Why Primary Care Teams Are Turning to the Adult Mental Health Practice Support Program

For most Nova Scotians, mental healthcare begins in a primary care setting. Family physicians, nurse practitioners and clinic teams are often the first point of contact when patients are struggling with anxiety, depression, substance use or the long-term effects of trauma.

These concerns rarely arrive in isolation. They often show up alongside physical symptoms, social pressures and years of lived experience that do not fit neatly into a brief appointment. Primary care teams have always carried the responsibility of supporting patients’ mental health. The challenge has been having the right support to do it well.

The Adult Mental Health Practice Support Program was designed to meet that reality. Offered through Nova Scotia Health’s Primary Health Care & Chronic Disease Management Network, the Practice Support Program provides practical training, structured learning and ongoing coaching to support family physicians, nurse practitioners and allied health professionals in diagnosing and managing mild to moderate mental health conditions using a trauma-informed approach. Winter registration is now open, with limited spaces available for upcoming cohorts.

The program is not about adding work. It is about strengthening the work that is already happening in primary healthcare.

“This program equips clinicians with tools to care for patients they are already seeing,” said Dr. Ajantha Jayabarathan, a family physician who has been involved since the program’s earliest days. “It helps them be effective, efficient and compassionate.”

Participants take part in six interactive learning sessions, each followed by structured action periods where new skills are applied directly in practice. Learning is reinforced through role-play, peer discussion and individual coaching.

This activity has been certified by the College of Family Physicians of Canada and the Nova Scotia Chapter for up to 44 Mainpro+® Certified credits.

The program is backed by system supports that acknowledge the time and complexity involved in mental healthcare. For physicians who complete the program, additional billing pathways are available to support longer assessments and follow-up when clinically appropriate. These pathways were developed alongside the program to better align expectations for care with the realities of clinical practice.

Participants describe greater confidence, clearer role alignment within teams and practical tools that can be used within existing scopes of practice. Many also note the benefit of developing a shared language for mental healthcare across disciplines.

Family physician and program facilitator Dr. Elizabeth King points to the program’s design as key to its sustainability. “The tools are meant to be used during an office visit,” she explained. “Some things take longer, like a diagnostic assessment, but many of the tools are designed to fit into regular practice.”

The program emerged from long-standing challenges in how mental healthcare was delivered in Nova Scotia. In the 1990s and early 2000s, primary care providers were seeing mental health concerns in the majority of visits, yet referrals to specialty care quickly overwhelmed the system. Wait times stretched into years, leaving many patients without timely support.

“Up to 80 per cent of what we see in family practice has a mental health component,” Jayabarathan said. “But the system was siloed, and we didn’t have the tools or the time to do this work well.”

In response, Nova Scotia took an unusual approach. Physicians, psychiatrists, social workers, patients, families and community partners were brought together to examine how mental healthcare was delivered and how it could be improved. Those early conversations challenged stigma, reframed ideas about recovery and laid the groundwork for a more integrated model of care.

Around the same time, a parallel effort was taking shape in British Columbia. Psychiatrists’ Dr. Rivian Weinerman and Dr. Helen Campbell, both with backgrounds in family medicine, developed what became the General Practice Services Committee Practice Support Program, focused on equipping primary care teams with practical skills and system support.

Nova Scotia became the first province to rigorously test whether this model could translate beyond British Columbia. Between 2013 and 2015, a randomized controlled trial involving 77 practices showed increased provider confidence, reduced professional distancing, improved recognition of stigma and measurable improvements in patient outcomes.

Providers trained through the program saw improvements in symptom ratings, particularly in the treatment of depression. Follow-up assessments conducted three to six months later showed that these gains were sustained, suggesting patients were not only improving, but continuing to do well over time.

The program continues to evolve in response to what teams are seeing in practice. One of the most significant recent updates is the integration of trauma-informed care throughout the curriculum.

Psychologist Dr. Ange Cooper, who helped guide this evolution, explained that many symptoms seen in primary care reflect the nervous system’s response to chronic stress and trauma. “When clinicians understand how trauma shows up in the body, it changes how they interpret symptoms,” she said. “It reduces stigma and improves trust in the room.”

Trauma-informed care does not require longer appointments for every patient. “Sometimes it’s asking permission, checking in, or helping someone regulate before moving forward,” Cooper said. “It can take seconds, but those seconds can change the entire interaction.”

“There’s a real hunger for this,” King said. “Especially in rural and underserved communities. Providers want skills they can use now.”

Winter registration for the Adult Mental Health Practice Support Program is now open, with cohorts beginning in early 2026. Participation is limited to support meaningful interaction, coaching and peer learning. Learn more and reserve your spot now: Adult Mental Health Practice Support Program | Information and Wellness Portal

Photo of session dates and times.