Experiences of Telemental Health Providers and Support Staff Serving Indigenous Patients of Northern Canada

Background: It is known that there is a high mental health burden among Indigenous communities in Northern Quebec. The use of telemental health (TMH) may be a potential solution in addressing this burden, but its use in the Northern Quebec context has never been studied. Methods: A purposive sample of eight healthcare providers and support staff comprising of an entire TMH clinic serving Indigenous patients in Northern Quebec was recruited. A qualitative descriptive approach was adopted, and semi-structured interviews were conducted, concurrent with thematic data analysis.Results: Overall, the TMH staff have a very strong sense of communication, which allows them to diligently serve the Indigenous communities, and reflect upon their own practice. On the other hand, Northern patient care at the inpatient unit is seen as a work in progress, as there exists further potential for culturally sensitive Indigenous patient care. Both the TMH clinic and the inpatient unit address the mental health gap in Northern Quebec, where local staff turnover is adversely affecting patient care. As for the delivery of the mental health care, the in-person and videoconferencing consultations have a synergistic effect, since they allow for the TMH psychiatrists to maintain both an insider and outsider identity. Finally, a comprehensive electronic medical record and further administrative reforms are desperately needed, which would increase the efficiency of all components of the TMH clinic. Conclusions: TMH is an indispensable component of Northern patient care, but there is room for further improvements, especially with regards to the inpatient unit and documentation methods. This study may have implications towards the development and improvement of telemental health in Northern Quebec.