Psychiatrist Dr. Michael Flynn will be at the forefront of Atlantic Canada’s first hospital-based rTMS program; an initiative funded by the QEII Foundation and its donors.
Originally published on saltwire.com.
While mental illness can cloud the mind and darken the thoughts, more than 17,000 Nova Scotians with treatment-resistant depression will soon have access to a procedure that has the power to bring them back into the light.
A recent $420,000 donation by Bell Let’s Talk has brought the QEII Foundation to its goal of $759,000 to launch an innovative new depression treatment program at two hospitals here in the province.
Repetitive Transcranial Magnetic Stimulation (rTMS) is a non-invasive procedure that has been sought after for more than 15 years, according to psychiatrist Dr. Michael Flynn of the Nova Scotia Hospital.
“When you are offering another option, it gives people more hope that there is some light at the end of the tunnel,” says Dr. Flynn.
rTMS involves stimulating or inhibiting nerve cells in the brain that are involved in controlling emotions. With repeated treatments, the magnetic pulses impact how the brain is working — easing depression symptoms and improving mood. It’s especially helpful for people with treatment-resistant depression who aren’t responding to antidepressant medication.
Dr. Flynn says about 20 per cent of the population will experience a depressive illness at some point in their lives. Here in Nova Scotia, he estimates about five per cent of the province has a depressive illness and at least 1/3 of those (about 17,000 people) will not respond to psychotherapy or medicines.
‘THE DEMAND IS GOING TO BE FIERCE’
Until now, rTMS has only been offered in the province at a private clinic in Halifax. Thanks to the generous support of Bell Let’s Talk and their $420,000 gift to the QEII Foundation, individuals will soon be able to access this life-changing treatment at the Nova Scotia Hospital in Dartmouth and at the Valley Regional Hospital in Kentville.
QEII Foundation president and CEO Susan Mullin says Bell Let’s Talk has done a tremendous amount of work breaking down the stigma surrounding mental illness and funding projects that improve access to mental health supports and services across Canada.
“If you’re going to encourage people to get help, you need to have services available to treat them — and this investment does just that,” says Mullin. “I’d like to thank Bell Let’s Talk for their generous donation to support the mental health of Nova Scotians. We’re very proud to make rTMS available as a publicly-funded service through donor and corporate support.”
The rTMS equipment has been secured, and now training is underway so enough nurses and technicians will be able to administer the treatment under psychiatrists’ guidance. At the Nova Scotia Hospital, Dr. Flynn and his team are preparing for an onslaught of requests for the innovative depression treatment.
“When you suddenly have a new service that everyone is desiring, you’re going from zero to 100,” says Dr. Flynn. “This will be another tool in our antidepressant strategy kit, and the demand is going to be fierce.”
HOW rTMS COMPARES TO ECT
Patients with depression typically begin with psychotherapy and/or medication, and it’s only after neither prove effective that other treatment options are considered. Until now, the next step has been electroconvulsive therapy (ECT), which involves administering a small electrical current to the surface of the scalp.
While Dr. Flynn says ECT remains the “gold standard” for treating depression, calling it “by far the most effective antidepressant we have,” it’s also a more complicated procedure involving general anesthesia, muscle relaxation and a short-lived confusional state.
By contrast, rTMS is easily tolerated with no cognitive side effects. Patients sit comfortably in recliner-style chairs and remain awake. They can return to normal, daily activities immediately following their treatment since no anesthesia is required.
“ECT works very effectively, but sometimes people would like to have another option before necessarily going there,” says Dr. Flynn, calling rTMS “an intermediate step” that will serve patients well and mean they may not need to progress onto ECT.
Dr. Flynn says the new rTMS program is “bringing Nova Scotia up to where we need to be,” and he’s considering it a positive first step in moving towards a province-wide depression treatment strategy.
rTMS ‘SAFE AND EFFECTIVE’
Dr. Ahmed Saleh is a psychiatrist at Valley Regional Hospital in Kentville, which will be the first rural site in Nova Scotia to offer rTMS.
Patients across the province will be able to access rTMS via a referral from their psychiatrist, and the priority will be to bring in patients with treatment-resistant depression, but Dr. Saleh is hopeful they’ll soon be able to expand their rTMS program.
“We’re designing our program to make sure we deliver evidence-based treatments for depression using well-validated and effective protocols, and right now we have strong evidence for rTMS treating depression. There is growing literature on the utility of rTMS in treating OCD and new studies exploring its role in treating PTSD, bulimia nervosa and substance abuse,” says Dr. Saleh. “It’s very well-tolerated, safe and effective, so it is my hope that rTMS can be more widely available in the future.”
‘A LIFE-CHANGING OPPORTUNITY’
Bell Let’s Talk has already invested in rTMS in hospitals in Quebec and Ontario, and Bell Let’s Talk Chair, Mary Deacon, says it was apparent that Nova Scotia was “ready and eager” for its own program — especially given the tragedies the province has faced over the last year, coupled with the COVID-19 pandemic.
“The impact of COVID-19 on mental health will continue long after the pandemic is over, and right now it really is a perfect storm of having difficulty accessing services combined with the impact of COVID increasing the need for services,” says Deacon. “Now, more than ever, accessible mental health services are crucial.”
Today (Jan 28, 2021) marks the 11th Bell Let’s Talk Day, where Canadians everywhere will join in the mental health conversation. For every applicable text, local or long distance call, tweet or TikTok video using #BellLetsTalk, every Facebook, Instagram, Pinterest, Snapchat, TikTok, Twitter and YouTube view of the Bell Let's Talk Day video, and every use of the Bell Let's Talk Facebook frame or Snapchat filter, Bell will donate 5 cents to Canadian mental health programs.
Based on the results of the first 10 Bell Let’s Talk Days, Bell has committed more than $113 million to mental health, including the company’s original $50 million pledge when Bell Let’s Talk launched in 2010 and a special $5 million fund in response to COVID-19. In March last year, Bell extended the initiative for another five years with a target of at least $155 million for mental health programs across the country.
“Our vision is to make sure all Canadians, now and in the future, get the mental health support they need — and we can all play a role in that,” says Deacon. She adds that Bell Let’s Talk is thrilled to be supporting this project and that the province’s excitement is a wonderful testament to the commitment and dedication of its healthcare professionals.
“We are confident that for those with treatment-resistant depression, this will be a life-changing opportunity.”
To learn more about rTMS and the QEII Foundation’s campaign to bring it to Nova Scotia, visit QE2Foundation.ca.