‘The conversation needs to begin somewhere’

Linda Liu (L) and Shannon Wright are advanced practice nurses who support patients in coping with their mental health concerns. (Photo: UHN)

Bell Let’s Talk Day provides Canadians with an annual opportunity to openly discuss mental health and reduce stigma.

For Shannon Wright, Nurse Practitioner (NP) in psychiatry at Toronto General Hospital’s (TG) Soham & Shaila Ajmera Family Transplant Centre, Linda Liu, Clinical Nurse Specialist (CNS) in psychiatry at TG, and Regina Sawh, CNS in psychiatry at Toronto Western Hospital, these conversations occur today – and every other day – with patients and caregivers all around UHN.

When patients are admitted to the hospital for pneumonia or a cardiac disease, one of the last things on their mind may be the way this experience will impact their mental health. If it does suffer, patients aren’t often aware of the services available to help them cope.

That’s why Shannon, Linda and Regina say their roles are so important in communicating the various resources in place to support patients’ mental health needs throughout their healthcare journey.

In their advanced practice nursing roles, these three make up a small team of mental health nurses who provide mental health support to the complex medically ill population, and also support teams across UHN on a consultation basis and educate staff on mental health literacy.

Several events are happening across UHN on Wednesday to mark Bell Let’s Talk Day. They include:

  • At Toronto Western Hospital, in coordination with UHN’s Wellness Centre, the Krembil Research Institute and TW will be hosting a variety of wellness-related drop-in sessions to promote positive mental health, teach stress-relieving techniques and provide access to resources.
    • Brain Breaks in TW and Krembil; 10:30 a.m. to 11:30 a.m.; 12th floor TW, Main Pavillion and Krembil Discovery Tower (KDT) 7th Floor Sky Lounge
    • Managing Stress & Finding Balance; 2:30 to 3:00 p.m.; KDT 4KD503
    • Experiential Mindfulness Practice; 3 p.m. to 3:30 p.m.; KDT 4KD503
  • At the Michener Institute, students and staff can wear blue and join student council in the lobby at 222 St. Patrick St. from 12:30 p.m. to 1:30 p.m. to share stories and inspiring messages about mental health. Coffee, tea and hot chocolate will be provided.

“We provide support to frontline staff when they have a concern about a patient’s mental health status, whether it’s a behavioural change, or concerns about mood and safety,” says Regina.

While the nurses usually work one on one with these patients, they also see opportunities to educate the care team on how to better support the patient.

“A huge component in helping these patients is also coaching the staff in communication and behavioural strategies to help them motivate their patients and support them along their recovery on both a physical and mental level,” Linda says.

Educating staff on mental health

The advanced practice nurses say some clinicians are surprised when a patient has mental health concerns while they are physically ill. Often, that mental health concern may be the patient struggling to adjust to their new situations and their loss of independence.

“Staff may at times not feel comfortable to provide that support, but what is great is they can reach out to us and they know there is someone they can ask,” Linda says. “That becomes an opportunity for us to enhance discussions in mental health.”

Acknowledging these gaps in clinician education around mental health and stigma, Shannon says UHN’s strategic priority to lead the integration of physical and mental health, and UHN’s forthcoming Mental Health Strategy, make her optimistic that there will be increased capacity for frontline staff in providing mental health support to patients.

“If you see that your patient is struggling, whether they are anxious, sad, withdrawn or having trouble sleeping, you can ask them how they are doing,” Shannon says. “It’s okay to begin a conversation about their mental health and how they are coping.

“The conversation needs to begin somewhere.”

As UHN continues to build capacity to ensure that all patients’ mental health needs are met, there’s a need to consider exploring inpatient nursing assessments, which don’t currently include a mental status assessment.

“We have daily assessments for all body systems, but currently nothing is built into that assessment for mental health, which means staff are not aware of a patient’s mental status before and during hospitalization,” Linda says.

Having the conversation

Regina says sometimes half the battle is building a rapport with the patient and explaining her role as a CNS in mental health, which serves to tackle stigma.

“These conversations are key in understanding if they have any supports or resources in place,” Regina says.

“Beyond their admission to the hospital, we ask ourselves, ‘How can we better connect them and their caregivers to services in their community?'”

Shannon says having these discussions every day is important in helping people realize the impact mental health has on physical recovery.

“Our services exist because this is a common issue that we see in the hospital, and we’re here to support the patients. The more people are aware of this, the more we can do to help,” Shannon says.

Linda says it’s important to remember that when someone is experiencing heart concerns, they will see a doctor and explore help. The same should and can be applied to mental health.

“Bell Let’s Talk Day creates a universal platform for us to openly promote and advance dialogues about mental health, and when we do that, stigma gets removed,” she says.

“Just like we want to make our hearts stronger, we want to make our minds stronger too.”

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