Why It Works! Multidisciplinary, Multi-Agency Weekly Mental Health Meeting
By Peter Bell Lead Physician Sharbot Lake Family Health Team
• The knowledge and skill of the combined team is far greater than any one or two of its members.
• The meetings are capacity enhancing for all of the participants.
• Participants develop a new awareness of the knowledge & skills of other team members resulting in more effective referrals.
• Integration and coordination of care provides greater efficiency & effectiveness while avoiding duplication that may be wasteful and confusing.
• Triage by the team is an effective way to identify who is most appropriate to accept a new referral based on skill set, acceptability to the patient and availability within a time frame appropriate to the urgency of the referral.
• Team members may adjust existing appointments to accommodate a more urgent consultation.
• The "warm handoff" achieves a higher rate of engagement with a new provider or agency than traditional intake.
• Direct referral within the team reduces wait time dramatically. Treatment that is delayed is less or ineffective.
• Referrals are frequently unsuccessful due to patient frustration and anger with the administrative intake interview.
• Team members who have never seen and may never see a patient often have helpful insights and suggestions.
• Team members who have never seen a patient often accept a new referral as a result of their participation.
• The combined team has a broad knowledge base of programs and resources and frequently identifies and recommends resources that the presenting provider has not already considered.
• Team members are often able to facilitate access to other consultants & resources in their base agencies.
• Mental health counselling is often challenging, potentially frustrating work. Team members gain a sense of recognition and support from participating in team-based problem solving.
NOTE:
➢ The above observations come from 5 decades of participation in multidisciplinary, multiagency, community based mental health team meetings.
➢ First name and last initial only are used to protect privacy.
➢ Both "multidisciplinary" and "multi-agency" are key to success.
➢ The weekly time interval is key to being able to respond in a timely fashion to provider concerns that are encountered on a daily basis during the preceding week.
➢ The 8:30 to 9:30 meeting time results in 30 minutes of lost direct patient care time and 30 minutes of personal time contribution for most providers. The lost patient care time is offset by improved efficiency and effectiveness of care.
➢ The very high rate of attendance of participants over the years demonstrates how highly they value participating in the meeting. Some may get recognition for starting their workday at 8:30 rather than 9 but I suspect that most if not all would be eager to participate whether or not they were contributing personal time.
➢ Team based triage and referral is not intended to replace the reporting relationship between workers and their supervisors. They can still present and get approval for new referrals as required by their supervisors BUT team-based triage should replace cumbersome, formal, impersonal, timewasting intake processes that are currently a serious barrier to effective care.
➢ It may be appropriate to have a goal to provide equitable care to all residents in the province but that should not mean “sameness” that blocks teams from developing innovative, community based, effective ways of responding to patient care needs.