While the diagnosis and treatment of mental health conditions is not within a chiropractor’s scope of practice, Dr. Janet D’Arcy believes chiropractors like you can play an important role in identifying someone who may need assistance, helping them access practical resources and making appropriate referrals. In this episode, Dr. D’Arcy, a certified mental health first aid instructor and chiropractor, outlines how you can increase your mental health literacy and prepare to appropriately engage and support a patient, colleague, or family member in their time of need.
While the diagnosis and treatment of mental health conditions is not within a chiropractor’s scope of practice, Dr. Janet D’Arcy believes chiropractors like you can play an important role in identifying someone who may need assistance, helping them access practical resources and making appropriate referrals. In this episode, Dr. D’Arcy, a certified mental health first aid instructor and chiropractor, outlines how you can increase your mental health literacy and prepare to appropriately engage and support a patient, colleague, or family member in their time of need.
Topics Covered:
Key Links to References/Resources Discussed:
About Dr. Janet D'Arcy:
Dr. Janet D’Arcy is a seasoned chiropractor who practises in an east-end Toronto Beach(es) clinic, along with a registered massage therapist.
In addition to her private practice, she is an Assistant Professor at the Canadian Memorial Chiropractic College (CMCC). Within this role, Dr. D’Arcy supervises interns providing patient care at CMCC’s clinic at Sherbourne Health. She also serves on the OCA’s Board of Directors.
Dr. D’Arcy received her undergraduate degrees in biology and physical & health education from Queen’sUniversity in 1989 and her Doctor of Chiropractic degree from the CMCC in 1993. She was also certified in acupuncture from Acupuncture Canada (formerly AFCI) in 2007.
In 2014, Dr. D’Arcy was certified by the Mental Health Commission of Canada to teach mental health first aid. Since then, she’s helped fellow clinicians, as well as CMCC staff, faculty and students increase their knowledge of mental health conditions, resources and practical approaches.
Dr. D’Arcy also received her Fellowship in Sports Sciences from the Royal College of Chiropractic Sports Sciences (Canada) in 2016. Along with Dr. Cameron Borody, she was recently awarded a Canadian Chiropractic Research Foundation (CCRF) grant for a study on Attitudes toward chiropractic: a survey of Canadian sport and exercise medicine physicians.
Episode 11 – Supporting Mental Health Needs Transcript
Introduction:
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Welcome to On Spinal Chat, where we explore what O-C-A is doing or supporting, to help enhance your patient care, grow your practice, or advance the chiropractic profession.
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Many Ontarians – including patients, clinicians and their teams - face mental health challenges, from anxiety to suicidal ideation.
While the diagnosis and treatment of mental health treatment is not within a chiropractor’s scope of practice, Dr. Janet D’Arcy believes chiropractors like you can play an important role in identifying someone who may need help, helping them access practical resources and making appropriate referrals.
I’m Leslie and today I’m speaking with Dr. D’Arcy about how you can increase your mental health literacy and prepare to appropriately engage and support a patient, colleague or family member in their time of need.
Dr. D’Arcy is a practising chiropractor, assistant professor at C-M-C-C, O-C-A Board member and certified mental health first aid instructor. Since 2014, she’s helped fellow clinicians increase their knowledge of mental health conditions, resources and practical approaches.
We’ll chat about her experiences and simple steps you can take to better support your patients, staff, family members or even your own mental health.
And be sure to check the show notes for links to practical resources discussed throughout this episode.
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Main Interview:
Leslie:
Thank you, Dr. D’Arcy, for joining me today to speak about mental health, which is an important topic as we hopefully move towards the end of this pandemic.
Dr. D'Arcy:
Well, thank you for having me. I appreciate it.
Leslie:
First off, how do you define mental health literacy?
Dr. D'Arcy:
Well, it's a fairly broad topic. It's a combination of knowledge about mental health conditions, what effective treatments are, what resources are out there, your understanding of all those things, as well as beliefs about mental health. It's also acknowledging stigma and the role that stigma unfortunately still plays in the way we view and the way we treat people dealing with mental health issues. And it's also understanding why it's important for chiropractors.
Obviously, mental health issues are not within our scope, but I think we play an important role as health care providers, in helping our patients understand mental health issues, helping them identify resources and helping make appropriate referrals for our patients because we see our patients a lot. And by virtue of that, I think sometimes we have an even closer relationship with our patients than they may with their family doc, for example. So, we may be finding ourselves in a unique position that we can potentially identify someone who might need help and make an appropriate referral, as well as provide support for that patient.
Leslie:
What type of mental health education do chiropractors get within their post-grad program?
Dr. D'Arcy:
There are classes in psychology that they do get in, I think, the first through third years at C-M-C-C. And again, they may have different backgrounds before coming to C-M-C-C. And one of the initiatives that C-M-C-C took was to improve mental health literacy amongst staff, faculty, as well as interns. So, one of the things that recent grads would have would be training in a course called Mental Health First Aid. Certainly, not all of the grads would have it, but there was an opportunity to take that two-day training course. And it's also been offered as a CE course through C-M-C-C in the past, and it's available to the general public as well. So, you don't have to be a healthcare provider to take it.
Leslie:
What is Mental health first aid?
Dr. D'Arcy:
Mental health first aid is the help provided to a person developing a mental health problem or in a mental health crisis. First aid is given until appropriate professional treatment is received or until the crisis is resolved. And what the aims of that are, are to preserve life where a person may be a danger to themselves or to others, to provide help to prevent the mental health problem from becoming more serious, promote the recovery of good mental health, and finally, to provide comfort to a person experiencing a mental health problem. And that comes directly from the Mental Health First Aid manual.
Leslie:
Okay. And that C-E course is still there?
Dr. D'Arcy:
It's not currently being offered. It was a little bit altered during the pandemic, but hopefully, at some point in the future, it will. It's also something that chiropractors could take, not necessarily through C-M-C-C, but they could take it through the Mental Health Commission of Canada.
Leslie:
So, how did you become involved in mental health initiatives?
Dr. D'Arcy:
Well, it was sort of accidental and perhaps out of necessity. I was supporting someone who's close to me who was dealing with some mental health issues, and that sort of piqued my interest. Partially because I witnessed the difficulty that they faced trying to get help, I also witnessed the impact that it had on their life and the significant negative ramifications that delayed diagnosis had with their ability to function. That led me to do more reading and research on my own, and I developed a rounds presentation for my interns, just going over the basics of mental health. What are some mental health issues that they might be facing with patients in their practice?
And what happened at that point was I had told someone in clinic management about this presentation and they suggested and put my name forward for some mental health initiative. And I thought I was going to go to a meeting, come back and have a report and present it to somebody. Then I found out they were sending me to get trained in delivery of Mental Health First Aid, the course. Which, at first, I was a little bit unsure of, because I thought, I don't know if this is in my comfort zone. It was really a tremendous opportunity, and it has really changed the way that I have been able to provide resources for my patients and provide support for my patients. And it's a really meaningful part of my role at C-M-C-C as a clinician. So teaching that course has been a fantastic experience. I learn something different every time just from teaching it.
Leslie:
I just want to probe a little more. Have you had much feedback from your students on this course, the information they've gleaned from it and how they've been able to apply it?
Dr. D'Arcy:
So again, throughout COVID, we were unable to deliver the course in person. So that's been on hiatus, but we are starting back this year. And the feedback that we have after the course has been really good. We have found that people have been able to implement some of the strategies we talk about, some of the tools that they get. Sometimes it can be the next day. There was an example of a clinician that we had who took the course. The next day the patient had come in, in crisis, and they were able to use some of the tools and resources that we had discussed the day prior with that patient to try to get them help.
So there's some really practical tools that that particular course teaches. And it's not the only resource. I don't mean for this to be a commercial for Mental Health First Aid, but it is a very useful tool to get you started. I think it really opens people's eyes as to what resources are out there. And there are a lot of resources that people may be unaware of.
Leslie:
So with that specific example, what was the most beneficial step that that clinician took?
Dr. D'Arcy:
In this case, I think it was using 211. So 211 is a resource that a lot of people don't know about. It's across Canada, it's city-specific for Toronto. Like 211, there's a 211 Toronto. I think people are familiar with 311, which is who you call if your garbage doesn't get picked up. But 211 Toronto has a plethora of resources from mental health supports to housing to legal aid. And that is a really helpful thing for a lot of people because it's hard to navigate the system and to know where help is.
Leslie:
Okay, so that's one resource. Within the confines of this podcast, we can't name them all, but what other key health resources are available to help our members, their families, their staff, as well as their patients?
Dr. D'Arcy:
Some of them were published in an O-C-A bulletin in the summer. So one of them is Connex Ontario, spelled C-O-N-N-E-X. And they have a website where practitioners can order information about the helplines that are available for patients who may be in crisis. So in my window at my office, I have a poster, and the poster has the helpline. And that is something that patients can access if they're dealing with mental health issues, addiction issues, or gambling issues. That is one really great resource. You can go online, you can order those materials for your office and it's free. Those are some things that you can have in your waiting room. You can have them in your treatment room. So just the cards that have that information. I've used those cards many times with patients in my role at my own practice as well as at the teaching clinic where I work downtown.
Connex Ontario is, again, one of those resources that people may not know about, but it's a very simple thing that can get people access. The people that you talk to on that line can help direct you to resources that are in your community.
Leslie:
And as we move away from COVID being surface transmitted, I believe we can put paper items back into clinics.
Dr. D'Arcy:
Exactly. I took them out of my clinic at the beginning of COVID, but I think they can go back now.
So another one that's relatively new since the onset of the pandemic is Bounce Back Ontario. That's a program that I think is delivered through the Canadian Mental Health Association. And it offers C-B-T, so cognitive behavioral therapy services to people to try and help manage specific symptoms with respect to depression and anxiety. It's free of charge, and again, you just go to bouncebackontario.ca. That is quite a good resource. That is Ontario-specific and is across the province.
Other things as far as knowledge about suicide and suicidal ideation and how to deal with that is the Centre for Suicide Prevention. That can provide some useful information, as well as there's a program called ASIST. So that stands for Applied Suicide Intervention Skills training. It's a two-day workshop specifically dealing with people who are in crisis and have expressed suicidal ideation. The Canadian Mental Health Association has various chapters and they can provide information.
Leslie:
Now, what can our members do to safeguard their own and their family members' mental health?
Dr. D'Arcy:
I think sometimes a large part of safeguarding is awareness and recognition. So I think it's important for us to become knowledgeable and to recognize the signs that someone may be needing help, as well as understanding that it's okay to ask for help. That applies not only to our patients, but to our friends, to our family, and as you say, staff members. So listening to people, creating an open environment where people feel comfortable talking, as well as being mindful of the way we speak about people with mental health issues. That's very important because words matter and language can really stigmatize and it can really minimize people who have mental health conditions.
Leslie:
Now, if members want to tap into some more expertise on a specific topic, could you highlight one of the services that's accessible to members through their O-C-A membership?
Dr. D'Arcy:
Well, people may or may not be aware, but just like if you have a life partner, or spouse, who has an employee assistance program, the OCA also has something that's comparable to an employee assistance program. It's the Employee and Family Assistance program, and that's available through LifeWorks, which was formerly known as Morneau Shepell, which people may be familiar with because they're a big player in this area. And so that can give you access to a whole variety of services, counseling, information and resources. And I think that information is available on the O-C-A website.
Leslie:
Yes. For clinic owners who are managing a team, how can they best support their team's mental health?
Dr. D'Arcy:
I think recognizing things like self-care. Self-care has become something that we talk about now that maybe we didn't talk about 10 years ago. So recognizing and promoting things like good diet, nutritious foods, sleep hygiene, self-talk, exercise, work life balance. If we're not working from a full cup, we're not going to be as effective in our roles at work as we could be. So I think those are all common sense things that maybe aren't always all that common.
Leslie:
Okay. Now moving on to our patients. You talked earlier about the relationship a chiropractor has with their patients, and we know there's a connection between chronic pain and mental health. Can you elaborate on that?
Dr. D'Arcy:
So, with chronic or persistent pain, we know that there's a bidirectional relationship between mood disorders. And upwards of 30 to 60 per cent of people who have been diagnosed with persistent pain will also report depression. When those two things coexist together, it's associated with higher treatment costs, increased pain severity, worse functioning, as well as more disability. Also, having a psychiatric diagnosis can be a risk factor for being prescribed an opioid and developing persistent opioid use disorder.
Again, mental health issues are not within our scope of practice to treat, but if we are not acknowledging, addressing, identifying, trying to assist our patients in getting resources, we're really only focusing on half the problem. So we need to be mindful and we need to be knowledgeable about how things like depression and anxiety affect people and how they're going to be prognostic factors. We also need to be proactive in terms of trying to help patients obtain the help that they need so that that aspect of the condition can be addressed. We can address what we address as chiropractors from a musculoskeletal perspective, and that way there's going to be better outcomes for the patient.
Leslie:
And from a practical perspective, how can a chiropractor effectively support a patient's mental health needs while also staying within their scope of practice? Because, obviously, it's a bit of a fine line.
Dr. D'Arcy:
It definitely is, but I think if we think about things like diabetes, we're well versed in knowing what signs and symptoms of diabetes are like. We encourage patients to follow up with their family doctor. We encourage them if they've been prescribed medication for diabetes. We encourage them to be adherent to that treatment regimen. We can do the same thing for mental health. It's important that we have an awareness of how common conditions will present because sometimes they're going to be undiagnosed. And we may be the first ones who think, maybe this person has symptoms that are consistent with anxiety, and we can have a conversation with them. Again, we're not diagnosing them, but we can send them in the direction where they could get diagnosed. And I think it all starts with creating an environment where people are comfortable talking. It can start at something as basic as our intake forms.
Up until less than 10 years ago in my practice, my intake forms didn't have a section for mental health issues. They had sections for GI issues, gynecological issues, joint issues, but there was not a section for mental health. Well, that's changed. And I think something as basic as having a spot on your intake paperwork that asks about, have you ever been diagnosed with any mental health issues, can open up the conversation. It can tell people that it's okay to talk about it, because unfortunately stigma still exists with respect to mental health conditions. And sometimes that stigma is internalized. It may be self-stigma and people just feel that, no, I can't talk about it.
Leslie:
And on your intake form, you've made this change. What's the result been?
Dr. D'Arcy:
So I've made the change. We made the change at C-M-C-C, at our teaching clinics as well, and people will list bipolar disorder, anxiety, depression, schizophrenia. They will list these things. Now, does everyone list if they've been diagnosed with a mental health disorder? I have no way of knowing. But what I do know is that people are putting those answers down and it opens the conversation and it puts it out there as that this, like any other issue, is something that we're going to talk about because it's going to be impacting your overall health.
Leslie:
And how does that impact their treatment?
Dr. D'Arcy:
It's not going to change their treatment really, because again, it's out of our scope. But it could certainly change the prognostic factors because it could be a negative prognostic factor and it would put us in a position where we're creating more realistic expectations. So if someone has had untreated depression or anxiety and we know that there can be a correlation between persistent pain in those things, then this may be something that may take a little bit longer and it will have an impact on your recovery. And it would also inform our treatment plan in that we would want to try to support that patient, either by a referral if the patient is interested in that. Again, we're not going to force people, but a referral for another professional who could help that aspect of their health.
Leslie:
When we're talking about the impact of mental health, does it impact compliance with prescription exercise and other self-care recommendations that a chiropractor might provide?
Dr. D'Arcy:
I think it certainly can. So, if someone is in the depths of a deep depression, I think it can be very challenging for that person to adhere to not just a treatment plan of coming into the office, but doing exercise, for example. So if we're prescribing exercise for someone who is in the depths of depression, it's going to be challenging for them. And I think that's important for us to recognize that it could be a factor that could be affecting compliance.
Leslie:
Any tips for chiropractors to ease that along and help get them to the point of exercising, but working with the issue at hand?
Dr. D'Arcy:
I think understanding where they're at, so meeting the patient where they're at. We try to do that for whatever the condition a patient has, but it's particularly important when they have a mood disorder when they have anxiety. And I think just trying to make sure the patient feels supported, that they are aware that help is available, that they're effective treatments. And again, because sometimes people may feel a sense of hopelessness. Again, they may have self-stigma, that they're too far gone, that there's nothing that can help them. But just being aware that there are things that can help. And also being aware that there's no one right pathway for every patient.
Leslie:
Okay. And you did mention earlier about patients who, because of mental health, maybe have a higher likelihood of being prescribed opioids. Now O-C-A has the Opioid and Pain Reduction Collaborative, which I believe you're familiar with. And our focus there is on low back, shoulder and neck pain. But I'm wondering if there's some overlap in some of the tools that provide that may also have some applicable use in mental health scenarios.
Dr. D'Arcy:
Again, one of the large sections that we go over in mental health first aid is substance use disorders, and opioid use would fall under that realm. It's one of many substances that we can talk about. So certainly there's an overlap there, and I think it's important for us as chiropractors. It's like we're stuck in the middle there because we have patients who have persistent pain, we have patients who have mental health disorders, and again, because the risk of getting prescribed opioids is increased with those patients who are facing mental health challenges. Again, it's important for us, because we're seeing these people quite often. It's important for us to identify that, so having knowledge on both fronts will help us better serve our patients.
Leslie:
I'm wondering if you could highlight some mental health issues that a patient might actually exhibit in a chiropractic clinic that our members should watch out for, mitigate the situation, and address it as effectively as possible.
Dr. D'Arcy:
I've seen a variety of things over the years in practice, and I think once we become aware and open to these things, we'll see them more. If we're not open to them, we may not see them. So for example, in my early years in practice, I had a patient who had just delivered a baby. And retroactively, I can say that she was exhibiting signs of postpartum depression, but at that time, either I wasn't comfortable or didn't have the knowledge. And I think just identifying and being aware of things like that, being aware of the signs and symptoms of depression, loss of interest in things that previously interested you, weight gain, weight loss. There's so many signs and symptoms of a mood disorder and sometimes they're complete polar opposites, but just being aware of the symptoms of some of the common things that people are going to present with. Things like mood disorders, things like anxiety, things like substance use disorder. Becoming aware of those and being able to talk to your patients about those is important.
So if you see someone who you think is struggling with a mood disorder, you can certainly ask them. And if you see someone who you think is expressing suicidal ideation, this is where that crisis intervention can be key, because you need to ask them specific questions. And the signs and symptoms of someone who has suicidal ideation are quite broad. But if you suspect that that is something that is going through a patient's mind, it's important to be comfortable having that conversation with them.
Leslie:
And have you ever been in a scenario where you've effectively handled that?
Dr. D'Arcy:
Yes. And again, it's a continuum, and you have to figure out where you are on that continuum by assessing the risk. It's not an exact science, but you can't assess the risk if you don't ask the questions. And sometimes those questions are uncomfortable and hard to ask. Because asking someone, are you thinking of killing yourself, is really, really hard. But it's really important, because first of all, it may be something that that person has never been asked before. It also validates that they're in pain. And that's really important too. And by asking them, it gives them permission to answer. So you open up the conversation by asking those difficult questions. And then there's a series of questions that you would continue asking to identify where are they at on this continuum. Sometimes it's having a conversation with the patient, just giving them the information for a crisis line.
I had that experience once. It was at the end of the day at the teaching clinic that I was at. Almost everyone had left, someone walked in, they weren't our patient, they were in crisis. And I sat down, had a chat with them. And at that point I felt comfortable, based on the questions that I had asked and their answers, giving them the information about the crisis line, which was Connex Ontario, which I will also point out is bilingual. So it's French on one side, English on the other. And French was this fellow's first language, so he was really happy about that.
And so that's one end of the continuum. I also had an experience where a patient had just started antidepressants and was expressing thoughts of wanting to die. I had a conversation, sat down and determined that the best course of action was to call the family doc. Luckily it was in business hours, and I connected the family doc and patient. He left the room, they had the conversation, and so it was handed off to his family doctor. So yeah, it will happen. It's hard and stressful and just knowing the right questions to ask can really help you feel confident that you've done the right thing and that you've not left someone at risk because that would be the worst thing.
Leslie:
Okay. Now, you've mentioned a lot about having the right questions to ask. Where would a chiropractor go to get an idea of the best questions to ask in this sort of a scenario?
Dr. D'Arcy:
There's the ASIST course, the Applied Suicide Intervention Skills Training, which I believe is a two-day course, so that's a time commitment. There's also, I think, a half-day course called safeTALK, and I believe those are offered through the Centre for Suicide Prevention. Mental Health First Aid also deals with that specifically. There's a specific section on dealing with someone who is in crisis with respect to suicidal ideation. And there's also a section for people who are in crisis on various other levels, for someone who may be having or dealing with a psychotic disorder, who's having a panic attack.
We're familiar with physical first aid and we all sort of know what to do if someone is having a heart attack, having a stroke, has broken a bone. But I think fewer of us know what to do if someone's having a panic attack or a psychotic episode or is suicidal. And again, I don't mean to make this a commercial for Mental Health First Aid, but I think it's a really useful course for people to have.
Leslie:
Okay, thank you. Now, we're coming through a fairly unusual period in history with the pandemic, I'm wondering if there's any types of mental health conditions that are more prevalent right now that we may want to be on the lookout for?
Dr. D'Arcy:
Certainly, I think if you have pre-existing anxiety, the last two years have been a challenge, so it may be exacerbating people's anxiety. It was also a very challenging time for people who have mood disorders, especially when we were in lockdown and we were isolating. But I think people seem to be talking about that a little bit more, from my end of one office.
Leslie:
Okay, thank you. Now, we've talked about a lot of things in terms of how to best support mental health for our clinicians, our family members, teams, as well as patients. What are the three steps that each of our members can take to enhance their mental health literacy after they leave this podcast?
Dr. D'Arcy:
I think it's being open to the knowledge that while we are musculoskeletal healthcare or neuromusculoskeletal healthcare practitioners, we can't separate. It's very artificial to separate mental health from physical health. And so, if we truly accept that, know that we need to explore that, then I think that's step one. Step two would be starting to look at the resources. Again, people may not know what's out in the community. And again, the O-C-A has some of them listed, and certainly, we can add more, but starting to look at what is out there. Typically, in our practices, we will often have a stable of practitioners that we may refer to. So if they're not in our office, we may refer to a massage therapist. We may refer to a physiotherapist. But thinking beyond that realm, who are the psychologists in the community? Who do I feel comfortable referring my patients to? What other forms of mental healthcare support are out there?
It's important to research their areas of expertise. So there may be practitioners out there in the field who are working with youth, for example. And so, if you have a patient who comes in who is a teenager, young adult, then having a practitioner who works specifically with youth could be helpful. Things like clinics that are specific to people who may have an eating disorder. Social workers. A lot of people, their extended health plans will cover the treatment from a psychologist. It'll also cover a social worker. Social workers do counseling. So just trying to create that network of people in your community who can be there to support your patients, so that you're not scrambling as the patient's sitting there. They can talk to you and they can tell you what's going on with them and you can think, okay, perhaps this is a mood disorder, or perhaps this is anxiety. What are the resources that I have at my fingertips that I can say, "Have you thought of trying this?"
Again, we're not diagnosing. Maybe, someone who's coming to us with a diagnosis of anxiety, they've tried all kinds of things. Have you tried the Anxiety and Phobia Workbook? This is a great tool, easily available at Chapters or Amazon. Simple things like that. Having those kinds of things in your office so that you could lend them to patients. And I think I need a third one.
Leslie:
You talked about resources. So there's the tangible resources and then there's experts. We could look at that as two and three.
Dr. D'Arcy:
Okay, fair enough.
Leslie:
What would you like to see five years from now as far as how mental health is being treated among chiropractors as well as the broader healthcare community and broader Ontario population?
Dr. D'Arcy:
I would like to see better access for people who are dealing with mental health issues. There's a real struggle right now for people to get help. And I would like to see better access for mental healthcare. I'd like to see less stigma. At one point, my goal was to go across the country and do mental health first aid and start at the grassroots level and create interest across the country for chiropractors. I'm not sure if that'll happen, but I think it's a reasonable goal and ask because a large portion of our population are dealing with mental health concerns. And when you don't get timely health, the outcomes aren't as good. Mental health impacts physical health. Physical health impacts mental health. We can't separate them.
Leslie:
Now, is there anything last that you would like to add that you think would be very helpful for our members to know about mental health?
Dr. D'Arcy:
I think it comes down to being comfortable having the conversations with these patients and people in our lives who are facing mental health challenges. It's important for all of us to be open because we know that mental health conditions impact a huge percentage of our population. We're always talking about one in five people are impacted by mental health conditions in any given year. And that likely underestimates the number because those numbers are, I think, usually being accessed from people who are utilizing the publicly funded healthcare system. And we know that a lot of people aren't accessing the publicly funded healthcare system. So the number of people who are dealing with mental health issues is really quite significant. We all know people who are, even though we may not know that they are. So I think that's something that's really important to remember. If we're not seeing it, it's not because it's not there.
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Outro:
Thank you Dr. D’Arcy for sharing your expertise in mental health resources members can access to build their mental health first aid kit.
Thanks also for explaining the importance of hard conversations and the value of asking questions to assess risk and inform the right action.
We’ll be back in November with another episode of pragmatic insights and tips to help you and your practice.
I hope you’ll join us.
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