Background Integrated primary care teams are ideally positioned to support the mental health care needs arising during the COVID-19 pandemic. Understanding how COVID-19 has affected mental health care delivery within primary care settings will be critical to inform future policy and practice decisions during the later phases of the pandemic and beyond. The objective of our study was to describe the impact of the COVID-19 pandemic on primary care teams’ delivery of mental health care. Methods A qualitative study using focus groups conducted with primary care teams in Ontario, Canada. Focus group data was analysed using thematic analysis. Results We conducted 11 focus groups with 10 primary care teams and a total of 48 participants. With respect to the impact of the COVID-19 pandemic on mental health care in primary care teams, we identified three key themes: i) the high demand for mental health care, ii) the rapid transformation to virtual care, and iii) the impact on providers. Conclusions From the outset of the COVID-19 pandemic, primary care quickly responded to the rising mental health care demands of their patients. Despite the numerous challenges they faced with the rapid transition to virtual care, primary care teams have persevered. It is essential that policy and decision-makers take note of the toll that these demands have placed on providers. There is an immediate need to enhance primary care’s capacity for mental health care for the duration of the pandemic and beyond.

Social workers are facing increasingly complex client needs during the coronavirus disease of 2019 (COVID-19) pandemic. Because of the social distancing requirements of the pandemic, social workers have undergone transformative changes in practice with the rapid uptake of virtual technologies. The objective of our study was to understand the experiences of social workers during the first-wave of the COVID-19 pandemic. We conducted a cross-sectional, web-based survey, comprised of close-ended and open-ended questions. Survey participants included social workers who were the members of a provincial social work association in Ontario, Canada. With n = 2,470 participants, the response rate was close to 40 per cent. Descriptive statistics were conducted on the close-ended questions. Two open-ended questions were coded using the thematic analysis. Nine themes were identified on the impact to social worker’s employment status: increased work-load; loss of employment; redeployment to new settings; early retirement; concern for personal health and safety; social workers in private practice seeing fewer clients; personal caregiving responsibilities; limiting recent graduates’ employment potential and social workers experiencing new opportunities. There were five themes on the impact on social work practice: clients with increasing complexities; challenges with transition to virtual care; benefits with transition to virtual care; adapting in-person services and personal well-being.

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Objective: We describe the implementation and evaluation of an integrated, stepped care model aimed to identify and address the concerns of adolescents with type 1 diabetes (T1D) associated with diabetes-related quality of life (DRQoL), emotional wellbeing, and depression. Research Design and Methods: The care model with 4 steps: (1) Systematic identification and discussion of concerns salient to adolescents; (2) Secondary screening for depressive symptoms when indicated; (3) Developing collaborative treatment plans with joint physical and mental health goals; and (4) Psychiatric assessment and embedded mental health treatment; was implemented into an ambulatory pediatric diabetes clinic and evaluated using quantitative and qualitative methods.Results: There were 236 adolescents (aged 13-18 years) with T1D that were enrolled in the care model. On average adolescents identified three concerns associated with their DRQoL and 25% indicated low emotional well-being. Fifteen adolescents received a psychiatric assessment and embedded mental health treatment.Both adolescents and caregivers were appreciative of a broader, more holistic approach to their diabetes care and to the greater focus of the care model on adolescents, who were encouraged to self-direct the conversation. Parents also appreciated the extra level of support and the ability to receive mental health care for their adolescents from their own diabetes care team. Conclusion:The initial findings from this project indicate the acceptability and, to limited extent, the feasibility of an integrated stepped care model embedded in an ambulatory pediatric diabetes clinic led by an interdisciplinary care team. The care model facilitated the identification and discussion of concerns salient to youth and provided a more holistic approach.

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