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Date of Award

5-2023

Document Type

Thesis - Campus Access Only

Degree Name

MS in Human Genetics

First Advisor

Lindsey Alico Ecker

Second Advisor

Dr. Jehannine Austin

Abstract

Psychiatric genetic counseling (pGC) is a small specialty within genetic counseling which aims to help people with psychiatric illnesses and their families by addressing misconceptions, promoting help-seeking behaviors and improving a patients’ perceived sense of control over their illness. Genetic testing is offered among most other specialities of genetic counseling, but it is not yet clinically available to diagnose or recognize predispositions to psychiatric conditions. Little research has evaluated psychiatrists practice of discussing genetics with patients and their understanding of pGC. After viewing a recorded pGC simulated session, 12 psychiatrists who practice in Ontario, Canada were interviewed for this study. Interpretive description was used as an inductive approach to data analysis which allowed for the creation of two theoretical models. The first model described the decision-making pathway psychiatrists follow when determining when to talk about genetics and referral practices. Within this model, three scalable concepts were determined to be crucial influencers in how psychiatrists discuss genetics with patients. These include psychiatrists’ perceived value of discussing genetics and their understanding, available time and awareness of the genetic counseling profession. Before watching the video, psychiatrists did not recognize the psychosocial skillset of genetic counselors and further advocacy for the profession is needed to facilitate the growth of pGC. Barriers to referral to genetic counseling were identified to be lack of access, perceived patient vulnerability and perceived patient disinterest. Facilitators of referral were identified to be trust, available funding and outcome data. An additional theoretical model described future directions for pGC within Ontario, as proposed by psychiatrists. Psychiatrists identified genetic counselors focusing on psychiatry to have utility in primary care, public health interventions and specialty psychiatric centers. Increased awareness of the profession and the skillset that genetic counselors bring is essential to future growth of the profession. This study identifies future directions for growing pGC within the Ontario healthcare context.

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