Primary care teams’ experiences of delivering mental health care during the COVID-19 pandemic: a qualitative study

Abstract

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.

Generalized anxiety disorder during COVID-19 in Canada: Gender-specific association of COVID-19 misinformation exposure, precarious employment, and health behavior change

“…Married) Single/widowed 1.74 0.99 3.07 0.012 0.91 0.34 2.48 0.816 1.19 0.72 1.97 0.372 2.26 1.18 4.33 0.001 Type of dwelling (Ref. Detached house) Low-rise apartment 1.68 0.90 3.16 0.033 4.95 1.99 12.36 <0.001 1.49 0.84 2.62 0.071 2.06 0.98 4.32 0.012 High-rise apartment 1.50 0.80 2.83 0.098 1.40 0.47 4.13 0.429 1.12 0.62 2.05 0.619 0.74 0.28 2.00 0.437 Others 0.91 0.58 1.43 0.581 1.24 0.57 2.74 0.476 0.81 0.54 1.23 0.198 0.73 0.41 1.30 0.160 Household size ( Ref. 2 persons) …”

“…As such, occupational justice is needed to confront the longstanding gender discrimination and the gendered nature of precarious labor underlying job precariousness. Moreover, considering that higher burden of anxiety was observed among jobless women as a consequence of COVID-19, primary care teams should expand access to virtual mental health care and recourses ( Ashcroft et al., 2021 ), such as Internet-delivered cognitive behavioral therapy, tailored to women coping with precarious employment. Social policies that redistribute resources could address upstream social determinants of health, particularly among women workers with precarious job ( Phelan et al., 2010 ).…”

The Delivery of Patient Care in Ontario’s Family Health Teams during the First Wave of the COVID-19 Pandemic

“…The future of virtual care requires strong system leadership ( Shaw et al 2017 ). While there has been intense focus on acute care in the early phases of the pandemic, policy makers need to give greater attention to primary care teams because they are uniquely positioned to deliver preventative care, manage chronic diseases and respond to the overwhelming mental healthcare demands that have emerged during the COVID-19 pandemic ( Ashcroft et al 2021a ; DeVoe and Bazemore 2021 ). Before the pandemic, wide differences existed across primary care organizations and models in Ontario ( Rudoler et al 2019 ).…”

Increase in Anxiety-Related Out-of-Hours Primary Care Consultations Since COVID-19: An Observational Study Using Routine Data in Flanders

“…Moreover, regular registration systems nor surveys might not be able to capture all problems. Therefore, governments need to think about advanced mental health infrastructures and systems that address well-being on a population level to better deal with these problems (14,15).…”