While talking to the many people who come to Richmond Mental Health and Addiction Services for help, Shelagh Smith, together with her colleagues, began to notice a demographic with a unique set of issues.

“I saw that people with chronic pain didn’t seem to be doing as well in groups for depression as people without chronic pain,” explains Shelagh who is the team leader for outpatient services. “Our program is oriented to the treatment of depression and anxiety and not so much for issues around chronic pain.”

So while completing a master’s degree at UBC in Rehabilitation Science, Shelagh chose to research the area of comorbid chronic pain and depression to better understand the experience of people with  chronic pain and depression who receive mental health services in Richmond. She hoped that the results would suggest more effective ways to address their complex needs.

A complex cycle

Shelagh interviewed three clients each of whom had developed chronic pain (and their mental health clinician and one family member) about living with pain and depression, and what recovery and wellness means to them.  She found that community and social support helped the clients self-manage their symptoms, helping them learn how to live with the pain.

“They get trapped in a complex cycle of depression and pain,” she says. “People need support to break that cycle and are able to with a strong community and good strategies. The pain and depression often results in social isolation…the loss of valued roles such as being a worker and the ability to do things they love. So support to grieve, learn to accept the pain and rebuild their lives is really important to recovery and feeling well again.”

As a result of her research, Shelagh is working with collegues to launch a program in the fall to help people tackle the problems and to bring awareness to this complex issue.

“People with chronic pain often develop depression and people with depression are more prone to developing chronic pain, “she says. “Pain clinics may see depression as a barrier to getting over the chronic pain and conversely, from our perspective, we see the chronic pain as a barrier to getting over the depression. I want to bring these two streams together within our mental health system, in one program, to help people live their lives and potentially save health care dollars.”

The big picture

How has her research helped in current role at Richmond Mental Health and Addiction Services?

“It’s forced me to look at the big picture,” she says, “and acknowledge the complex social, psychological and physical needs of people with comorbid illnesses and what  contributes to overall wellness. And it’s also emphasized the need for families, care providers and the client to work together improving how we can offer mental health services to people who have both depression and chronic pain.”

Celebrate Mental Health Week: May 5-11

Read more about the great work of our teams across VCH as we celebrate Mental Health Week:

• Nobody is beyond hope – For Jane and Sam, Assertive Community Treatment teams, known as ACT, continue to make a difference in their lives on the Downtown Eastside.
• The “heart and soul” of the mental health and addiction team – The first regional orientation session for mental health and addiction staff – called Heart & Soul – welcomed new hires to the team and discussed topics that impact practice.
• Walk a Mile event – The Walk-a Mile for Mental Health event began 25 years ago at Riverview Hospital, and last year it was hosted for the first time at the new VGH Willow Pavilion site.