Overview: A new model for pain and mental health at UHN
At University Health Network (UHN), a groundbreaking shift is underway. Dr. Jeffrey Wieskopf joined the organization in 2022 with a clear mission: treat chronic pain and mental health as a single, interconnected system. His work goes beyond managing physical symptoms; it seeks to ease the emotional wear and tear that often accompanies long-standing pain. The aim is to help patients live freer from both physical pain and emotional strain by breaking down the silos between pain medicine and psychiatry.
The rationale: Why integrated care matters
Excluding mental health from the pain narrative can leave patients caught in a cycle where physical symptoms amplify emotional distress, and vice versa. Dr. Wieskopf notes that the interplay between pain and mental illness is frequently overlooked, even though the risk of adverse outcomes, including suicide, rises when both conditions co-exist. “People recognize the importance of treating mental illness, and they recognize the importance of treating pain,” he says. “But the interplay between them — how one can easily impact the other — is often missed.”
To address this, he envisions a system where pain specialists and psychiatrists collaborate routinely. The goal is timely, integrated care that addresses not only pain but also anxiety, depression and sleep disturbances that accompany it. The result is a more humane, effective path to recovery.
A patient story: From opioid dependence to holistic recovery
The story of Paul Ross illustrates the stakes of integrated care. Beginning in his 40s, Paul endured constant, unrelenting pain, undergoing nineteen surgeries and living with metal implants and a feeding tube. Opioids provided temporary relief but did not solve the underlying problem, and over time the brain became numb to pain rather than healed by it.
When Paul’s health deteriorated and the supportive network around him grew thin, he sought help at a hospital in Toronto. There, Dr. Hance Clarke of the Transitional Pain Clinic led a careful, patient-centered opioid taper, staying by Paul’s side through the most challenging moments, including moments of withdrawal and the use of naloxone when necessary. Once opioids came off, pain returned more intensely, prompting a pivotal referral to Dr. Wieskopf.
Working together, they adopted a dual strategy: address the physical pain while also treating the emotional burden. Dr. Wieskopf diagnosed major depressive disorder and introduced a plan combining mindfulness, meditation and targeted medications. Dr. Clarke complemented this with innovative pain therapies such as self-hypnosis, acupuncture and hyperbaric oxygen therapy. Over time, Paul’s pain declined, he regained mobility, and he was able to discontinue pain medications.
From relief to resilience: Addressing the emotional aftermath
Paul’s improvement surprised him in two ways. First, the relief of pain created a new sense of freedom; second, the emotional vacuum that followed required its own attention. “Pain is a full-time job,” Paul reflects. “And when all of a sudden, you’re fired from that job … then what do you do?” Dr. Wieskopf helped him navigate this transition, encouraging conversations beyond pain and guiding him toward meaningful activities—like volunteering at UHN—to restore purpose and connection.
The impact and the path forward
Dr. Wieskopf’s leadership has already sparked systemic change at UHN. As the first psychiatrist to work in a pain clinic at UHN and among the early adopters of integrated care in Canada, he leads an annual educational series to spread these concepts more broadly. The ultimate aim is to normalize conversations about both pain and mental health, ensuring patients receive comprehensive care that honors the full spectrum of their experience.
Why this model matters now
When mental health care and pain management operate independently, patients risk fragmented care and poorer outcomes. By bridging the gap, UHN is signaling a shift toward holistic, patient-centered treatment that recognizes the intertwined nature of physical and emotional suffering. Paul’s story ends with a hopeful note: with the right support, care, and purpose, people can reclaim their lives and rejoin their families and communities with dignity.
