Continuum of care for persons with common mental health disorders in Nunavik: a descriptive study.

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Version: Final published version
Serval ID
serval:BIB_E73285F7137B
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Continuum of care for persons with common mental health disorders in Nunavik: a descriptive study.
Journal
International Journal of Circumpolar Health
Author(s)
Lessard L., Fournier L., Gauthier J., Morin D.
ISSN
2242-3982 (Electronic)
ISSN-L
1239-9736
Publication state
Published
Issued date
2015
Peer-reviewed
Oui
Volume
74
Pages
27186
Language
english
Abstract
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.
Pubmed
Web of science
Open Access
Yes
Create date
23/01/2015 10:50
Last modification date
20/08/2019 16:10
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