Dr. Jeffrey Wieskopf joined UHN in 2022 with a clear mission: To treat chronic pain and mental health as one.
Whether he's treating some of the hospital's most complex patients, or creating educational workshops for fellow clinicians, his goal is to help people live free from both physical pain and emotional strain.
"People recognize the importance of treating mental illness, and they recognize the importance of treating pain," says Dr. Wieskopf, the first psychiatrist to ever work in a pain clinic at UHN. "But the interplay between them — how one can easily impact the other — is often missed."
In some cases, easing physical pain can reduce symptoms of anxiety and depression. In others, untreated mental health issues can intensify the experience of pain.
Dr. Wieskopf's work is rooted in understanding this complex relationship — and in building a model of care that treats both sides of the equation.
"I truly believe breaking down the silos between pain medicine and psychiatry, creating a system where pain doctors and psychiatrists can talk to each other, is the key to helping patients get through their pain journey," he says.
Dr. Wieskopf adds the risk of suicide nearly doubles in patients who suffer from both chronic pain and mental illness. He says this highlights the urgency of timely, integrated care that addresses not just the physical symptoms, but the emotional toll as well.
Paul Ross knows the feeling.
For Paul, the pain came first. It didn't just hurt. It lingered, complicated and reshaped everything that followed in its path.
From his 40s through to his late 60s, Paul was suffering morning, noon and night. Nineteen surgeries, metal implants and tube feeding left him feeling physically broken and emotionally drained.
With surgeries came opioids. Hydromorphone, administered through a syringe every few hours for almost 20 years, bought him time, but didn't solve the problem.
"Opioids didn't help the pain — they numbed my brain," says Paul, now 68.
Dr. Wieskopf says once opioids enter the picture, the mental health implications and the risks become more complex.
When pain becomes too much to bear
Paul's family began to constantly worry for him. He required daily support and care from his wife.
After a bout of sepsis from a tube feeding infection, Paul found himself in the hospital, without the energy to continue.
"There's only so much you can take," says Paul. At his breaking point, he asked hospital staff for help getting off opioids.
He was referred to Dr. Hance Clarke at Toronto General Hospital's Transitional Pain Clinic, a place designed to help patients manage post-surgical pain while minimizing opioid use.
Dr. Clarke, founder of the Transitional Pain Clinic, stayed by Paul's side for 24 hours during his transition off opioids. He held a bucket as Paul vomited, carried him to the bathroom and administed naloxone when needed.
"It brought me to tears," Paul recalls.
Once Paul was off opioids, the pain returned full force.
That's when Dr. Clarke referred him to Dr. Wieskopf, who worked together to address both Paul's physical pain and emotional suffering.
Dr. Wieskopf diagnosed Paul with major depressive disorder. He started him on a treatment plan that included mindfulness, meditation and medication. This targetted Paul's pain, but also his mood and sleep.
Meanwhile, Dr. Clarke treated him with a series of innovative pain interventions, including self-hypnosis, acupuncture and hyperbaric oxygen therapy.
Paul's pain began to ease. Over time, the pair helped Paul reclaim his life with dignity. He no longer needed a walker, could move freely and was successfully off pain medications.
A holistic approach to recovery
What Paul wasn't expecting was the depression after his pain was relieved.
"Pain is a full-time job," Paul says. "And when all of a sudden, you're fired from that job ... then what do you do?"
Dr. Wieskopf helped Paul navigate the emotional aftermath.
"Despite the positivity, there was a void," Paul explains. "All my conversations for 20 years were about pain. Jeff helped me learn to talk about other things — normal things."
He also encouraged Paul to reconnect with life, suggesting volunteer work at UHN.
"I thought it was the perfect idea," says Paul. "I want to give back to health care for how much they've helped me."
Dr. Wieskopf hopes his work encourages other providers to treat pain and mental health together. As the first psychiatrist to work in a pain clinic at UHN — and one of the first to lead in Canada — he hosts an educational series at UHN every year to help spread the word on a larger scale.
Paul says the care he received from UHN was holistic, compassionate and personal.
"Some psychiatrists just wanted to medicate me and didn't want to hear me," he says. "Jeff isn't like that. He's always been there for me."
Paul can now sleep, be fully involved with his grandchildren and maintain a relationship with his wife as partners — not as patient and caregiver.
"They didn't change my life," Paul says of Drs. Clarke and Wieskopf.
"They saved it."
