E1-b - Challenges in implementing collaborative mental health care: the case study of PARTNERs -Primary Care Assessment and Research of a Telephone Intervention for Neuropsychiatric Conditions with Education and Resources

1. Access to care: improving access to team-based care

  • Date: Friday, September 20, 2019
  • Concurrent Session E

  • Time: 11:00am–11:45am

  • Room: Pier 9
  • Style: Presentation (information provided to audience, with opportunity for audience to ask question)
  • Focus: Balance between both (e.g. Presentation of a best-practice guideline that combines research evidence, policy issues and practical steps for implementation)
  • Target Audience: Leadership (ED, clinical lead, board chair, board member, etc.), Clinical providers, Administrative staff, Representatives of stakeholder/partner organizations

Learning Objectives

At the end of this presentation, attendees will learn:

  1. The limitations of usual (“standard”) care in treatment of common mental health conditions   
  2. The common enablers and barriers in implementing a collaborative care program within primary care 
  3. The impact of usual care and collaborative care in primary care patients across Ontario with depression, anxiety, or at-risk drinking

 

Summary/Abstract

This concurrent session will describe the challenges of adopting an integrated care model, and provide examples of how the project successfully addressed these barriers. This presentation is based on practical experience implementing PARTNERs; a randomized controlled trial (RCT) of a collaborative care intervention for primary care patients experiencing depression, anxiety, or at-risk drinking. PARTNERs addresses some barriers to the adoption of collaborative care by: (1) using lay providers supervised by a psychiatrist to address the relative lack of trained mental health providers; (2) providing services by telephone to eliminate geographic barriers and increase access; and (3) applying a transdiagnostic approach since most treatments for depression or anxiety are effective for both conditions. Over 54 months, 186 primary care providers (PCPs) at 24 urban, suburban, and rural locations across Ontario referred 853 patients and 504 were randomized. While our participants’ experience of telephone assessments and coaching were highly positive, PCPs and sites varied greatly in their adoption of this model. The study design and its rationale will be presented followed by a discussion of the results of a qualitative study that explored the experience of PCPs with PARTNERs and their perceptions of implementing  collaborative care. Finally, the discussion will present factors that influenced the effectiveness of the intervention. Lessons learned from the PARTNERs project will be synthesized and their relevance to dissemination of integrated mental health care models will be discussed.
 

Presenter

  • Athina Perivolaris, RN, MN, Centre for Addiction and Mental Health (CAMH) 
  • David Rodie, MD, FRCPC, Centre for Addiction and Mental Health (CAMH)

Authors/Contributors

  • Benoit Mulsant, MD, MS, FRCPC, University of Toronto Department of Psychiatry
  • Nadiya Sunderji, MD, MPH, FRCPC, Waypoint Centre for Mental Health Care 
2019 Concurrent Session