Dr. Olufemi Banjo: supporting patients outside of GRH

Mental health providers at Grand River Hospital often work outside of the hospital to support patients.

Such is the case with Dr. Olufemi Banjo. As a consultant psychiatrist at GRH, Dr. Banjo also offers his expertise with health professionals at St. Mary’s General Hospital (opens in a new window).

Dr. Banjo reflects on his work within multidisciplinary teams for patients dealing with dementia and other medical conditions.

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In addition to your work as a consultant psychiatrist to Grand River Hospital, in what other areas do you provide consultant services?

I provide consultation and liaison to admitted patient at St Mary's General Hospital at the request of the treating medical or surgical consultant and the team.

l also run a monthly clinic with the Geriatric Medical Complex Clinic at St Mary's General Hospital. I work collaboratively with the geriatricians who are the best in their field.

My work includes:

• Managing patients with medical conditions that result in psychiatric symptoms such as delirium;
• Supporting the management of patients with underlying mental disorder that have been admitted for treatment of medical problems;
• Managing patients with medically unexplained physical symptoms; and
• Diagnosis and management of dementia and capacity assessment.

What are the unique needs of patients in those services?

Their needs are not much different than others - prompt diagnosis, treatment and also patient and family support.

How closely can a mental illness be tied to a life-threatening or chronic physical illness?

Mental illness and physical illness are closely linked. People with mental illness are at higher risk of experiencing a wide range of chronic medical conditions.

Likewise, people with chronic physical conditions are at higher risk of experiencing mental illness compared to general population. For example, depression has been linked to stroke, coronary heart disease and other medical conditions.

What do you find most interesting about providing care outside of a dedicated mental health setting?

In hospital wards, I enjoy the more acute aspects of my work. Moreover, I see a wide range of psychiatric disorders, some of which may have arisen as a result of a physical health problem.

In other cases, the psychiatric disorder may have led to the health problem or the two problems may co-exist.

In addition, working closely with the consultants and professionals from other disciplines also makes my practice interesting.

What do you find challenging about providing care outside of a dedicated mental health setting?

As cases become more complex, it can take somewhat longer to get a complete picture of a patient’s needs. As a result, I greatly depend on information being reliably recorded and communicated so I can provide the best support.

From your experience, how do care teams work together to treat physical and mental illness when they happen at the same time?

We look at the situation and difficulties in a holistic manner. We may also need to involve another discipline or transfer the patient to the psychiatric ward. We may write prescriptions taking into account how medication for mental health needs may interact with the physical illness.

We will inform the family physician of the agreed upon care plan and liaise with other professionals where appropriate, with the patient's permission. We also make sure that family members are involved when appropriate, taking into account the confidentiality of the patient.

If someone is dealing with a physical illness, what are the mental health warning signs they should watch out for?

Feeling worried or anxious, feeling low or unhappy, sleep problems, feeling guilty or withdrawn, weight changes, extreme high and lows, feeling of persecution, confusion, hearing voices, suicidal thoughts and unexplained physical symptoms.

How can patients seek help?

If you are concerned about a friend or loved one, encourage them to talk to their family doctor. When someone’s at an immediate risk of suicide or self-harm, call 911 or 24/7 crisis help line or bring them to the nearest emergency department right away.