An update on Canterbury DHB consumer advisor Linda Smith's progress with Equally Well education.

Linda Smith is one of the consumer advisors working within the Canterbury District Health Board (DHB). It is Linda’s role within the Canterbury DHB Specialist Mental Health Service to work with managers to improve the services provided for people experiencing mental health issues. Linda comes from a medical background and has a lived experience of significant medical comorbidities. Jane Foley and Tanya Ewart are registered nurses working within the Specialist Mental Health service and together Linda, Jane and Tanya have developed an education package for junior doctors. All are passionate advocates for Equally Well action. 

Equally Well was endorsed by the Canterbury DHB in October 2015. Many initiatives have been progressed since then and were featured in an e-news article last year.

Fifth-year medical students were identified as a group where the key Equally Well messages could be introduced with the objective of raising awareness around the physical health comorbidities and the effects of psychotropic medication for those with serious mental health issues. Linda comments, “Initially we discussed the proposal with psychiatry clinicians and curriculum organisers within the DHB and the Medical School, who agreed we needed to include Equally Well in the programme”.

The Equally Well teaching session has become an established part of the fifth year medical student psychological medicine programme. It provides a great opportunity for medical students to learn from nurses and consumers about the relationships between mental and physical health issues. 

Jane, Tanya and Linda present the 90-minute group presentation together. It explores:

  • key Equally Well concepts
  • statistics
  • risks, and effects of psychotropic medications
  • diagnostic over-shadowing (where a physical health issue is wrongly attributed to the mental health issues)
  • stigma and discrimination
  • trauma-informed care. 

The training package is presented monthly over the academic year to groups of up to 12.

A key part of the presentation is facilitated by Linda, who shares her story of lived experience. Jane comments “This part of the presentation has a significant impact on the students and facilitates their understanding of the physical effects of serious mental illness and provides a real face to the journey of recovery”. 

Peri Renison, Chief of Psychiatry, believes the training is a crucial part of supporting the DHB’s desire to achieve Equally Well status for people living with mental health issues.

As a doctor one must think and continue to think broadly and consider all possible differentials

Students’ feedback suggests that they regard this session as a valuable part of their learning:

“Thought this was very valuable, especially for us given that next year when we're house officers our primary role on our psych rotation will be looking after the physical needs of the patients.” 

“Great to have the patient perspective of Linda (consumer advisor) as well as the perspective from nursing. Important issues to discuss and highlight the inequities.”

“Good having three people share the tutorial. Patient's story was very valuable; her story hammered in the fact that as a doctor one must think and continue to think broadly and consider all possible differentials.” 

In the long-term, Linda hopes Equally Well concepts will be incorporated into a holistic practice approach. The ultimate aim is to reduce the physical health inequities experienced by those with serious mental health issues within the DHB.