To fix the wiring in your house, you need an electrician. To fix the pipes, you need a plumber.

To address mental health problems in a multi-generational family, you need to engage with persons with specific roles and functions and specialities.

Let’s look at 3 roles: the therapist, the coach and the mental health advisor.

The therapist ( a social worker, psychotherapist or psychiatrist) enters into a therapeutic alliance ( relationship) with the patient.

This role is carefully defined by the provider’s approach to mental health. The provider’s regulator ( College) has much to do with how the relationship unfolds. It is essential that the provider use motivational interviewing strategies to engage the patient with the objective of getting healthier. The therapist can’t push too hard or the therapeutic alliance will be damaged and the process will stop.  The process is typically incremental. Small steps over time.  The goal is to keep the patient involved over time.  And there are over 300 therapeutic models that can be employed to assist the patient. Maybe more than 300 models. So this choice of therapeutic model is complex.

The coach takes a different approach. Coaching is goal oriented. There is a goal and an outcome. The coach is there to reinforce this process of trying to reach those goals. Consequences or alternative strategies might result if the patient fails to attain the goals.  The relationship with the coach is about negotiating the goals and then reinforcing the process of attempting to attain them. There can be friction in this relationshp but that is factored into the approach. Coaching might be shorter term than therapy because it about clearly defined goals over a certain time horizon.

The advisor is different. The mental health advisor for the family is the architect of the entire solution. This relates to both the family system and the person of concern. The mental health advisor defines the problem or problems involving both the family system and the person of concern. Then the mental health advisor orchestrates the solution with an integrated team of providers. These can be therapists or coaches using many different modalities from family system coaching to music therapy to wilderness therapy. The mental health advisor must have a complete understanding of all the options available to address the problems. The approach has to be comprehensive. It is sometimes costly and the mental health advisor will help with the budget for these services.

Case Study:

Andy was 9 years of age. He had a bad temper and would act out periodically. His older brother would taunt him. His father had big expectations about his sports performance.

One day, he ran screaming into the kitchen, grabbed a sharp knife and threatened to self harm.

That is a crisis for this family. Our job at RCM Health Consultancy was to take the role of mental health advisor for the family.

It took a village to address this set of problems because it involved all the members of the family.

Our job was to mobilize an integrated team of providers to assist and to address the root cause of Andy’s acting out.

Our process worked to assist Andy and the family.

This is often a work in progress requiring tweaking over time as the children grow and mature and the family system seeks to adapt.

Raymond Rupert

CEO

RCM Health Consultancy Inc.

647 350 5500

info@rcmhealthconsultancy.com

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The findings show that worsening psychological health, an increase in employment dissatisfaction, and extended mental strain continue to impact the mental wellbeing of Canadians.

The score of -11.1 is a slight improvement from October (-11.4). The score measures the improvement or decline in mental health from the pre-2020 benchmark of 75. “We’re at a pivotal point in navigating the pandemic.

On one hand, the recent news about potentially life-saving vaccines being administered in the first half of next year should bring Canadians some encouragement.

On the other hand, we are also approaching some of the most difficult months of the year for many Canadians as we approach the holidays and winter months,” says Stephen Liptrap, president and chief executive officer. “Information overload will continue to be an issue in the coming months.

Employers cannot assume that all employees are feeling positive about the new pandemic-related developments and must continue to check in on their wellbeing to maintain a productive workforce.”

This increase in the incidence of mental health amongst employees is of concern. There is a gap in the supply of psychiatric services for these patients. The EAP providers fill an important need for mental health services. However, many of these cases are complex and there is a gap in the suppliers of mental health services for complex mental health patients.

That is a role that RCM Health Consultancy fulfills in the Canadian healthcare ecosystem for mental health services.

Raymond Rupert patient advocate and healthcare consultant

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I remember it as a turning point in my understanding of what a doctor and patient advocate should aspire to be.

To the many whom he inspired, Dr Rakoff is remembered for his extraordinary intellect, kindness, sense of wonder and the agility with which he wove together ideas from a vast range of disciplines, from classic literature and philosophy to politics and pop culture.

At a time when many people were divided and entrenched in their own viewpoints, Dr. Rakoff’s open-mindedness and willingness to engage in reasoned discussion are qualities the world needs now more than ever, Dr. Voineskos, VP of research at CAMH recalls.

“That way of thinking, that ability to tolerate complexity and uncertainty and multiple viewpoints concurrently, I think, is not just important for the future of psychiatry, it’s important for the future of science and the advancement of humanity,” Dr Voinieskos said.

Ultimately, his multi-dimensional perspective gave him a better understanding of the patients he sought to help, said Dr. Roger McIntyre, a professor of psychiatry and pharmacology at the University of Toronto.

“It made him a better physician, in my view, because I still believe despite all the technology we have and all the exciting advances in science… the role of the physician, still to this day, is to bring relief to people’s suffering,” Dr. McIntyre said.

And so it is sad that Dr Vivian Rakoff has passed but his legacy as the role model of role models will endure.

Raymond Rupert, patient advocate and healthcare consultant.

source: Globe And Mail. Oct 10 2020. page B24. Wency Leung Health Reporter.

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