scholarly journals Primary care teams’ experiences of delivering mental health care during the COVID-19 pandemic: a qualitative study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Rachelle Ashcroft ◽  
Catherine Donnelly ◽  
Maya Dancey ◽  
Sandeep Gill ◽  
Simon Lam ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Qualitative Study ◽  
Mental Health Care ◽  
Focus Groups ◽  
Care Delivery ◽  
Virtual Care ◽  
Primary Care Teams ◽  
The Impact

Abstract Background Integrated primary care teams are ideally positioned to support the mental health care needs arising during the COVID-19 pandemic. Understanding how COVID-19 has affected mental health care delivery within primary care settings will be critical to inform future policy and practice decisions during the later phases of the pandemic and beyond. The objective of our study was to describe the impact of the COVID-19 pandemic on primary care teams’ delivery of mental health care. Methods A qualitative study using focus groups conducted with primary care teams in Ontario, Canada. Focus group data was analysed using thematic analysis. Results We conducted 11 focus groups with 10 primary care teams and a total of 48 participants. With respect to the impact of the COVID-19 pandemic on mental health care in primary care teams, we identified three key themes: i) the high demand for mental health care, ii) the rapid transformation to virtual care, and iii) the impact on providers. Conclusions From the outset of the COVID-19 pandemic, primary care quickly responded to the rising mental health care demands of their patients. Despite the numerous challenges they faced with the rapid transition to virtual care, primary care teams have persevered. It is essential that policy and decision-makers take note of the toll that these demands have placed on providers. There is an immediate need to enhance primary care’s capacity for mental health care for the duration of the pandemic and beyond.

Interdisciplinary Team Perspectives on Mental Health Care in VA Home-Based Primary Care: A Qualitative Study

2019 ◽  
Vol 27 (2) ◽  
pp. 128-137 ◽  
Author(s):  
Suzanne M. Gillespie ◽  
Chelsea Manheim ◽  
Carrie Gilman ◽  
Jurgis Karuza ◽  
Tobie H. Olsan ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Qualitative Study ◽  
Mental Health Care ◽  
Interdisciplinary Team ◽  
Home Based Primary Care ◽  
Home Based

scholarly journals Evaluation of the impacts of a district-level mental health care plan on contact coverage, detection and individual outcomes in rural Uganda: a mixed methods approach

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
J. E. M. Nakku ◽  
S. D. Rathod ◽  
E. C. Garman ◽  
J. Ssebunnya ◽  
S. Kangere ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Disorders ◽  
Mental Health Care ◽  
Symptom Severity ◽  
Population Level ◽  
Care Plan ◽  
Health Care Plan ◽  
The Impact

Abstract Background The burden of mental disorders in low- and middle-income countries is large. Yet there is a major treatment gap for these disorders which can be reduced by integrating the care of mental disorders in primary care. Aim We aimed to evaluate the impact of a district mental health care plan (MHCP) on contact coverage for and detection of mental disorders, as well as impact on mental health symptom severity and individual functioning in rural Uganda. Results For adults who attended primary care facilities, there was an immediate positive effect of the MHCP on clinical detection at 3 months although this was not sustained at 12 months. Those who were treated in primary care experienced significant reductions in symptom severity and functional impairment over 12 months. There was negligible change in population-level contact coverage for depression and alcohol use disorder. Conclusion The study found that it is possible to integrate mental health care into primary care in rural Uganda. Treatment by trained primary care workers improves clinical and functioning outcomes for depression, psychosis and epilepsy. Challenges remain in accessing the men for care, sustaining the improvement in detection over time, and creating demand for services among those with presumed need.

scholarly journals Acceptability of a mental health care pathway to address dementia risk factors in primary care settings: A qualitative study

2020 ◽  
Vol 16 (S10) ◽  
Author(s):  
Carrie A McAiney ◽  
Camryn Berry ◽  
Fiona Parascandalo ◽  
Nick Kates ◽  
Karen Saperson ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Primary Care ◽  
Health Care ◽  
Qualitative Study ◽  
Mental Health Care ◽  
Care Pathway ◽  
Primary Care Settings ◽  
Dementia Risk

Do patients with and without a regular primary care physician have their psychological distress looked after differently?

2018 ◽  
Vol 41 (2) ◽  
pp. 399-404 ◽  
Author(s):  
Kai Sing Sun ◽  
Tai Pong Lam ◽  
Kwok Fai Lam ◽  
Tak Lam Lo ◽  
David Vai Kiong Chao ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Psychological Distress ◽  
Mental Health Care ◽  
Continuity Of Care ◽  
Primary Care Physicians ◽  
Care Delivery ◽  
Care Physician ◽  
Psychological Problems

Abstract Background While qualitative studies suggested that continuity of care by primary care physicians (PCPs) facilitated consultations for psychological problems, there was limited quantitative evidence. This survey compared management of psychological distress between patients with and without a regular PCP. Methods A questionnaire survey was conducted with 1626 adult primary care attenders from 13 private and 6 public clinics in Hong Kong. Management of psychological distress between respondents with a regular PCP and those without were compared. Effects of demographic factors were adjusted for by multivariable logistic regression. Results Among the 1626 respondents, 650 (40.0%) reported that they had ever experienced psychological distress. Of the 650 respondents experienced distress, 307 (47.2%) had a regular PCP. A significantly higher proportion of patients with a regular PCP than those without reported: (i) their PCPs sometimes/often asked about psychological problems [37.7 versus 20.1%, adjusted OR = 2.241]; (ii) they sometimes/often mentioned their psychological problems to PCPs [45.2 versus 24.9%, adjusted OR = 2.503]; and (iii) their distress had been treated by PCPs [22.1 versus 13.4%, adjusted OR = 1.702]. Conclusion Patients with a regular PCP have around double odds of receiving mental health care. Continuity of care by PCPs should be emphasized in mental health care delivery.

scholarly journals Evaluation Of District Mental Health Programme In The District Of Dharmapuri, Tamil Nadu, India And Evolution Of Mental Health Care Delivery System For Our State

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 2586-2590
Author(s):  
Kannapiran R.Thiruvengadam ◽  
Indiran Meenakshi
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Tamil Nadu ◽  
Care Delivery ◽  
Health Care Delivery System ◽  
Paramedical Personnel ◽  
Mental Health Programme ◽  
The Impact ◽  
Health Programme

District mental health programme was started in India with the idea of decentralizing mental health care. The plan was to train the general medical officers working in primary health centers so that they can identify and treat psychiatric disorders. After the district mental health programme was started, it is time to review its effects. In Dharmapuri, a district in Tamil Nadu, India, medical officers and paramedical personnel were trained and sensitized to identify psychiatric disorders and a district psychiatrist was posted in the district headquarters hospital, who would conduct psychiatric clinics in headquarters and taluk hospitals. We are evaluating the impact of these in terms of actual benefit to the community. A number of new case registrations, before and after the training of the paramedical personnel, a pattern of referral and the impact of starting the psychiatric clinics in taluk hospitals are all assessed. When the peripheral clinics were started, new case registrations increased by 142% in the taluk hospitals. After the training of the paramedical personnel, there was an increase of new cases in the peripheral clinics from 56 to 70. Based on this experience, a suitable pattern of community mental health care delivery system for our state is evolved, taking into consideration availability of qualified manpower, resources, an expectation of the public and WHO guidelines.

Perceived Facilitators and Barriers to Implementation of a Decision Support Tool for Adolescent Depression and Suicidality Screening: A Qualitative Study (Preprint)

2020 ◽  
Author(s):  
Ana Radovic ◽  
Nathan Anderson ◽  
Megan Hamm ◽  
Brandie George-Milford ◽  
Carrie Fascetti ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Qualitative Study ◽  
Focus Groups ◽  
Decision Support Tool ◽  
Depression Screening ◽  
Self Disclosure ◽  
Support Tool ◽  
Adolescent Parent ◽  
Barriers To Implementation

BACKGROUND Screening Wizard (SW) is a technology-based decision support tool aimed at guiding primary care providers (PCPs) to respond to depression and suicidality screens in adolescents. Separate screens assess adolescents’ and parents’ reports on mental health symptoms, treatment preferences, and potential treatment barriers. A detailed summary is provided to PCPs, also identifying adolescent-parent discrepancies. The goal of SW is to enhance decision making to increase utilization of evidence-based treatments. OBJECTIVE We describe a multi-stakeholder qualitative study with adolescents, parents, and providers to understand potential barriers to implementation of SW. METHODS We interviewed 11 parents and 11 adolescents, and conducted 2 focus groups with 17 healthcare providers (PCPs, nurses, therapists, staff) across 2 pediatric practices. Participants described previous experiences with screening for depression and were shown a mock-up of SW and asked for feedback. Interviews and focus groups were transcribed verbatim, and codebooks inductively developed based on content. Transcripts were double-coded, and disagreements adjudicated to full agreement. Completed coding was used to produce thematic analyses of interviews and focus groups. RESULTS We identified five main themes across the interviews and focus groups: (1) parents, adolescents, and pediatric PCPs agree that depression screening should occur in pediatric primary care; (2) there is concern that accurate self-disclosure does not always occur during depression screening; (3) Screening Wizard is viewed as a tool that could facilitate depression screening, and which might encourage more honesty in screening responses; (4) parents, adolescents and providers do not want Screening Wizard to replace mental health discussions with providers; and (5) providers want to maintain autonomy in treatment decisions. CONCLUSIONS We identified that providers, parents, and adolescents all have concerns with current screening practices, mainly regarding inaccurate self-disclosure. They recognized value in SW as a computerized tool that may elicit more honest responses and identify adolescent-parent discrepancies. Surprisingly, providers did not want the SW report to include treatment recommendations, and all groups did not want the SW report to replace conversations with the PCP about depression. While SW was originally developed as a treatment decision algorithm, this qualitative study has led us to remove this component, and instead focus on aspects identified as most useful by all groups. We hope that this initial qualitative work will improve future implementation of SW.

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