Richard Zayed1, Brenda Davidson1, Lucie Nadeau2, Terrence S Callanan3, William Fleisher4, Lindsay Hope-Ross5, Stacey Espinet1, Helen R Spenser6, Harold Lipton7, Amresh Srivastava1, Lorraine Lazier8, Tamison Doey9, Sarosh Khalid-Khan10, Ann McKerlie11, Neal Stretch12, Roberta Flynn13, Sabina Abidi8, Kimberly St John3, Genevieve Auclair2, Vitaly Liashko8, Sarah Fotti4, Declan Quinn14, Margaret Steele15. 1. The University of Western Ontario, Department of Psychiatry, London, Ontario. 2. McGill University, Montreal, Quebec. 3. Memorial University of Newfoundland, St. John's, Newfoundland. 4. University of Manitoba, Winnipeg, Manitoba. 5. Alberta Health Services, Healthy Minds/Healthy Children Outreach Services, Calgary, Alberta. 6. Childrens Hospital of Eastern Ontario, Ottawa, Ontario. 7. Formerly Alberta Health Services, Calgary, Alberta. 8. Dalhousie University, Windsor, Nova Scotia. 9. Hotel Dieu Grace Hospital, Windsor, Ontario. 10. Queen's University, Kingston, Ontario. 11. Hamilton-Wentworth District School Board, Hamilton, Ontario. 12. University of Ottawa, Hanover, Ontario. 13. Health PEI, Charlottetown, Prince Edward Island. 14. University of Saskatchewan, Division of Child and Adolescent Psychiatry, Saskatoon, Saskatchewan. 15. The University of Western Ontario - London Health Sciences Centre, London, Ontario.
Abstract
INTRODUCTION: Primary Care Physicians (PCP) play a key role in the recognition and management of child/adolescent mental health struggles. In rural and under-serviced areas of Canada, there is a gap between child/adolescent mental health needs and service provision. METHODS: From a Canadian national needs assessment survey, PCPs' narrative comments were examined using quantitative and qualitative approaches. Using the phenomenological method, individual comments were drawn upon to illustrate the themes that emerged. These themes were further analyzed using chi-square to identify significant differences in the frequency in which they were reported. RESULTS: Out of 909 PCPs completing the survey, 39.38% (n = 358) wrote comments. Major themes that emerged were: 1) psychiatrist access, including issues such as long waiting lists, no child/adolescent psychiatrists available, no direct access to child/adolescent psychiatrists; 2) poor communication/continuity, need for more systemized/transparent referral processes, and need to rely on adult psychiatrists; and, 3) referral of patients to other mental health professionals such as paediatricians, psychologists, and social workers. CONCLUSIONS: Concerns that emerged across sites primarily revolved around lack of access to care and systems issues that interfere with effective service delivery. These concerns suggest potential opportunities for future improvement of service delivery. IMPLICATIONS: Although the survey only had one comment box located at the end, PCPs wrote their comments throughout the survey. Further research focusing on PCPs' expressed written concerns may give further insight into child/adolescent mental health care service delivery systems. A comparative study targeting urban versus rural regions in Canada may provide further valuable insights.
INTRODUCTION: Primary Care Physicians (PCP) play a key role in the recognition and management of child/adolescent mental health struggles. In rural and under-serviced areas of Canada, there is a gap between child/adolescent mental health needs and service provision. METHODS: From a Canadian national needs assessment survey, PCPs' narrative comments were examined using quantitative and qualitative approaches. Using the phenomenological method, individual comments were drawn upon to illustrate the themes that emerged. These themes were further analyzed using chi-square to identify significant differences in the frequency in which they were reported. RESULTS: Out of 909 PCPs completing the survey, 39.38% (n = 358) wrote comments. Major themes that emerged were: 1) psychiatrist access, including issues such as long waiting lists, no child/adolescent psychiatrists available, no direct access to child/adolescent psychiatrists; 2) poor communication/continuity, need for more systemized/transparent referral processes, and need to rely on adult psychiatrists; and, 3) referral of patients to other mental health professionals such as paediatricians, psychologists, and social workers. CONCLUSIONS: Concerns that emerged across sites primarily revolved around lack of access to care and systems issues that interfere with effective service delivery. These concerns suggest potential opportunities for future improvement of service delivery. IMPLICATIONS: Although the survey only had one comment box located at the end, PCPs wrote their comments throughout the survey. Further research focusing on PCPs' expressed written concerns may give further insight into child/adolescent mental health care service delivery systems. A comparative study targeting urban versus rural regions in Canada may provide further valuable insights.
Entities:
Keywords:
access to care; primary care; rural and remote; service delivery; systems issues
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