Psychiatric Genetic Counseling- a new clinical service ((by Anna))

It has happened numerous times in clinic where I am taking a family history and the patient describes to me his/her extensive family history of depression or bipolar disorder or some other mental illness. Oftentimes, they express concern about developing a mental illness themselves or their children. And all I can tell them is that mental illness is multifactorial- caused by a complex interplay between genetic susceptibility and environment and there is no genetic testing available. Then I would assess psychosocial supports and offer resources, if appropriate. I wished there was something more that I could offer these individuals.

Last summer, I had the privilege of doing my summer internship at the world’s first psychiatric genetic counseling clinic- based out of the BC Women’s Hospital in Vancouver, British Columbia, Canada. Started in February 2012 by Dr. Jehannine Austin CCGC/CGC with Angela Inglis, CCGC/CGC, the clinic offers its services to British Columbia residents. The clinic helps individuals and their families

  • Learn more about the causes of mental illness
  • Answer questions about causes of their or their family members’ mental illness
  • Address concerns about potential risks for their children or other family members to develop a mental illness
  • Understand protective factors to reduce onset or future episodes of mental illness

Given the amount of stigma and misconceptions surrounding mental illness, one of the greatest benefits of this clinic has been to alleviate feelings of guilt, shame and stigma individuals feel about their own or their family members’ mental illness.

Here are some patient testimonies after meeting with one of the genetic counselors:

“It made me realize that my illness is not all my fault – that heredity plays such a big role in how I am today – BIG NEWS.”

“I don’t feel as bad about having the need to take medications in order to regulate the chemical imbalance in my brain. I don’t feel as guilty about it or think of myself as “weak,” though I realize that there are some things I am responsible for (exercise, eating right) in order to take care of and maintain my mental health.”  

“Counseling made clearer my understanding of the part genetics plays in mental illness. It also allowed me to put things in perspective and to be able to pass valuable information along to my offspring that may assist them in maintaining good mental health.”

Some common questions or concerns patients have that are discussed during the session include:

  • Why did I get sick?
  • Why do I have a mental illness and my family member or friend does not?
  • What is the recurrence risk?
  • What can I do to protect myself from having a mental illness or a relapse?

A typical session runs from one to two hours depending on how much the patient would like to discuss. Sessions involve taking a detailed family history and offering personalized risk assessment based on the extent of mental illness in the family. No genetic testing is offered (unless there is suspicious of 22q11.2).

Currently, the psychiatric genetic counseling clinic is being used as a guide for other countries to develop similar programs.

Last month, the clinic was discussed in an article in the local Vancouver newspaper: http://www.vancouversun.com/health/Unique+genetic+counselling+program+helps+empower+people+with+mental+health+disorders/9325226/story.html 

For more information on the clinic, check out:

The BC Mental Health & Substance Use Services: http://www.bcmhsus.ca/programs-and-services/psychiatric-genetic-counselling-service-adult

Visit their Facebook page: https://www.facebook.com/understandingmentalillness

On Twitter: https://twitter.com/psychgenetcouns 

Members can download resources from the NSGC and CAGC websites.

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