A determination to combine the teachings of herbal medicine with expertise in mental health has seen one Sydney psychiatrist pave the way towards a more integrative approach within the medical healthcare model.As a qualified psychiatrist and naturopath currently practising at St John of God Private Hospital in Burwood, Dr Clayton Smith has built a loyal patient following based on his holistic approach to treating mental illness.“Being qualified as both a conventional and complementary health practitioner has broadened my perspective when it comes patient care,” said Dr Smith.“Both forms of healthcare have their place. This isn’t about encouraging patients to manage their illness without medicine as many of my patients absolutely require conventional medicines as part of their treatment. This is about looking deeper when advising a patient to ensure they receive holistic care which will better improve their quality of life in the long-term.”Dr Smith said there were several methods he drew upon to support patients who had become dependent on the ‘medicine treadmill’.“I discuss lifestyle and diet with all my patients as a rule which is where I leverage my background in naturopathy. Sometimes there are changes that can be made and dietary supplements that can effectively complement the orthodox treatments,” Dr Smith said.Practising mindfulness-based cognitive therapy techniques, Dr Smith helps patients with a history of depression work against a tendency to return back to automatic thought processes which can trigger depressive episodes. This is achieved through teaching patients to focus less on reacting to incoming thoughts and feelings, and instead accepting and observing them without judgement.“The most effective type of care is always going to be patient-focussed. After all, the patient is the expert on themselves. We’re just here to support them through their treatment.”“At the end of the day, people gravitate towards others that treat them with warmth and respect. For these reasons I believe the shift we are seeing away from the more paternalistic healthcare approach to a more collaborative system is the right one.”Dr Smith is also raising the profile of evidence-based complementary therapies within his own profession.“I have found the psychiatry profession in Australia to be open to integrative medicine, as long as there is credible research to back the findings of complementary treatments. The good news is the studies being released in this area are getting better and better.”This was demonstrated last month when Dr Smith presented research which shows Omega 3 fatty acids can be used to treat mood disorders to his colleagues.“I realised the appetite was there when the hospital pharmacist was inundated with Omega 3 purchases after the talk.”Building on this foundation to encourage the integration of more evidence-based natural therapies into the field of psychiatry is something Dr Smith plans to pursue.“The way I can achieve this is to remain abreast of the literature and distil the evidence available for complementary medicine and present it in the language of conventional medicine.”“I also hope to make more linkages with other medical practitioners and leading researchers to help spread the word further.”Dr Smith originally decided to study naturopathy after developing a strong interest in herbs which stemmed from being a keen gardener. He went on to study naturopathyat Endeavour College of Natural Health’s Brisbane campus.“I loved the course and found it fascinating. It stimulated my interest to learn more, and many of the people I met there remain my dearest friends to this day.”After working in health food stores, Dr Smith enrolled in a Bachelor of Medicine degree at the University of Newcastle.“I became interested in Traditional Chinese Medicine and this directed me towards further study in psychiatry, as it as the practise within medicine most linked to the mind body philosophy.”Dr Smith isn’t alone. A study conducted by Melbourne’s La Trobe University in 2009 interviewed doctors working in integrative medicine and found all respondents believed a holistic and patient-centred approach was central to their practice. The study found that doctors’ motivations for choosing an integrative approach were influenced by personal and professional experiences of alternative approaches. Does the research support an integrative approach?Dr Jerome Sarris, a National Health and Medical Research Council (NHMRC) Clinical Research Fellow at the University of Melbourne recently released research which found that naturopathic medicine may be an effective integrative solution for improving mental health. Specifically, his study has found that kava, a plant-based relaxant used in the Pacific, is moderately effective at reducing short-term anxiety.The study, published in the Journal of Clinical Psychopharmacology, involved a group of 75 people with Generalised Anxiety Disorder. At the conclusion of the trial, the researchers found that 37% of the kava group reported reduced anxiety symptoms compared with 23% of the placebo group.A quarter of the kava group reported complete remission of their anxiety symptoms at the end of the trial, compared to 6% of the placebo group.“We are not saying we are looking at kava as a replacement for conventional care but we see it as an additional option,” Dr Sarris said.The researchers noted that their study did not examine the long term health effects of kava use and the drug may not be appropriate for those using other psychotropic medication.