The daily need for clinical collaboration

People with mental health problems come to us seeking care on a daily basis. Complex issues and overcoming challenges are inevitable, therefore it is unrealistic to take on the task alone. Facing these issues effectively involves taking into account countless biopsychosocial factors and mastering very diverse specialized skills in interpersonal, diagnostic, therapeutic, social and community fields. Many clinicians have experienced the effectiveness of collaborating with various partners within their local network. In the context of a special report reviewing the literature on the effectiveness of collaborative mental health care in the treatment of depression, we will examine its daily clinical advantages experienced by both the population and clinicians.

Collaboration between a patient’s care providers demonstrates existing links and allows for consistency in interventions, instilling confidence and improving the patient’s involvement in the treatment process. The patient can be accompanied and more easily introduced to available resources. Moreover, the quick transmission of information to each care provider optimizes interventions. Collaborative care also allows for the concerted involvement of various resources. With role sharing, these resources make the most of each clinician’s expertise.  

Interprofessional collaboration is a great tool to help overcome difficult clinical mental health situations. It helps clarify our perspective, see our clients in a different light, avoid the pitfalls of splitting and obtain recommendations that draw upon complementary expertise. This type of collaboration allows us to share the challenges we face in complex interventions, obtain emotional support and feel a sense of involvement instead of one of solitude. Furthermore, collaboration within an interdisciplinary team and within a local network is invaluable since the responsibility of difficult decisions can be shared as a group and their application can be validated. In addition, frequent discussions increase our understanding of our partners’ abilities and promote knowledge sharing.

Providing clinical support for family doctors is at the core of collaborative care. The scientific literature reviewed in this report describes concrete and measurable strategies implemented to properly organize collaboration, in view of optimizing care provided by family doctors. It also identifies specific and effective practice recommendations. We hope the following material will provide food for thought regarding a meaningful and rewarding daily clinical practice: meeting, concertedly sharing our efforts, learning from each other and collaborating!


One comment for "The daily need for clinical collaboration"

  1. I attended a presentation by Nick Kates recently (with Geneviève Cloutier) that was organized by the Department of Psychiatry at Université Laval. I was struck by some of the questions that Dr. Kates was asked by members of the audience. For instance, several of the questions turned around the issue of the feasibility of implementing collaborative care here in the province of Quebec. The issue of legal responsibilities was raised, the problem of lack of time and overloaded caseloads, as well as difficulties working with primary care providers.

    All too often, people focus and get stuck on implementation barriers and forget that there are other things out there than can facilitate change and innovation. Collaborative care is an intervention that is very well described in the literature, there is ample evidence of its effectiveness and many of the issues raised regarding implementation barriers have been overcome elsewhere. Furthermore, in Quebec we tend to view interdisciplinarity and evidence-based practices positively, and there is leadership for this model of care at various levels, including from within the Ministry of Health. So, why shouldn’t it work here?

    Practice change may not be easy but where there’s a will there’s a way. In one of Dr Kates slides, it says “Tradition: just because you’ve always done it that way doesn’t mean its not incredibly stupid”. In another slide, it says “A culture of improvement: Not what we can’t do. What we can do by Friday.” That’s the right attitude to have, and that’s why collaborative care is flourishing in Hamilton Ontario!


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