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Nurses using advanced technology, therapies to treat mental health issues

Sara Wikstrom
Registered psychiatric nurse Sara Wikstrom

Winnipeg Regional Health Authority
Published Monday, May 7, 2018

As she was training in university to become a registered psychiatric nurse, Sara Wikstrom looked forward to the day when she'd be able to guide patients along the road to improved mental health. What she didn't know was that she'd soon be working on the forefront of a new technology - repetitive transcranial magnetic stimulation, more commonly called rTMS - that's yielding promising results in patients with mild to moderate depression.

"I've always been interested in psychiatric nursing and my goal was to work in an outpatient department, helping people in the community who were dealing with mental health issues," Wikstrom says. "rTMS was something I was unaware of as I was training, but a position became available that allowed me to get a foot in the door, and it ended up being something I'm really excited to be a part of."

rTMS uses a concentrated magnetic field to produce pulses that activate neurons firing in a small area of the brain's frontal lobe that is believed to be related to symptoms of depression. rTMS is non-invasive and the patients are awake the entire time. They can talk, drive after treatment, and unlike electroconvulsive therapy (ECT or shock therapy), there are no memory loss concerns, issues with dizziness or loss of consciousness. A headache is the most common side effect.

Through research conducted by Dr. Mandana Modirrousta at St. Boniface Hospital, Wikstrom is able to explore the use of rTMS treatment with her patients.

"Our positive response rates are somewhere in the 60-65 per cent range," Wikstrom says. "As a treatment option, it's really the new kid on the block and a relatively new technology in the field of psychiatry. It's not a perfect fit for everybody, but it's nice to see this option available."

Wikstrom has been part of the rTMS program since its inception at St. Boniface Hospital in 2012, splitting her time between that team and managing a caseload of about 40 patients for a variety of services that include medication management, resource connections, psychotherapy and cognitive behavioural therapy.

No matter the treatment methodology she employs, Wikstrom says her ultimate goal remains the same.

"The rewards of being a psychiatric nurse flow from helping patients meet their mental health goals, whatever they may be," she says, adding that the range of patients she sees defies categorization.

"I see patients from all walks of life," Wikstrom says. "Mental health issues don't discriminate and it's something that everyone is going to experience at some point in their lives, either with themselves, a loved one or close friend. It's going to touch all of us at some point."

Nevertheless, she adds, the stigma around mental health issues is only slowly dissipating.

"There's still a lot of stigma surrounding mental health and many people are still hesitant to seek out treatment," Wikstrom says. "I've seen that changing slowly over the course of my career and there are a lot more awareness drives in the community," she adds, including initiatives such as Bell's Let's Talk and advocacy efforts like the Winnipeg Jets' Hockey Talks initiative, a national awareness campaign for Canadian NHL teams designed to encourage conversations about mental health.

"When you get celebrities involved, you can see that there are people who are very successful in life that are struggling and overcoming mental health concerns every day. So it's slowly changing, but there's still a lot of stigma and a lot of resistance at times to seeking out mental health services."

Overcoming that resistance is an important factor in early intervention and better outcomes, Wikstrom says.

"The faster you can diagnose a mental illness, the faster you can find a solution, whether it's a medication regime, a new technology such as rTMS, or some sort of therapeutic alliance where you can speak to someone about what's going on. So, if you are having issues with your mental health, don't suffer in silence. Reach out to anyone who might listen. Family physicians are great resources. Seek help soon. Just as if you find a cancer tumor in an early stage, or recognize the warning signs for chronic illnesses like diabetes or high blood pressure, you're chances for a positive outcome for a mental health issue is likely going to be a lot higher when you access diagnosis and treatment earlier."

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