Approximately two in five Canadians live with a mental-health disorder and about eight million are struggling with non-prescriptive addiction.
Medically managed intensive outpatient programming, or MMIOP, provides rapid access to treatment, resolution of symptoms and rapid return to work, said Dr. Rob Tanguay, vice-president and chief medical officer at the Newly Institute, during a session at Benefits Canada‘s 2021 Mental Health Summit.
While the traditional treatment model helps people get back to work within three to six months, “the ultimate goal of MMIOP is to get even the most complex individuals back to work in weeks rather than months or years,” he said.
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“Rather than seeing someone every few weeks, we see them daily,” he added, noting in an intensive outpatient program, the daily visits allow increased trauma therapy, more individualized and group therapy, more rapid medication changes and faster medical stabilization and optimization — all of which lead to a rapid return to work.
MMIOP best practices begin with seeing the individual almost immediately after they go off work. “If someone is so unwell that they are unable to go to work, there is likely a significantly complex issue that needs to be addressed immediately” said Dr. Tanguay. “This allow individuals to be rapidly assessed rather than waiting months to years to get an independent medical exam.”
MMIOP offers an interdisciplinary team of registered practitioners such as psychological, medical and return to work staff who work together to conduct an immediate assessment using objective testing such as psychometric evaluations and pharmacogenetic testing to back up their diagnosis. They then develop an individualized, comprehensive treatment plan.
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According to Dr. Tanguay, some of the conditions that can be effectively treated with MMIOP include depression, anxiety, post-traumatic stress disorder, childhood traumas and operational stress injuries, as well as chronic pain due to fibromyalgia and chronic back pain.
“Medical managed intensive outpatient programs are considered best practice when it comes to addiction,” he said, noting they may generate positive outcomes for traumatic psychological addiction to medications and substances such as alcohol, opioids and cannabis, as well as non-substance addiction like gambling and sex.
Evidence suggests that intensive outpatient programming improves return to work, addiction and pain outcomes. The key to rapid return to work, according to Tanguay, is making sure the integration process starts in therapy. “Rather than just focusing on treating the mental-health disorder or the addiction, we’re also focusing on the anticipatory anxiety of returning to work and preparing that individual from the day they start programming.”
Read more coverage of the 2021 Mental Health Summit.