Introducing a nurse practitioner in child and youth mental health
Mental health support is needed now more than ever. Finding the right outlet, and the right person, to assist in building a road to recovery is crucial to patients. The Child and Youth Mental Health program at Hamilton Health Sciences (HHS) is one the largest pediatric mental health programs in Canada. Our programs are offered out of two sites: acute care is located at McMaster Children’s Hospital (MCH), and ambulatory care is offered at Ron Joyce Children’s Health Centre (RJCHC).
Brigitte Landriault, a nurse practitioner who helps lead the program at RJCHC, is motivated to provide the best system of support to all patients she works with. A nurse practitioner (NP) is a registered nurse with advanced university education who can assess, diagnose, treat and monitor a wide range of health problems.
“Our clinic is the first at HHS to allow NPs to become the most responsible provider (MRP), meaning we are responsible for leading the patient’s care plan.”
“Our mental health system is very complex,” says Landriault. “We work closely with agencies and mental health community partners. I work very hard to ensure that patients get to where they need to go as quickly as possible.”
The biggest challenge Landriault sees within her role is the increase in volume and managing the consultation waitlists. The pandemic has created a double-whammy where more people need to access care for mental health, and also people are not reaching out for help until their need is more severe.
“My passion is building connections with patients,” says Landriault. “I try to make sure patients aren’t bounced around the system, and can access the support they need right away.”
The hospital’s new digital health system, Epic, now plays a significant role in bridging care between inpatient settings and out-patient settings across the organization, helping to make sure patients can get the resources they need.
“Using Epic definitely helped with ensuring all information about the patient’s visits with other hospitals or clinics was tracked clearly and efficiently,” says Landriault.
First clinic at HHS with NP as most responsible provider
Landriault wears many hats, including being part of the Brief Intervention Services Consultation team, which plays a big part in providing diagnostic assessments and planning where patients need to go for ongoing care.
“Our clinic is the first at HHS to allow NPs to become the most responsible provider (MRP), meaning we are responsible for leading the patient’s care plan,” she says. “Because of my ability to use my full scope of practice, I can provide diagnostic clarification and treatment recommendations.”
“I realized there was a gap – a huge one.”
The majority of Landriault’s work focuses on youth with probable co-morbid mental health issues – meaning having more than one disorder at a time – with safety concerns. She also works with young people experiencing depression, anxiety, OCD, ADHD, bi-polar disorder, autism and eating disorders. Many of her patients struggle with impairment functioning such as losing the ability to go to school or being able to manage personal care like brushing their teeth.
Treatment paths are based on determining the care needed, and ongoing management in each case. Landriault focuses on improvement and continuity of care. She also follows up with patients to ensure they are receiving everything they need from the program.
Wanting to help close the gap
Landriault says she always had a strong desire to pursue advanced nursing. After graduating from the Bachelor of Science in Nursing program in 2011, she started her career in hematology at SickKids hospital in Toronto. It wasn’t until she was asked to take a shift in the mental health ward that she discovered she wanted to learn more about the field.
“I realized there was a gap – a huge one. There was not enough mental health support given,” says Landriault.
Brigitte went to the University of Toronto to get her Master of Nursing and Nurse Practitioner, in order to have the ability to be autonomous in providing diagnostic assessments and ongoing management.
In 2018 Landriault started with HHS’ Child and Youth Mental Health Programs Ambulatory Services at RJCHC. She continues to spend her days helping young people in crisis, and supporting various quality improvement initiatives within the program.
“I wouldn’t want to be anywhere else,” says Landriault. “It is so rewarding when patients receive a diagnosis and connect with the proper support. I love collaborating with members of the community and I’m always looking for ways to make our program better each and every day.”