Continuum of care for persons with common mental health disorders in Nunavik: a descriptive study
Background: Changing Directions, Changing Lives, the Mental Health Strategy for Canada, prioritizes the development of coordinated continuums of care in mental health that will bridge the gap in services for Inuit populations. Objective: In order to target ways of improving the services provided in...
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2015
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Online Access: | https://doi.org/10.3402/ijch.v74.27186 https://doaj.org/article/a7d5abaeb5c54fcfb11b9a44ab25fa62 |
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ftdoajarticles:oai:doaj.org/article:a7d5abaeb5c54fcfb11b9a44ab25fa62 2023-05-15T15:17:47+02:00 Continuum of care for persons with common mental health disorders in Nunavik: a descriptive study Lily Lessard Louise Fournier Josée Gauthier Diane Morin 2015-05-01T00:00:00Z https://doi.org/10.3402/ijch.v74.27186 https://doaj.org/article/a7d5abaeb5c54fcfb11b9a44ab25fa62 EN eng Taylor & Francis Group http://www.circumpolarhealthjournal.net/index.php/ijch/article/view/27186/pdf_4 https://doaj.org/toc/2242-3982 2242-3982 doi:10.3402/ijch.v74.27186 https://doaj.org/article/a7d5abaeb5c54fcfb11b9a44ab25fa62 International Journal of Circumpolar Health, Vol 74, Iss 0, Pp 1-13 (2015) MESH care pathways depression anxiety disorders continuity of care Inuit Community Mental Health Services Primary Health Care Quality of Patient Care Rural Health Services Arctic medicine. Tropical medicine RC955-962 article 2015 ftdoajarticles https://doi.org/10.3402/ijch.v74.27186 2022-12-31T13:32:26Z Background: Changing Directions, Changing Lives, the Mental Health Strategy for Canada, prioritizes the development of coordinated continuums of care in mental health that will bridge the gap in services for Inuit populations. Objective: In order to target ways of improving the services provided in these contexts to individuals in Nunavik with depression or anxiety disorders, this research examines delays and disruptions in the continuum of care and clinical, individual and organizational characteristics possibly associated with their occurrences. Design: A total of 155 episodes of care involving a common mental disorder (CMD), incident or recurring, were documented using the clinical records of 79 frontline health and social services (FHSSs) users, aged 14 years and older, living in a community in Nunavik. Each episode of care was divided into 7 stages: (a) detection; (b) assessment; (c) intervention; (d) planning the first follow-up visit; (e) implementation of the first follow-up visit; (f) planning a second follow-up visit; (g) implementation of the second follow-up visit. Sequential analysis of these stages established delays for each one and helped identify when breaks occurred in the continuum of care. Logistic and linear regression analysis determined whether clinical, individual or organizational characteristics influenced the breaks and delays. Results: More than half (62%) the episodes of care were interrupted before the second follow-up. These breaks mostly occurred when planning and completing the first follow-up visit. Episodes of care were more likely to end early when they involved anxiety disorders or symptoms, limited FHSS teams and individuals over 21 years of age. The median delay for the first follow-up visit (30 days) exceeded guideline recommendations significantly (1–2 weeks). Conclusion: Clinical primary care approaches for CMDs in Nunavik are currently more reactive than preventive. This suggests that recovery services for those affected are suboptimal. Article in Journal/Newspaper Arctic Circumpolar Health International Journal of Circumpolar Health inuit Nunavik Directory of Open Access Journals: DOAJ Articles Arctic Canada Nunavik International Journal of Circumpolar Health 74 1 27186 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
MESH care pathways depression anxiety disorders continuity of care Inuit Community Mental Health Services Primary Health Care Quality of Patient Care Rural Health Services Arctic medicine. Tropical medicine RC955-962 |
spellingShingle |
MESH care pathways depression anxiety disorders continuity of care Inuit Community Mental Health Services Primary Health Care Quality of Patient Care Rural Health Services Arctic medicine. Tropical medicine RC955-962 Lily Lessard Louise Fournier Josée Gauthier Diane Morin Continuum of care for persons with common mental health disorders in Nunavik: a descriptive study |
topic_facet |
MESH care pathways depression anxiety disorders continuity of care Inuit Community Mental Health Services Primary Health Care Quality of Patient Care Rural Health Services Arctic medicine. Tropical medicine RC955-962 |
description |
Background: Changing Directions, Changing Lives, the Mental Health Strategy for Canada, prioritizes the development of coordinated continuums of care in mental health that will bridge the gap in services for Inuit populations. Objective: In order to target ways of improving the services provided in these contexts to individuals in Nunavik with depression or anxiety disorders, this research examines delays and disruptions in the continuum of care and clinical, individual and organizational characteristics possibly associated with their occurrences. Design: A total of 155 episodes of care involving a common mental disorder (CMD), incident or recurring, were documented using the clinical records of 79 frontline health and social services (FHSSs) users, aged 14 years and older, living in a community in Nunavik. Each episode of care was divided into 7 stages: (a) detection; (b) assessment; (c) intervention; (d) planning the first follow-up visit; (e) implementation of the first follow-up visit; (f) planning a second follow-up visit; (g) implementation of the second follow-up visit. Sequential analysis of these stages established delays for each one and helped identify when breaks occurred in the continuum of care. Logistic and linear regression analysis determined whether clinical, individual or organizational characteristics influenced the breaks and delays. Results: More than half (62%) the episodes of care were interrupted before the second follow-up. These breaks mostly occurred when planning and completing the first follow-up visit. Episodes of care were more likely to end early when they involved anxiety disorders or symptoms, limited FHSS teams and individuals over 21 years of age. The median delay for the first follow-up visit (30 days) exceeded guideline recommendations significantly (1–2 weeks). Conclusion: Clinical primary care approaches for CMDs in Nunavik are currently more reactive than preventive. This suggests that recovery services for those affected are suboptimal. |
format |
Article in Journal/Newspaper |
author |
Lily Lessard Louise Fournier Josée Gauthier Diane Morin |
author_facet |
Lily Lessard Louise Fournier Josée Gauthier Diane Morin |
author_sort |
Lily Lessard |
title |
Continuum of care for persons with common mental health disorders in Nunavik: a descriptive study |
title_short |
Continuum of care for persons with common mental health disorders in Nunavik: a descriptive study |
title_full |
Continuum of care for persons with common mental health disorders in Nunavik: a descriptive study |
title_fullStr |
Continuum of care for persons with common mental health disorders in Nunavik: a descriptive study |
title_full_unstemmed |
Continuum of care for persons with common mental health disorders in Nunavik: a descriptive study |
title_sort |
continuum of care for persons with common mental health disorders in nunavik: a descriptive study |
publisher |
Taylor & Francis Group |
publishDate |
2015 |
url |
https://doi.org/10.3402/ijch.v74.27186 https://doaj.org/article/a7d5abaeb5c54fcfb11b9a44ab25fa62 |
geographic |
Arctic Canada Nunavik |
geographic_facet |
Arctic Canada Nunavik |
genre |
Arctic Circumpolar Health International Journal of Circumpolar Health inuit Nunavik |
genre_facet |
Arctic Circumpolar Health International Journal of Circumpolar Health inuit Nunavik |
op_source |
International Journal of Circumpolar Health, Vol 74, Iss 0, Pp 1-13 (2015) |
op_relation |
http://www.circumpolarhealthjournal.net/index.php/ijch/article/view/27186/pdf_4 https://doaj.org/toc/2242-3982 2242-3982 doi:10.3402/ijch.v74.27186 https://doaj.org/article/a7d5abaeb5c54fcfb11b9a44ab25fa62 |
op_doi |
https://doi.org/10.3402/ijch.v74.27186 |
container_title |
International Journal of Circumpolar Health |
container_volume |
74 |
container_issue |
1 |
container_start_page |
27186 |
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1766348022111797248 |