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Faces of CMHA WW: Catherine Miller, Nurse Practitioner with Eating Disorders Team

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Mental Health is health and a big part of any individual’s journey to experience health. Mental illness needs to get the same priority as any other illness. Everyone knows someone that has been affected by this personally or has impacted the lives of people around them. I am privileged to play a role working with people in their social, physical and psychological wellbeing.

1. What is involved in your role?

I feel quite privileged to be part of a team that works with individuals that struggle with eating disorders. We know that eating disorders, specifically Anorexia Nervosa, has the highest risk of mortality of any mental illness (10-20%). We know that it is a life threatening disorder due to the effects of weight loss and starvation on the body and brain and this is further complicated by other symptoms associated with eating disorders. The impact of eating disorder from both a health and economic perspective is enormous. Eating disorders cause health complications throughout life.

As a Nurse Practitioner (NP) I provide the medical support for children, adolescents and adults in our program. With every person I see, I provide a comprehensive and holistic medical and mental health assessment, make diagnosis(s), provide treatment plans which include ordering and monitoring diagnostic tests and results, prescribe medications, monitor medical status, make referrals as needed and support the persons road to recovery. As part of this team we work closely together to support our people.

A NP is a graduate level prepared registered nurse that is regulated by the College of Nurses of Ontario. NPs must meet rigorous requirements and standards to enter and maintain ongoing registration. NPs can work independently providing a full range of health care to individuals, families and communities. NPs also work in partnership with physicians, nurses and other health care professionals such as social workers, mental health workers to provide health services across the health spectrum.

2. Why did you become involved in the mental health field?

I have a long history of working in the Emergency department setting as both a nurse and NP, First Nation and Inuit Communities, Sexual Assault and Domestic Violence, as well as Primary Health Care. As a front-line health care provider, I have worked with individuals struggling with varied levels of mental health issues and concerns. Mental Health is health and a big part of any individual’s journey to experience health. Mental illness needs to get the same priority as any other illness. Everyone knows someone that has been affected by this personally or has impacted the lives of people around them. I am privileged to play a role working with people in their social, physical and psychological wellbeing.

3. How do you support people at CMHA in your role?

I am proud to be part of a team of highly skilled, dedicated, knowledgeable, compassionate and creative people. Our work is very demanding and stressful. We often are supporting people that need alternate levels of care that are not available and individuals can be very medically fragile. Our team is creative in their approaches with individual support in a group based model of care. We have an inter-professional team that works collaboratively. My role as the NP means that not only am I providing medical assessments, diagnosis, treatments, pharmacological treatment, psychological support, therapy and crisis counselling, I am also providing health teaching and education to others.

I feel challenged and rewarded every day. The treatment for eating disorders is very complicated, the symptoms are enduring and recovery involves many resources, lots of time, support from family and friends, multiple treatment options and often adjustments in the treatments, support and treatment for many interfering medical risks and complications and relapse is common. The complicated nature of this illness is also what draws me to working with this population. Having support, empathy, pragmatism, understanding, harm reduction, knowledge and focused education and treatment for eating disorders in an integrated and holistic nature helps individuals find the road to recovering along with fostering and accepting their own self compassion and accepting their body.

4. What are you proud of during your time at CMHA?

There is a lot that I am proud of during my time at CMHA. I am proud to have been the first NP hired both provincially and locally to an Eating Disorders Program. The first year that I worked in this program I knew very little about eating disorders but was able to apply my broad knowledge base and learn from my team and clients to develop the role of the NP and integrate the medical practice into an area where there was a definite need. Now I do not think we could manage without this level of expertise. I am proud to be acknowledged as an expert in the eating disorders field and have had the opportunity to provide education to other NPs, physicians, medical residents and health care providers.

I have presented at numerous provincial eating disorder conferences and continue to be sought out for my recommendations and opinions by other health care providers and eating disorder clinicians. I am so proud when I hear our eating disorder recovery speakers reflect on the value of NP support in their journey to recovery.

I am proud that I can spend time and listen to our people telling their own unique stories and validating their resiliency in their journey to recovery. I am proud that I have had opportunities to mentor other nurse and NP students to eating disorders and other NPs that have and are working on our team as well as part of the Provincial Network of NPs working in eating disorders.

I am also proud to be part of past research in Family Based Therapy and current research on Canadian practice guidelines for the treatment of children and adolescents with eating disorders, focused on psychotherapeutic and psychopharmacological treatments hoping to be published this year.  I am proud to be part of an organization that supports many of our vulnerable in our community as well as increasing access to mental health care and support. I have had the opportunity to sit on a number of agency committees over the years that I have been here. I also am part of the provincial committee representing our LHIN and our program.

I am sure there are other things… but, finally I am proud to be a Nurse Practitioner and work with a population of individuals that are often misunderstood, that suffer in silence, that are all genders, sexual orientations, abilities, ages, socio economic classes, races and ethnic backgrounds. Eating disorders is an epidemic that remains one of the most common, dangerous and least understood illnesses.

 

 

 

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