Exploring Core Competencies for Mental Health and Addictions Work within the Family Health Team Setting: Final Report

Rush, Brian; McPherson-Doe, Catherine; Behrooz, Renee C.; Cudmore, Alan

doi:10.1037/e508622014-001

Cited by 3 publications

(5 citation statements)

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“…Given that the bulk of literature on primary care incentives focuses on single-provider models of care, future research is needed to generate knowledge about incentive models relevant for interprofessional primary care settings. Realigning incentive systems for interprofessional primary care contexts is necessary if optimal prevention and management of CMDs is going to be achieved in Canada (Dewa et al 2001; Durbin et al 2016; Mulvale et al 2008; Rush et al 2013; Steele et al 2013). Understanding incentives and disincentives influencing care is essential in order to achieve greater integration and capacity for care (Ashcroft et al 2014; Craven and Bland 2013).…”

Section: Discussionmentioning

confidence: 99%

“…The greatest opportunity to address the needs of patients with CMDs resides in primary care (Craven and Bland 2013; Cuijpers et al 2012; Jenkins and Strathdee 2000; Mohamoud et al 2012). Several authors have argued that important barriers to the optimal prevention and management of CMDs in Canadian primary care services lie in the misaligned incentive systems currently in place (Dewa et al 2001; Durbin et al 2016; Mulvale et al 2008; Rush et al 2013; Steele et al 2013). …”

Section: Introductionmentioning

confidence: 99%

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A Qualitative Study on Incentives and Disincentives for Care of Common Mental Disorders in Ontario Family Health Teams

Ashcroft

Silveira

McKenzie

2016

hcpol

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Background: An opportunity to address the needs of patients with common mental disorders (CMDs) resides in primary care. Barriers are restricting availability of treatment for CMDs in primary care. By understanding the incentives that promote and the disincentives that deter treatment for CMDs in a collaborative primary care context, this study aims to help contribute to goals of greater access to mental healthcare. Method: A qualitative pilot study using semi-structured interviews with thematic analysis. Results: Participants identified 10 themes of incentives and disincentives influencing quality treatment of CMDs in a collaborative primary care setting: high service demands, T

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Qualitative Study on Incentives and Disincentives for Care of Common Mental Disorders in Ontario Family Health Teams

Ashcroft

Silveira

McKenzie

2016

hcpol

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“…Patients build long-term relationships with their primary care providers, allowing these professionals to develop unique insights that assist with diagnosis, treatment, and follow-up [38]. Strengthening primary care's capacity is one of the most effective approaches for meeting population need for mental health care and health equity [2,[39][40][41][42][43].…”

Section: Mental Health Equity In Primary Carementioning

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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“…6 Patients can also build long-term relationships with their family physicians, allowing these professionals to develop unique insights that assist diagnosis and treatment. 11 With recent reforms, access to interprofessional primary care teams has the potential to offer holistic management of mental and physical health problems. 11 12 Several systematic reviews suggest that treatment of CMDs in primary care can be effective.…”

Section: Introductionmentioning

confidence: 99%

“…17 In Ontario, numerous barriers to integration have been encountered: inconsistent collaboration between family physicians and mental health professionals; poor access to psychiatric consultations; limited time dedicated to mental health preventive care; challenges with hiring mental health professionals-particularly in rural areas; and disconnects between FHTs and other communitybased mental health providers. 11 17 49-51 Furthermore, the funding models intended to incentivise physicians have been recognised as a challenge for integrating physical and mental healthcare in FHTs. 17 Incentives and disincentives-leveraging change Incentives constitute key tools in the design of healthcare systems to leverage individual provider and organisational change.…”

Section: Introductionmentioning

confidence: 99%

Incentives and disincentives for treating of depression and anxiety in Ontario Family Health Teams: protocol for a grounded theory study

et al. 2016

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IntroductionThere is strong consensus that prevention and management of common mental disorders (CMDs) should occur in primary care and evidence suggests that treatment of CMDs in these settings can be effective. New interprofessional team-based models of primary care have emerged that are intended to address problems of quality and access to mental health services, yet many people continue to struggle to access care for CMDs in these settings. Insufficient attention directed towards the incentives and disincentives that influence care for CMDs in primary care, and especially in interprofessional team-based settings, may have resulted in missed opportunities to improve care quality and control healthcare costs. Our research is driven by the hypothesis that a stronger understanding of the full range of incentives and disincentives at play and their relationships with performance and other contextual factors will help stakeholders identify the critical levers of change needed to enhance prevention and management of CMDs in interprofessional primary care contexts. Participant recruitment began in May 2016.Methods and analysisAn explanatory qualitative design, based on a constructivist grounded theory methodology, will be used. Our study will be conducted in the Canadian province of Ontario, a province that features a widely implemented interprofessional team-based model of primary care. Semistructured interviews will be conducted with a diverse range of healthcare professionals and stakeholders that can help us understand how various incentives and disincentives influence the provision of evidence-based collaborative care for CMDs. A final sample size of 100 is anticipated. The protocol was peer reviewed by experts who were nominated by the funding organisation.Ethics and disseminationThe model we generate will shed light on the incentives and disincentives that are and should be in place to support high-quality CMD care and help stimulate more targeted, coordinated stakeholder responses to improving primary mental healthcare quality.

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Exploring Core Competencies for Mental Health and Addictions Work within the Family Health Team Setting: Final Report

Cited by 3 publications

References 0 publications

A Qualitative Study on Incentives and Disincentives for Care of Common Mental Disorders in Ontario Family Health Teams

A Qualitative Study on Incentives and Disincentives for Care of Common Mental Disorders in Ontario Family Health Teams

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

Incentives and disincentives for treating of depression and anxiety in Ontario Family Health Teams: protocol for a grounded theory study

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