Table 1

Description of integrated care team

Family medicine
  • Attending physicians.

  • Family medicine resident physicians.

  • Registered nurse care coordinators.

 Cultural training
  • Refugee-focused didactic sessions throughout family medicine resident physicians’ second year (eg, grand round lectures, workshops and informal meetings that focus on cultural practices of different refugee groups).

  • Physical health management/treatment.

  • Referrals to specialty care.

Behavioural health*
  • Attending clinical psychologists.

  • Doctoral students in clinical psychology.

  • One second-year family medicine resident physician at a time (all are required to rotate for 4 weeks).

  • Up to one fourth-year medical student at a time (option to rotate for 2 or 4 weeks).

 Cultural training
  • Regular discussion around culture-specific elements of ongoing cases during supervision.

  • Option to join cultural training programming that is offered within the Family Medicine Department.

 Developmental Screeners
  • A 60 min session completed for infants and toddlers prior to well child check-ups.

  • If areas of developmental concern are identified (ie, delayed speech, limited fine motor movement, suspected autism spectrum disorder), referrals are placed to further assessment and/or intervention recommendations are provided to parents.

 Behavioural health appointments
  • A targeted, 30–60 min brief intervention.

  • Focused on identifying and intervening on a specific aspect of the patient’s life that is troubling them the most (eg, low mood, psychosomatic headaches, stress, insomnia, parenting difficulties, difficulty communicating with spouse, smoking).

  • Up to five behavioural health appointments are available to each IFMC patient each year.

 Ongoing psychotherapy
  • Recurring, 50 min individual, couples or family therapy.

  • Duration and frequency of the treatment, along with treatment goals, are collaboratively determined between patient and provider.

  • Psychiatrist attending.

  • Fourth-year psychiatry resident physicians on the Global Mental Health Track.

 Cultural training
  • Extensive didactics on cultural psychiatry.

  • Monthly journal club that focuses on issues involving culture and psychiatry/evaluation.

  • Weekly group supervision to collaboratively discuss new intakes and the ongoing care needs of established patients.

  • Medication management.

  • Integrated psychiatry and psychotherapy services.

  • Medication consultation services for family medicine providers.

  • Typically serving patients who:

    • Failed pharmacotherapy initiated by the family medicine providers.

    • Have more severe or persistent symptoms.

    • Who appear not to be adjusting months-to-years after resettlement and are suspected of experiencing depression or some other psychiatric concern.

  • *Behavioural health team is referred to as Family Stress Clinic.

  • IFMC, International Family Medicine Clinic.