A Fresh Approach to Reform? A Policy Analysis of the Development and Implementation of Ontario’s Mental Health and Addictions Strategy

Bullock, Heather; Abelson, Julia

doi:10.12927/hcpol.2019.25794

Cited by 6 publications

(6 citation statements)

References 13 publications

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“…From a health system policy level (CFIR; outer setting), improvements to promote collaborative teambased care across settings are warranted [60,61], such as improving complex billing procedures and creating processes and policies to support collaborative working relationships among primary care, specialists and community care actors [62][63][64]. In addition, countries like Canada, with restrictive payment models for non-physicians who are compensated mostly through private or third-party sources, can face system-level barriers to collaborative care implementation [65] within the context of geriatric-HIV models of care that rely on community stakeholders to deliver some non-medical services. The integration of information systems (e.g.…”

Section: Discussionmentioning

confidence: 99%

Exploring implementation considerations forgeriatric‐HIVclinics: A secondary analysis from a scoping review onHIVmodels of geriatric care

Kokorelias,

Grosse,

Zhabokritsky

et al. 2023

HIV Medicine

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ObjectivesThis review aimed to map the current state of knowledge regarding the implementation considerations of existing geriatric‐HIV models of care, to identify areas of further research and to inform the implementation of future geriatric‐HIV interventions that support older adults living with HIV.MethodsWe conducted a scoping review that was methodologically informed by the Arskey and O’Malley's 5 step framework and theoretically informed by the Consolidated Framework for Implementation Research (CFIR). A systematic search of six databases was conducted for peer‐reviewed literature. The grey literature was also searched. Article screening was performed in duplicate. Data was extracted for the purpose of this secondary analysis using a data extraction template informed by the CFIR. Data was inductively and deductively analyzed.ResultsIn total, 11 articles met the inclusion criteria. The models of care described varied in terms of their location and setting, the number and type of care providers involved, the mechanism of patient referral, the type of assessments and interventions performed and the methods of longitudinal patient follow‐up. Four key categories emerged to describe factors that influenced their implementation: care provider buy‐in, patient engagement, mechanisms of communication and collaboration, and available resources.ConclusionsThe findings from this scoping review provide an initial understanding of the key factors to consider when implementing geriatric‐HIV models of care. We recommend health system planners consider mechanisms of communication and collaboration, opportunities for care provider buy‐in, patient engagement and available resources. Future research should explore implementation in more diverse settings to understand the nuances that influence implementation and care delivery.

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Section: Discussionmentioning

confidence: 99%

Exploring implementation considerations forgeriatric‐HIVclinics: A secondary analysis from a scoping review onHIVmodels of geriatric care

Kokorelias,

Grosse,

Zhabokritsky

et al. 2023

HIV Medicine

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“…We agree that greater attention is needed to ensure that the underlying structure of the FHT model is designed to consistently promote high quality mental health care. Ontario has had a challenging history addressing populations’ mental health care needs [ 76 ]. We believe that there remains opportunity to improve Ontarians’ mental health care needs.…”

Section: Discussionmentioning

confidence: 99%

Inequities in the delivery of mental health care: a grounded theory study of the policy context of primary care

Ashcroft

Menear

Silveira

et al. 2021

Int J Equity Health

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Background Strengthening capacity for mental health in primary care improves health outcomes by providing timely access to coordinated and integrated mental health care. The successful integration of mental health in primary care is highly dependent on the foundation of the surrounding policy context. In Ontario, Canada, policy reforms in the early 2000’s led to the implementation of a new interprofessional team-model of primary care called Family Health Teams. It is unclear the extent to which the policy context in Ontario influenced the integration of mental health care in Family Health Teams emerging from this period of policy reform. The research question guiding this study was: what were key features of Ontario’s policy context that influenced FHTs capacity to provide mental health services for mood and anxiety disorders? Methods A qualitative study informed by constructivist grounded theory. Individual interviews were conducted with executive directors, family physicians, nurse practitioners, nurses, and the range of professionals who provide mental health services in interprofessional primary care teams; community mental health providers; and provincial policy and decision makers. We used an inductive approach to data analysis. The electronic data management programme NVivo11 helped organise the data analysis process. Results We conducted 96 interviews with 82 participants. With respect to the contextual factors considered to be important features of Ontario’s policy context that influenced primary care teams’ capacity to provide mental health services, we identified four key themes: i) lack of strategic direction for mental health, ii) inadequate resourcing for mental health care, iii) rivalry and envy, and, iv) variations across primary care models. Conclusions As the first point of contact for individuals experiencing mental health difficulties, primary care plays an important role in addressing population mental health care needs. In Ontario, the successful integration of mental health in primary care has been hindered by the lack of strategic direction, and inconsistent resourcing for mental health care. Achieving health equity may be stunted by the structural variations for mental health care across Family Health Teams and across primary care models in Ontario.

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“…More specifically, we employed an interpretive description methodology to explore the type of knowledge participants used during the workshops' discussion sessions, after the slide deck presentation [36][37][38][39]. Traditionally used in nursing to inform clinical practice, researchers have used interpretive description across applied health practices and management, teaching, and health policy analysis [39][40][41][42][43][44]. We selected this methodology because it allows us to descriptively explain a phenomenon to generate knowledge for practice [36,38,39].…”

Section: Secondary Post Hoc Analysismentioning

confidence: 99%

Knowledge exchange sessions on primary health care research findings in public libraries: A qualitative study with citizens in Quebec

Laberge¹,

Brundisini²,

Zomahoun³

et al. 2023

PLoS ONE

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Little is known about knowledge transfer with the public. We explored how citizens, physicians, and communication specialists understand knowledge transfer in public spaces such as libraries. The initial study aimed at evaluating the scaling up of a program on disseminating research findings on potentially inappropriate medication. Twenty-two citizen workshops were offered by 16 physicians and facilitated by 6 communication specialists to 322 citizens in libraries during spring 2019. We did secondary analysis using the recorded workshop discussions to explore the type of knowledge participants used. Participants described four kinds of knowledge: biomedical, sociocultural beliefs, value-based reasoning, and institutional knowledge. Biomedical knowledge included scientific evidence, research methods, clinical guidelines, and access to research outcomes. Participants discussed beliefs in scientific progress, innovative clinical practices, and doctors’ behaviours. Participants discussed values related to reliability, transparency, respect for patient autonomy and participation in decision-making. All categories of participants used these four kinds of knowledge. However, their descriptions varied particularly for biomedical knowledge which was described by physician-speakers and communication specialists-facilitators as scientific evidence, epidemiological and clinical practice guidelines, and pathophysiological theories. Communication specialists-facilitators also described scientific journalistic sources and scientific journalistic reports as proxies of scientific evidence. Citizens described biomedical knowledge in terms of knowledge to make informed decisions. These findings offer insights for future scientific knowledge exchange interventions with the public.

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A Fresh Approach to Reform? A Policy Analysis of the Development and Implementation of Ontario’s Mental Health and Addictions Strategy

Abstract: Nouvelle fraîcheur dans la réforme ? Analyse des politiques liées au développement et à la mise en oeuvre de la stratégie ontarienne de santé mentale et de lutte contre les dépendances

Cited by 6 publications

References 13 publications

Exploring implementation considerations forgeriatric‐HIVclinics: A secondary analysis from a scoping review onHIVmodels of geriatric care

Exploring implementation considerations forgeriatric‐HIVclinics: A secondary analysis from a scoping review onHIVmodels of geriatric care

Inequities in the delivery of mental health care: a grounded theory study of the policy context of primary care

Knowledge exchange sessions on primary health care research findings in public libraries: A qualitative study with citizens in Quebec

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