May 13, 2024

At this year’s CANA/CSN/Can-SOLVE CKD Joint Symposium, audience members were encouraged to think beyond kidneys and consider an important but under-discussed topic: mental health.

To kick off the session, a video spotlighted the stories of three Can-SOLVE CKD patient partners – Charles Cook, Arlene Desjarlais, and Tamara Beardy. The patient partners shared stories about their mental health experiences following kidney disease diagnosis – either theirs or that of a loved one. While each expressed different challenges, common sentiments included isolation, anger, frustration, and fatigue from the daily challenges of living with a chronic illness.

Next, Gavril Hercz, a nephrologist and psychotherapist based in Toronto, took the stage to discuss ways of addressing mental health in the clinic. He noted that, especially in kidney disease, simply focusing on the biochemical signatures of depression may not be appropriate for many patients. “The vast majority of these cases aren’t major depression, but cases of distress,” Hercz said. “I think a more useful model of care is to think about the impact of trauma.”

Hercz used the COVID-19 pandemic as an example of a recent trauma that caused ongoing anxiety for many people, underscoring how situational stress can make people feel vulnerable. He encouraged health care providers in the room to ask their patients about mental health, regardless of how well they may be doing in a physical sense. “There is no symmetry with how someone is doing physically and emotionally,” he said.

The second speaker was Kara Schick-Makaroff, a Can-SOLVE CKD researcher based in Alberta who has been working with patient partners for years on the Mind the Gap research project. This project has undertaken extensive surveys and consultations with people affected by kidney disease to identify key areas of mental health support that can be improved. Schick-Makaroff provided an overview of a mental health pathway her team created for care practitioners, as well as a huge database of freely available mental health support resources from across the country. A patient-facing version of the tool is pending.

Next, Karthik Tennankore, a nephrologist based in Halifax, described an intervention to introduce cognitive behavioural therapy (CBT) into dialysis clinics. While involving just four to eight CBT sessions over a period of several months, the intervention was still found to benefit some patients. “Those with the most severe depression benefitted the most,” Tennankore noted.

Can-SOLVE CKD patient partner Charles Cook discussed his experience contributing to research, emphasizing the importance of including diverse patient partner perspectives – a suggestion that gained applause throughout the conference room.

During the Q&A, panelist Janet Graham of the Canadian Association of Nephrology Administrators (CANA) highlighted three key avenues for audience members to pursue: a culture of compassion, the use of mental health tools to support clinicians and patients, and the power of advocacy. As well, panelist Peter Yoeun, a pharmacist, discussed practical ways to address depression and anxiety, noting that some medications can take up to two months to take effect.

As the event came to an end, attendees were quick to discuss the talk with neighbours, showing that the conversation around mental health is far from over.