For Dr. Rachel Grimminck, breaking down mental health stigmas includes those in health care itself
Calgary psychiatrist wins Early-Career Leadership in Medical Education Award
Rachel Grimminck, MD, FRCPC, stumbled upon Psychiatry in medical school after a degree in mechanical engineering. Her colleagues and residents are certainly grateful she did.
“My plan was to shadow a physician in Psychiatry once, and then have nothing to do with it again,” says the clinical medical director for Psychiatric Emergency Services at Foothills Medical Centre in Calgary. “Orthopedics would have made more sense but I found Psychiatry really fascinating.”
That decision has had many positive reverberations in medical education at the University of Calgary’s Cumming School of Medicine, where she is now a clinical assistant professor in Psychiatry. Those far-reaching impacts are also why Dr. Grimminck is the 2020 recipient of the Royal College Award for Early-Career Leadership in Medical Education.
Across the board, Dr. Grimminck’s work reflects her deep commitment to breaking down stigma around mental illness.
“I try to help students see mental illness in a different light,” she says. “That means helping them relate to patients and think through peoples’ difficulties in a holistic manner.”
She’s also committed to addressing stigma in health care fields. Working in the emergency department, she has seen people from all walks of life come in for emergency mental health treatment, including medical students and physicians. Too often, she says, the stigma of being a health care professional delays these patients in seeking treatment.
“There is definitely stigma in the medical system,” says Dr. Grimminck, “and that’s really sad to me.”
The emergency psychiatry gap
Her experience in the emergency department shapes her many contributions to curriculum design. In particular, Dr. Grimminck has made a big impact in developing a new curriculum in emergency psychiatry — an area she says was lacking in her own early education in the field.
“I found it really stressful, not being well-prepared for emergency care,” she says of her early years of practice. “My hope with this curriculum design is to give people skills so they have a framework and an approach.”
Much of this new training involves safety. “It’s about improving their environmental awareness,” she says. “The more junior someone is the more likely they are to be assaulted. The idea here is to just give them a really good foundation.”
The new curriculum has proven popular and “we keep improving it every year,” she says.
From role-playing to simulation
Simulation education is part of those ongoing improvements. Dr. Grimminck was introduced to simulation training through a course offered to faculty at the University of Calgary and quickly embraced it as a way of taking role playing to the next level.
“Her skill in teaching and curriculum design was so evident that in 2018 she took on leadership of the development and delivery of our department’s first-ever Psychiatry simulations,” says Valerie Taylor, MD, FRCPC, head of Psychiatry at the university.
Dr. Grimminck says simulation is particularly helpful with agitation management and dealing with adverse clinical events in Psychiatry wards.
“That’s where it started and we’ve added to that with different simulations, like informing a patient with dementia and their family that the patient can no longer drive or working with sexually inappropriate patients.”
She adds, “More recently we’ve been working with other disciplines in this area, such as assessing capacity in brain-injured patients. We have upcoming work related to Indigenous mental health … it’s really enriching to work with other disciplines, as well, because we learn from each other.”
Contributing in Tanzania
Dr. Grimminck’s work in curriculum development also reflects an interest in meeting the needs of marginalized populations and the cross-cultural aspects of Psychiatry.
“When I was younger, my family lived in Zimbabwe so global mental health is a good fit for me,” she says.
She has made substantial contributions to curriculum development internationally through a University of Calgary partnership in Tanzania — where stigmas around mental illness run deep and getting treatment is frowned upon. She was the medical education director for the partnership from 2016 to 2019, a member of the executive leadership team and was the lead faculty for the international trips in 2017 and 2018.
As she wraps up her first decade in medicine, Dr. Grimminck is widely regarded as the epitome of an expert medical educator.
“I have simply never met someone who has established herself so quickly and in as many areas as Dr. Grimminck,” says Lauren Zanussi, MD, FRCPC, site chief at Foothills Medical Centre. “She is already a leader in education in a department that prides itself on innovation and quality, in undergraduate and residency education.”