Collaborative Mental Health Care in Canada: Challenges, Opportunities and New Directions

Kates, Nick; Sunderji, Nadiya; Ng, Victor; Patriquin, Maria; Alloo, Javed; Mirwaldt, Patricia; Burrell, Erin; Gervais, Michel; Siddiqui, Sanam

doi:10.1177/07067437221102201

Cited by 11 publications

(11 citation statements)

References 66 publications

(324 reference statements)

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“…It is clear, however, that in China as in Canada, collaboration between specialists and general practitioners, as well as between pediatric specialists and psychiatrists, again following the same stepped care model, is essential for quality ADHD management. To this end, as in Canada [ 22 – 25 ], collaboration exists between the two disciplines. The annual meetings of the Chinese National Psychiatric Association and the Association of Developmental Behavioral Pediatrics provide a learning platform for mutual exchange between the two specialties.…”

Section: Discussionmentioning

confidence: 99%

“…In Canada, several systemic changes have been implemented to address these problems. For example, the Canadian Psychiatric Association and the College of Family Physicians of Canada have established strong collaborative bonds between family physicians and psychiatrists to promote timely evaluation and treatment for mental health conditions [ 22 – 25 ]. Patients with uncomplicated mental health problems are treated by GPs while consultation-liaisons by specialists meet the needs of the most complex patients [ 26 ].…”

Section: Introductionmentioning

confidence: 99%

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Barriers and facilitators to implementing a Canadian shared-care ADHD program in pediatric settings in Shanghai: a consolidated framework for implementation research approach

Bahraini,

Maisonneuve,

et al. 2024

BMC Health Serv Res

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Objectives The vast majority of children with Attention-Deficit Hyperactivity Disorder (ADHD) do not have access to proper diagnosis and treatment in China. The goal of this project is to identify the challenges and facilitators in implementing a Canadian ADHD Shared Care Pathways program in pediatric settings in Shanghai region. Methods Purposive semi-structured focus groups were conducted on a total of 13 healthcare practitioners from the Shanghai Xinuha, Ninghai and Chongming hospitals. Two independent researchers conducted a thematic analysis of the data with themes emerging based on the Consolidated Framework for Implementation Research (CFIR). Results Notable barriers identified by participants included: (1) lack of knowledge in the management of ADHD, primarily among general practitioners; (2) lack of resources such as lack of staff, time, and medication for ADHD; (3) challenges in implementing an international multicentre intervention (such as communication difficulties between teams and integration of resources available in different hospitals); and (4) mental health stigma, difficulties in identifying ADHD patients, and logistical problems related to medication procurement rules put in place by provincial governments. Notable facilitators included: (1) the strong motivation of stakeholders and their confidence in their ability to learn and subsequently execute action plans to achieve the implementation goal; (2) the compatibility between the values and goals of the stakeholders and those of the program despite some cultural tension, a positive learning climate, strong tensions for change, and the high interest of organization leaders in engaging in the program (3) the perceived benefits of the program, such as standardization of the diagnostic and treatment process, and engaging primary care providers in ADHD management; and (4) the strong relationship between participating institutions and schools as well as provincial health initiatives available to support collaborative models of care. Mixed factors to implementation were also explored. Conclusions Appropriate training of health care providers, cultural adaptation of the program, increase public awareness about ADHD to decrease stigma, as well as strong project management and guidelines that clearly describe the role and expectations of each team member appeared essential to successful implementation.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Barriers and facilitators to implementing a Canadian shared-care ADHD program in pediatric settings in Shanghai: a consolidated framework for implementation research approach

Bahraini,

Maisonneuve,

et al. 2024

BMC Health Serv Res

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“…The intersectoral approach connects mental health diagnosis and treatment to targeting social and structural determinants of illness. Existing evidence on CMHC shows how it can improve access by decreasing stigma and fostering alignment on cultural factors in patients’ illness experience, creating higher levels of satisfaction and therapeutic adherence [ 57 ]. Furthermore, studies indicate how a collaborative approach allows structural determinants of mental health to be targeted [ 58 ].…”

Section: Introductionmentioning

confidence: 99%

Developing a Collaborative Approach to Support Access and Acceptability of Mental Health Care for Refugee Youth: An Exploratory Case Study with Young Afghan Refugees

Versteele,

Rousseau,

Danckaerts

et al. 2024

IJERPH

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Despite an increased prevalence of psychiatric morbidity, minor refugees resettled in Western host societies are less likely to access mental health care services than their native peers. This study aims to explore how a collaborative approach can be implemented to promote access to specialized mental health care. Collaborative mental health care embeds specialized intervention in primary care settings and emphasizes the inclusion of minority cultural perspectives through an interdisciplinary, intersectoral network. In this study, we analyze how such a collaborative approach can support access to specialized mental health care for refugee youth. The study presents findings from a qualitative multiple-case study (n = 10 refugee patients), conducted in the setting of a psychiatric day program for young refugees that develops an intersectional, collaborative practice in supporting minor refugees’ trajectory from referral to admission. Building on in-depth interviews, participant observation and case documents, within-case analysis and cross-case inductive thematic analysis identify the specific working mechanisms of a collaborative approach. The results indicate how this intersectoral approach addresses the interplay between traumatic suffering and both cultural and structural determinants of mental health. To conclude, a discussion identifies future research directions that may further strengthen the role of collaborative practice in promoting mental health care access for refugee youth.

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“…The Canadian Psychiatric Association and the College of Family Physicians of Canada (CFPC) recently published an updated position paper in the Canadian Journal of Psychiatry that highlighted the challenges, opportunities, and new directions for collaborative mental health care in Canada. 3 Collaborative, team-based care can be defined as "the process whereby primary care and mental health providers share resources, expertise, knowledge and decision-making to ensure that primary care populations receive person centred, effective and cost effective care from the right provider." 4 Collaborative care is a core value of the CFPC's vision of family medicine in Canada, as indicated in the CFPC's Patient's Medical Home.…”

mentioning

confidence: 99%