Guiding Principles for Implementing Stepped Care in Mental Health:  Aligning on the Bigger Picture

Mughal, Sarah; Salmon, Amy; Churchill, Annmarie; Tee, Karen; Jaouich, Alexia; Shah, Jai

doi:10.31234/osf.io/2pazw

Cited by 2 publications

(1 citation statement)

References 7 publications

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“…It makes recommendations that neurodevelopmental approaches be developed through a stepped care model [36]. Stepped care approaches are used within mental health services to deliver care in a range of settings depending on needs, risk, and complexity [37]. New ways of working with a broader multidisciplinary team have the potential to deliver services more suited to neurodivergent people.…”

Section: Adultsmentioning

confidence: 99%

Perspective Chapter: Rethinking Autism Assessment, Diagnosis, and Intervention within a Neurodevelopmental Pathway Framework

Rutherford¹,

Johnston²

2023

Autism Spectrum Disorders - Recent Advances and New Perspectives

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The neurodiversity paradigm is reshaping how we understand, use language, interpret and undertake research, and support autistic people and those with related neurodevelopmental differences across the lifespan. Multi-disciplinary teams are seeking new ways to operationalise deficit focussed diagnostic criteria, to reflect the preferences of autistic people and the wider neurodiversity movement. In this chapter, we explore what the neurodiversity paradigm could mean in practice and how to reconcile the position that autism is a difference not a deficit and therefore individuals do not need to be “fixed” or “cured,” with the continued importance of timely diagnosis and the very real impact on participation, engagement, and wellbeing of autistic individuals and their families, within the environments of home, education, community, employment, and care. We present work underway to move from “single condition” pathways to neurodevelopmental pathways and new approaches which consider co-occurring conditions in a single process, involve autistic people as partners and value differences.

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Section: Adultsmentioning

confidence: 99%

Perspective Chapter: Rethinking Autism Assessment, Diagnosis, and Intervention within a Neurodevelopmental Pathway Framework

Rutherford¹,

Johnston²

2023

Autism Spectrum Disorders - Recent Advances and New Perspectives

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Reducing wait times and avoiding unnecessary use of high-cost mental health services through a Rapid Access and Stabilization Program: protocol for a program evaluation study

Adu,

da Luz Dias,

Obuobi-Donkor

et al. 2024

BMC Health Serv Res

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Background Emergency psychiatric care, unplanned hospital admissions, and inpatient health care are the costliest forms of mental health care. According to Statistics Canada (2018), almost 18% (5.3 million) of Canadians reported needing mental health support. However, just above half of this figure (56.2%) have reported their needs were fully met. In light of this evidence there is a pressing need to provide accessible mental health services in flexible yet cost-effective ways. To further expand capacity and access to mental health care in the province, Nova Scotia Health has launched a novel mental health initiative for people in need of mental health care without requiring emergency department visits or hospitalization. This new service is referred to as the Rapid Access and Stabilization Program (RASP). This study evaluates the effectiveness and impact of the RASP on high-cost health services utilization (e.g. ED visits, mobile crisis visits, and inpatient treatments) and related costs. It also assesses healthcare partners' (e.g. healthcare providers, policymakers, community leaders) perceptions and patient experiences and satisfaction with the program and identifies sociodemographic characteristics, psychological conditions, recovery, well-being, and risk measures in the assisted population. Method This is a hypothesis-driven program evaluation study that employs a mixed methods approach. A within-subject comparison (pre- and post-evaluation study) will examine health services utilization data from patients attending RASP, one year before and one year after their psychiatry assessment at the program. A controlled between-subject comparison (cohort study) will use historical data from a control population will examine whether possible changes in high-cost health services utilization are associated with the intervention (RASP). The primary analysis involves extracting secondary data from provincial information systems, electronic medical records, and regular self-reported clinical assessments. Additionally, a qualitative sub-study will examine patient experience and satisfaction, and health care partners' impressions. Discussion We expect that RASP evaluation findings will demonstrate a minimum 10% reduction in high-cost health services utilization and corresponding 10% cost savings, and also a reduction in the wait times for patient consultations with psychiatrists to less than 30 calendar days, in both within-subject and between-subject comparisons. In addition, we anticipate that patients, healthcare providers and healthcare partners would express high levels of satisfaction with the new service. Conclusion This study will demonstrate the results of the Mental Health and Addictions Program (MHAP) efforts to provide stepped-care, particularly community-based support, to individuals with mental illnesses. Results will provide new insights into a novel community-based approach to mental health service delivery and contribute to knowledge on how to implement mental health programs across varying contexts.

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Guiding Principles for Implementing Stepped Care in Mental Health: Aligning on the Bigger Picture

Cited by 2 publications

References 7 publications

Perspective Chapter: Rethinking Autism Assessment, Diagnosis, and Intervention within a Neurodevelopmental Pathway Framework

Perspective Chapter: Rethinking Autism Assessment, Diagnosis, and Intervention within a Neurodevelopmental Pathway Framework

Reducing wait times and avoiding unnecessary use of high-cost mental health services through a Rapid Access and Stabilization Program: protocol for a program evaluation study

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