Janet Durbin1, Avra Selick2, Deborah Hierlihy3, Sarah Moss2, Chiachen Cheng4. 1. Performance Measurement and Implementation Research Unit, Centre for Addiction and Mental Health, Toronto, Ontario, Canada. janet.durbin@camh.ca. 2. Performance Measurement and Implementation Research Unit, Centre for Addiction and Mental Health, Toronto, Ontario, Canada. 3. Oriole Research and Design Inc., Picton, Ontario, Canada. 4. First Place, Canadian Mental Health Association - Thunder Bay Branch, Thunder Bay, Ontario, Canada.
Abstract
AIM: Ontario, Canada is a large province with a geographically dispersed population. Early psychosis intervention (EPI) programmes are available province-wide, with delivery approaches adapted to context. This study examined EPI programme delivery in relation to recently released provincial EPI Program Standards, and variations based on geographic context. METHODS: The data source was a province-wide key informant survey of early psychosis programmes conducted after release of the Standards. Chi-squared tests compared large- and small-area programmes on selected programme structural features and perceived adherence to 19 service components. RESULTS: Responses were obtained from 52 programme sites, including 21 small-area programmes with 1 to 2 staff. In general, frequency of EPI delivery was highest for individual assessment and treatment components, and moderate for social supports and family support. Implementation was lowest for public education, early detection and recovery planning. Small-area programmes reported lower implementation for over half of the components, with differences statistically significant for psychiatric assessment and physical health monitoring. CONCLUSION: Since the release of the Standards, the Ontario Ministry of Health has partnered with a provincial network of EPI stakeholders to support practice improvement. This survey identified components where more implementation support is needed, overall and for rural area delivery. Ultimately, systematic monitoring of programme fidelity and measuring client outcomes are key to advancing the quality of EPI programme delivery.
AIM: Ontario, Canada is a large province with a geographically dispersed population. Early psychosis intervention (EPI) programmes are available province-wide, with delivery approaches adapted to context. This study examined EPI programme delivery in relation to recently released provincial EPI Program Standards, and variations based on geographic context. METHODS: The data source was a province-wide key informant survey of early psychosis programmes conducted after release of the Standards. Chi-squared tests compared large- and small-area programmes on selected programme structural features and perceived adherence to 19 service components. RESULTS: Responses were obtained from 52 programme sites, including 21 small-area programmes with 1 to 2 staff. In general, frequency of EPI delivery was highest for individual assessment and treatment components, and moderate for social supports and family support. Implementation was lowest for public education, early detection and recovery planning. Small-area programmes reported lower implementation for over half of the components, with differences statistically significant for psychiatric assessment and physical health monitoring. CONCLUSION: Since the release of the Standards, the Ontario Ministry of Health has partnered with a provincial network of EPI stakeholders to support practice improvement. This survey identified components where more implementation support is needed, overall and for rural area delivery. Ultimately, systematic monitoring of programme fidelity and measuring client outcomes are key to advancing the quality of EPI programme delivery.
Authors: Kelly K Anderson; Ross Norman; Arlene G MacDougall; Jordan Edwards; Lena Palaniyappan; Cindy Lau; Paul Kurdyak Journal: Can J Psychiatry Date: 2018-03-21 Impact factor: 4.356
Authors: Nicole Kozloff; George Foussias; Janet Durbin; Sanjeev Sockalingam; Jean Addington; Donald Addington; Augustina Ampofo; Kelly K Anderson; Melanie Barwick; Sarah Bromley; Jasmyn E A Cunningham; Simone Dahrouge; Lillian Duda; Catherine Ford; Sheila Gallagher; John D Haltigan; Joanna Henderson; Alexia Jaouich; Dielle Miranda; Patrick Mitchell; Josette Morin; Claire de Oliveira; Valerie Primeau; Eva Serhal; Sophie Soklaridis; Diana Urajnik; Krista Whittard; Juveria Zaheer; Paul Kurdyak; Aristotle N Voineskos Journal: BMJ Open Date: 2020-06-03 Impact factor: 2.692