Introduction: A new approach to pain and mental health
At Toronto’s University Health Network (UHN), a quiet revolution is underway. Dr. Jeffrey Wieskopf joined UHN in 2022 with a mission: to treat chronic pain and mental health as two sides of the same coin. His work is reshaping patient care by breaking down the traditional silos that separate pain medicine from psychiatry, and by building an integrated model designed to relieve both physical and emotional suffering.
Why integrated care matters
Dr. Wieskopf explains that the interplay between pain and mental health is often misunderstood. “People recognize the importance of treating mental illness, and they recognize the importance of treating pain,” he notes. “But the interplay between them — how one can easily impact the other — is often missed.” In practice, easing physical pain can lessen anxiety and depression, while untreated mental health issues can amplify the experience of pain. This bidirectional relationship requires a coordinated strategy rather than two separate treatments.
A clinician-led model at a leading institution
As the first psychiatrist to work in UHN’s pain clinic, Dr. Wieskopf has been building and championing a collaborative system where pain doctors and psychiatrists routinely communicate. The goal is to shorten the distance between the patient’s pain journey and its emotional toll, ensuring care is timely, empathetic, and comprehensive. The urgency is underscored by data that the risk of suicide nearly doubles in patients experiencing both chronic pain and mental illness, highlighting the need for integrated support that addresses mood, sleep, and daily functioning alongside physical symptoms.
A patient’s journey: Paul’s story
Paul’s experience exemplifies the challenges and breakthroughs that come with a holistic care model. From his 40s to his late 60s, he endured chronic pain and a long medical odyssey, including nineteen surgeries, metal implants, and prolonged opioid use. Opioids helped him survive but did not restore his quality of life; instead, they dulled his thoughts and complicated his mental health.
After a severe infection and a hospital stay, Paul sought help to reduce opioid dependence. He was referred to Dr. Hance Clarke at Toronto General Hospital’s Transitional Pain Clinic, where a careful weaning process and alternative therapies were explored. Dr. Clarke provided around-the-clock support during Paul’s opioid transition, and when pain resurged post-opioids, he connected Paul with Dr. Wieskopf for simultaneous pain and mood management.
Dr. Wieskopf diagnosed major depressive disorder and crafted a plan that combined mindfulness, meditation, and appropriate medications, aiming to ease pain while stabilizing mood and sleep. Dr. Clarke offered innovative pain interventions, including self-hypnosis, acupuncture, and hyperbaric oxygen therapy. The result was meaningful progress: reduced reliance on pain meds, regained mobility, and a renewed sense of purpose for Paul.
From relief to reconstruction: the emotional aftermath
Even after physical pain diminished, Paul faced an emotional void. “Pain is a full-time job,” he observes. When the body finally finds relief, the mind may still be figuring out how to live differently. Dr. Wieskopf guided Paul through this transition, helping him reframe conversations, reconnect with everyday activities, and even reintegrate into meaningful work by volunteering at UHN. This phase—addressing the emotional and social dimensions of recovery—illustrates how integrated care can restore dignity and purpose beyond symptom relief.
The broader impact: educating the field
Dr. Wieskopf’s work extends beyond individual patients. He hosts annual educational series at UHN to share insights on integrating pain management and psychiatry, aiming to cultivate a wider network of clinicians who treat both physical and emotional suffering. By fostering interdisciplinary dialogue, UHN hopes to influence care models across Canada and beyond.
A hopeful closing: a new standard of care
For Paul, the care he received was more than medical treatment—it was transformative. He now sleeps better, engages with his grandchildren, and participates in his marriage as partners rather than patients. “They saved my life,” he says of the clinicians who guided him through both the medical and emotional dimensions of recovery. For Dr. Wieskopf and UHN, the mission continues: to ensure that every patient’s pain journey is met with a compassionate, integrated, and effective approach to healing.
