Helping patients a ‘rewarding’ experience, says forensic psychiatrist

Dr. Mara Muraven, a forensic psychiatrist at Waypoint Centre for Mental Health Care, keeps a “rainy day folder” in her desk.

A place to record good feedback and positive outcomes, it reminds her of the excellent work the hospital does fostering a healing environment for patients in its provincial forensic mental health-care programs.

These programs are located in the province’s only high-secure forensic mental health facility. Waypoint serves the highest needs and most complex patients from Ontario who have serious mental illnesses — schizophrenia, bipolar disorder, personality disorder andsubstance abuse, for example — and have become involved with the criminal justice system.

The behaviours of the men admitted to these programs for care and/or assessment are such that they cannot be safely managed in a less secure environment.

Treatment journeys can be long and challenging, given the severity of the patients’ conditions, which makes the wins all the more rewarding for Dr. Muraven and her colleagues. One particularly meaningful note in Dr. Muraven’s folder is about the time she ordered medication changes for a patient who was suffering deeply due to the multiple symptoms burdening him.

“I got an email from the recreation therapist saying the patient got up, cleaned his room, took a shower, came out of his room and said, ‘I feel like a new man,’” she recalled. “That’s an incredible thing, and that happens a lot.”

Originally from Montreal, Dr. Muraven attended medical school at McGill University before completing a psychiatry residency and forensic fellowship in New York City. She moved to Toronto in 2002 and practised emergency psychiatry at St. Michael’s Hospital for 12 years.

As if clinical work wasn’t enough, she also held a series of secondary jobs, including working at the University of Toronto’s Faculty of Medicine, as a medical adviser at the College of Physicians and Surgeons of Ontario, and as an investigating coroner and inquest coroner.

Even while busy with that challenging work, she began filling in for doctors across the province during the COVID-19 pandemic: “A lot of psychiatrists in small communities were completely burned out. I would go and give a doctor a chance to have a break.”

Since arriving at Waypoint in March 2021, she has covered for doctors in the Acute Assessment Program, as well as the Bayview and Georgianwood programs, which care for patients with developmental disabilities and mental-health needs, and mental-health and substance-use problems, respectively.

When a forensic psychiatrist left in early 2022, she jumped at the chance to work with patients in the provincial forensic mental health-care programs to support their treatment and rehabilitation needs.

“I think it’s the coolest job in the whole world,” Dr. Muraven said. “It’s very rare that I don’t have a day where there is a win of some kind that is incredibly rewarding.”