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When first entering the mental health and addictions systems, trying to understand the roles of professionals, when they should be contacted and how they can support your loved one, can be very frustrating. The truth is, the mental health and addictions system is very complex and each professional has a specific role in providing care.
Mental health professionals can be found in many settings. However, when many people think of where mental health support and/or treatment is provided, they often think of inpatient programs, hospitals or Psychiatrist offices. Despite this belief, the majority of mental health support is actually provided by community mental health agencies.
This guide will help you understand each professional’s role, and how they can support your loved ones on their journey to recovery. Here are the types of programs offered in both hospital and community settings, and how/when to access them.
General Practitioner (GP)
General Practitioners are also frequently referred to as Primary Care Providers or Family Doctors. General Practitioners are in fact, practitioners of general medicine. What this means, is that they have knowledge on a wide range of medical ailments, ranging from pediatric conditions, to cardiovascular disorders and everything in between. When it comes to mental health and addictions, some GP’s are more comfortable than others providing medical care and treatment. Typically, GP’s will treat more mild or situational conditions and refer those with more serious mental health or chronic conditions to a Psychiatrist. GP’s may or may not, prescribe psychotropic medications, however, all GP’s costs are covered by OHIP, therefore, those with a valid Ontario health card do not have to pay out of pocket for their GP appointments.
Psychiatrist
A Psychiatrist is essentially a medical doctor who specializes in mental health and mental illness. Typically, Psychiatrists focus is on providing a diagnosis and prescribing medications to assist in managing mental health symptoms and they do not typically provide therapy. They may however briefly discuss coping strategies with their patients.
Appointments are typically short (15-30 minutes), occurring monthly at initial diagnosis. Once medications are working as prescribed and symptoms are manageable, Psychiatrist appointments will decrease in frequency to once every 3 months. Psychiatrist fees are covered by OHIP.
Psychologist (Therapist)
Psychologists hold a doctoral degree in clinical psychology. Similar to Psychiatrists, Psychologists are able to prescribe psychotropic medications, however, they also provide therapy. Psychologists are trained to evaluate a person’s mental health using clinical interviews, psychological evaluations and testing. They can make diagnoses and provide individual and group therapy. Some may have training in specific forms of therapy like cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT) and other behavioral therapy interventions. They have knowledge of developmental processes; mental health problems, disorders and needs; assessment, testing and test interpretation; therapeutic and behavioral management approaches to treatment; and provision of therapy, counselling and consultation. Psychologists will work with their patients to develop skills and strategies to manage thoughts, emotions and behaviours that impact an individual’s mental health. Psychologists are not covered by OHIP and must be paid for out of pocket. Many insurance companies have a benefit for Psychologists which can cover some of these costs.
Case Manager/ Mental Health Worker
Case Managers are typically mental health workers who work in community settings. Case Managers assist in navigating the mental health system and connecting people to supports and services. These supports can include: accessing treatment, counselling, housing, social, vocational, and income supports. They can also provide education around mental health, including symptoms, and medication side effects, work with you on learning coping strategies, and support you on your journey. Case Managers/Mental Health Workers typically have a background as a social worker or nurse. You will typically visit with a Case Manager for an hour or two, once per week. Many case management agencies are funded by the Ministry of Health and are free to you (you can apply for Case Manager in York Region or South Simcoe, by clicking here). You can also hire a private Case Manager, if you wish. There is usually no difference in the type of support or qualifications between the Case Management services funded by the Ministry of Health and those paid for out of pocket.
Nurse
Most contact with a nurse will typically occur while someone is admitted to an inpatient unit in a hospital, visiting an outpatient program or involved with a medically monitored program in the community (you can learn more about types of programs …… ). While in hospital, nurses will work as part of the therapeutic team and will ensure treatment and/or medication prescribed by the Psychiatrist and/or Medical Doctor is administered and that progress is monitored and recorded.
In outpatient programs, nurses may provide education around medications and symptoms.
When involved with a higher intensity support, such as the Assertive Community Treatment Team, nurses will visit patients in home to check blood pressure, cholesterol and sugar levels (if these levels can be affected by the medications prescribed). They can also provide education around symptoms, side effects and they ensure that the program Psychiatrist is up to date on each patients situation.
Social Worker
Social Workers have knowledge of family and social history; family functioning and specific areas of social work. (e.g., addictions, adoption, abuse, community living services, mental health). In a hospital, a social worker may coordinate the discharge planning process. Once someone leaves the hospital, community social workers may coordinate recovery support to ensure people are connected to the resources they need.
Pharmacist
Pharmacists have knowledge of the outcomes and side effects of medications, their interactions and reactions, and what substances and foods to avoid when taking certain medications. The Pharmacy can provide a great deal of written information to the public. Consulting services by Pharmacists are free and are a part of the process of dispensing medications, all you have to do is ask.
Alcohol and Drug Counsellor
Counsellors have knowledge of symptoms and effects of alcohol and drug use, therapeutic approaches and counselling to support recovery. They may provide one-on-one support, recommend group supports or provide referrals to various services of the addictions’ system of care – such as a residential treatment facility. These services may be paid for by the Ministry of Health (community addictions services such as Addictions Services for York Region), or be required to be paid out of pocket (private).
Counsellor
Counsellors have knowledge of counselling approaches and provide support on behavioural management, development of skills and strategies to manage the thoughts, emotions and behaviours that impact mental health. Community counselling agencies typically have a sliding scale and cost is dependent on an individuals income, private counsellors must be paid out of pocket, some insurance providers may cover these costs.
Advocate
Advocates are typically available to individuals when they are admitted to an inpatient service. Advocates speak or act on behalf of an individual to ensure concerns they have about the service they are receiving are addressed. In some communities, paid, formal advocate positions have been created. Each hospital has access to a Patient Representative who will help deal with concerns about the health care you or a family member receives.