working to provide education on the patient health questionnaire, so that there is familiar language being used and more people have access to depression screening."
Grimes said the learning was that of a thorough nature. "What it involved was intensive learning. We travelled to Saskatoon for four workshops throughout an 18-month period of time and they learned all about depression care, best practices in depression care and how to improve that care within their own practice."
The collaborative was not only for those directly involved in the counselling of depression. "We were able to have people attend that provided support to the practices. So for example, in Maryfield, the mental health social worker and occupational therapist were two of the team members" said Grimes.
The result of the collaborative is sure to impact the lives of those rural residents living with depression and its symptoms. "Through their learning and understanding of what best practice depression care is, they developed several tools to help improve the care they were providing their patients. And one of the tools they developed is called a depression self management toolkit. And what that is is its basically the patients manual for their mental health. And it includes several sections for the patient to work with their health care provider to help improve their care."
"So some of the contents of that toolkit were homework for them to do so if there was any self-management homework that they needed to do to have some accountability, goal-setting which is very important. Small goals just to be able to work towards, there is also a section called the anti-depression skills workbook and that is through Simon Fraser University and that has a lot of information that the patients are able to work through on thinking about self-care and getting a little bit more information on what depression actually is."
"Then there is also the patient health questionnaire which is a depression screening tool and that is used to identify patients who have depression as well as to help track their scores overtime to see if there are improvements so any remission or relapse can be shown through that questionnaire."
"There are also some sections on medications, coping with suicidal thoughts, a journal section so the patients are able to track how they are feeling and what's going on. It's very important to focus on the positives. When you have depression, it's very easy to think of all the negatives, but it is very important to think of the positives. A lot of resources specific to chronic disease as well because they is correlation between other chronic diseases and depression and then there's lots of other information such as exercise tips, myths about depression and then one section is on your reasons for getting better so why do you want to get better. And that's a place where patients can put pictures of loved ones or activities that they used to love to do. It just gives them some incentive of why they want to get better."
Locally, the collaborative has resulted in great success. Maryfield has received media attention acknowledging their efforts to increase depression support. They extended the use of the workbook into a depression support group. Grimes said In addition to the toolkit, "the social worker and occupational therapist also ran a depression support group. And that was basically where they went through the workbook and had patients come together. You know, it was really nice for the other patients in their community to know that in their small community, there were people coping with the other problem. It was very good to identify that they were not alone."
Carlyle also participated in the collaborative. Jeanne Daku, nurse practitioner in Carlyle, said "I actually incorporated the [screening] questions into regular physicals because if someone is struggling, you can really catch it right there. And then you can progress as needed. So that's one thing that we've done here. It's really nice because the mental health worker is here on Wednesdays and so is the psychiatrist, so if there is ever a time that I need someone to counsel them [patients], it is valuable because they are here. It is a real team effort here. We can collaborate between us to help our patients."
Daku participated in the collaborative in order to better serve her patients and in hopes of bringing her knowledge back to the practice. "Depression isn't a big comfort zone for a lot of people and I just thought that I have to be able to deal with this in my practice, because really, there is lots of prevalence there. So that's why I really wanted to focus on the depression part of it. Depression isn't like a forefinger or stitching to do, it is very personal and is very different for everybody."
As for the patients, "You know it has been really nice. If someone came a year ago and they were really struggling, you know, usually in six months you can get them to do the scoring again. And most times their score has changed so much and they actually get to see that on paper. And while they often know they are feeling better, they can actually see it which makes a big difference."
While finding depression care in rural Saskatchewan may have been difficult years ago, the tides have turned and help is just outside your front door. "It is hard to find the support groups in small communities because it's just not right there. But we definitely have the counselling and the access. And if there is access to getting help, then we can figure out where to go from there. And that's what is important to me" said Daku.
