Addressing Cultural Diversity Through Collaborative Care

Nadeau, Lucie; Rousseau, Cécile; Measham, Toby

doi:10.1007/978-1-4614-7615-3_10

Cited by 41 publications

(14 citation statements)

References 43 publications

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“…Nevertheless, collaborative models of care have shown positive outcomes in terms of improved access to and efficiency of mental health care (see, for instance, Rousseau, Measham & Nadeau, 2012;Nadeau, Rousseau, & Measham, 2014).…”

Section: Discussionmentioning

confidence: 99%

“…Similarly to other countries of resettlement (see Colucci, Szwarc, Minas, Paxton, & Guerra, 2014;Nadeau, Rousseau, & Measham, 2014), in Australia refugee children and young people have even lower rates of service utilisation (Paxton, et al, 2011) and face significant barriers to accessing mental health services (de Anstiss, Ziaian, Procter, Warland, & Baghurst, 2009;Michelson & Sclare, 2009), which include the low priority that children and young people of refugee backgrounds place on mental health; lack of knowledge of 'mental health' and services; distrust of services; and the stigma associated with psychosocial problems and help-seeking.. It is important to examine barriers and facilitators to mental health service access and delivery for refugee young people specifically; in the absence of such research "policy makers, service planners, and mental health professionals have little option but to draw unreliable inferences from research based on children in the general population or ethnic minority adults" (de Anstiss, et al, 2009, p. 598).…”

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confidence: 99%

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In or out? Barriers and facilitators to refugee-background young people accessing mental health services

Colucci

Minas

Szwarc

et al. 2015

Transcult Psychiatry

136

162

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Refugee young people are identified as a group with high risk for mental health problems, due to their experience of trauma, forced migration and stressors associated with settlement. A high prevalence of mental health problems is reported in this group, however limited information suggests refugee young people have low rates of mental health service access after settlement, and there is little information on barriers and facilitators to mental service delivery for this group. Using data from 15 focus groups and five key informant interviews with a total of 115 service providers from 12 agencies in Melbourne, Australia, this paper explores barriers and facilitators to engaging young people from refugee backgrounds with mental health services. Eight key themes emerged: cultural

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

In or out? Barriers and facilitators to refugee-background young people accessing mental health services

Colucci

Minas

Szwarc

et al. 2015

Transcult Psychiatry

136

162

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“…This also refers to ‘shared care’ or ‘collaborative care’ in mental health for instance, which consists of “a structured system for achieving integration of care across multiple autonomous providers and services with both primary and secondary care practitioners contributing to elements of a patient’s overall package of care” where “mental health experts work with first-line care providers in the delivery of mental health promotion, illness prevention, detection and treatment of mental illnesses, as well as rehabilitation and recovery support [ 70 , 71 ].” For example, in the identified intervention studies formal integration was mainly done through teams including both primary care physicians and specialized health service providers in mental health, alcohol and substance abuse, and home care programs. An illustration of formal integration is a medical home (called Family Medicine Groups in Quebec or Family Health Teams in Ontario, Canada) when parents in situation of vulnerability are informed about all available services (approachability) to get them in time (availability) and free (affordability) including transcultural child mental health support if needed [ 72 ].…”

Section: Discussionmentioning

confidence: 99%

Organizational interventions improving access to community-based primary health care for vulnerable populations: a scoping review

Khanassov

Pluye

Descôteaux

et al. 2016

Int J Equity Health

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Access to community-based primary health care (hereafter, ‘primary care’) is a priority in many countries. Health care systems have emphasized policies that help the community ‘get the right service in the right place at the right time’. However, little is known about organizational interventions in primary care that are aimed to improve access for populations in situations of vulnerability (e.g., socioeconomically disadvantaged) and how successful they are. The purpose of this scoping review was to map the existing evidence on organizational interventions that improve access to primary care services for vulnerable populations. Scoping review followed an iterative process. Eligibility criteria: organizational interventions in Organisation for Economic Cooperation and Development (OECD) countries; aiming to improve access to primary care for vulnerable populations; all study designs; published from 2000 in English or French; reporting at least one outcome (avoidable hospitalization, emergency department admission, or unmet health care needs). Sources: Main bibliographic databases (Medline, Embase, CINAHL) and team members’ personal files. Study selection: One researcher selected relevant abstracts and full text papers. Theory-driven synthesis: The researcher classified included studies using (i) the ‘Patient Centered Access to Healthcare’ conceptual framework (dimensions and outcomes of access to primary care), and (ii) the classification of interventions of the Cochrane Effective Practice and Organization of Care. Using pattern analysis, interventions were mapped in accordance with the presence/absence of ‘dimension-outcome’ patterns. Out of 8,694 records (title/abstract), 39 studies with varying designs were included. The analysis revealed the following pattern. Results of 10 studies on interventions classified as ‘Formal integration of services’ suggested that these interventions were associated with three dimensions of access (approachability, availability and affordability) and reduction of hospitalizations (four/four studies), emergency department admissions (six/six studies), and unmet healthcare needs (five/six studies). These 10 studies included seven non-randomized studies, one randomized controlled trial, one quantitative descriptive study, and one mixed methods study. Our results suggest the limited breadth of research in this area, and that it will be feasible to conduct a full systematic review of studies on the effectiveness of the formal integration of services to improve access to primary care services for vulnerable populations.

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“…In 2013, a two-year evaluative research project was conducted to document the impact of ICDSs on the case formulation process and the subjective experience of ICDS participants. ICDSs are held on a monthly basis in three collaborative care mental health settings which provide services for a large populations of new migrants (Nadeau et al., 2014). Members of an interdisciplinary group present the clinical history and are asked to formulate their understanding of the case at the end of this presentation (initial formulation).…”

Section: Methodsmentioning

confidence: 99%

“…In parallel, guidelines increasingly insist on the importance of direct clinical experience under the supervision of culturally trained clinicians (American Psychiatric Association, 2013). This supervision can be provided during specialized rotations, for example in a CCS, or in community rotations (Nadeau, Rousseau, & Measham, 2014). However, the relative lack of trained supervisors is a major limitation to compliance with this training objective (Rousseau & Guzder, 2015).…”

Section: Introductionmentioning

confidence: 99%

Interdisciplinary case discussions as a training modality to teach cultural formulation in child mental health

Rousseau

Johnson‐Lafleur²,

Papazian-Zohrabian

et al. 2018

Transcult Psychiatry

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The DSM-5 Cultural Formulation Interview (CFI) may become an important tool to help operationalize culture in the clinical realm. However, challenges exist in teaching its use to avoid the risk of stereotyping and oversimplification, which could result in misunderstanding and stigma. The aim of this article is to document whether the CFI can be taught using regular Interdisciplinary Case Discussion Seminars (ICDSs), proposed as continuing education in child mental health and as part of clinical rotations for new trainees. During a two-year evaluative research project, ICDSs were held monthly in three different primary care settings servicing recent immigrants in Montreal, Canada. ICDSs were recorded and analyzed to examine their effect on the cultural formulation process and focus groups were conducted to explore the subjective experience of the participant trainees and professionals. Results suggest that ICDSs are a helpful way to teach the use of the CFI. The group discussions helped participants to better capture the complexity of the cultural and social experience of the child and family by moving away from simple identity assignations, supporting an inquiry into structural dimensions, and considering stigma and inequality in their formulation. The multiple levels of diversity (individual, disciplinary, and interinstitutional) represented in the discussion groups helped clinicians to understand the cultural formulation as situated in a specific relational context and a particular moment and, in so doing, helped trainees to avoid cultural formulations that essentialize culture.

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Addressing Cultural Diversity Through Collaborative Care

Cited by 41 publications

References 43 publications

In or out? Barriers and facilitators to refugee-background young people accessing mental health services

In or out? Barriers and facilitators to refugee-background young people accessing mental health services

Organizational interventions improving access to community-based primary health care for vulnerable populations: a scoping review

Interdisciplinary case discussions as a training modality to teach cultural formulation in child mental health

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