Wait Time Impact of Co-Located Primary Care Mental Health Services: The Effect of Adding Collaborative Care in Northern Ontario

Abstract

Objectives: In the shared care model, psychiatrists and physicians work in the same office areas, write their notes in the same casebooks, and can more rapidly exchange information about referrals and health conditions of their patients. We evaluated the impact of the introduction of a shared mental health care service, co-located with a primary care site, on wait times for mental health services in a northern Ontario city. Method: Chart reviews were conducted to examine a total of 3589 referrals for 5 mental health outpatient services (1 shared care and 4 existing services) from January 2001 to the end of June 2004. The shared mental health care service site was started in July 2001. Wait time was measured 6 months prior to and up to 3 years after the introduction of the shared care service. Results: The shared care site offered services more than 40 days sooner and also helped to reduce wait time on the nonshared care sites. After shared care began, the pre-existing, nonshared care services had wait times of about 13 days shorter during the 3 subsequent years. Conclusions: The shared care service maintained the lowest overall wait times, compared with the existing nonshared care services. The existing services experienced a decrease in the number of days waiting when the baseline wait time was compared with that of the following year. W W W Objectifs : Dans le modèle des soins partagés, psychiatres et médecins travaillent dans les mêmes bureaux, rédigent leurs notes dans les mêmes recueils, et peuvent échanger plus rapidement l'information sur l'aiguillage et l'état de santé de leurs patients. Nous avons évalué l'effet de l'introduction d'un service de soins de santé mentale partagés, installé au même endroit que des soins de première ligne, sur les temps d'attente des services de santé mentale dans une ville du nord de l'Ontario. Méthode : Une étude des dossiers a été menée pour examiner un total de 3589 consultations pour 5 services externes de santé mentale (1 de soins partagés et 4 services existants) de janvier 2001 à la fin de juin 2004. Le service de soins de santé mentale partagés a ouvert ses portes en juillet 2001. Les temps d'attente ont été mesurés 6 mois avant et jusqu'à 3 ans après l'ouverture du service de soins partagés. Résultats : Le site des soins partagés offrait des services plus de 40 jours plus tôt et contribuait également à réduire les temps d'attente des sites de soins non partagés. Après le début des soins partagés, les services de soins non partagés préexistants ont eu des temps d'attente de quelque 13 jours plus courts durant les 3 années subséquentes. Conclusions : Le service des soins partagés a maintenu les temps d'attente les plus faibles en général, comparativement aux services de soins non partagés existants. Les services existants ont connu une diminution du nombre de jours d'attente, lorsque les temps d'attente de départ ont été comparés avec ceux de l'année suivante.

Processes of patient-centred care in Family Health Teams: a qualitative study

“…This finding supports the link between access and patient-centred care and is noteworthy given that prior research showed an association between patient-centred care and positive mental health outcomes. 17 Research on the integration of mental health services into primary care practices has been limited to the experiences of shared care models in limited geographic locations, 21,22 whereas our findings reflect 20 FHTs across Ontario.…”

“…20 Improved access to care is a central mandate for FHTs. Our study and other research 5,21,22 have shown that this is being achieved, albeit through various approaches. Our study participants' unsolicited emphasis of the added value of unique access to mental health services within their FHTs was a new and important finding.…”

Disability and Psychiatric Symptoms in Men Referred for Treatment with Work-Related Problems to Primary Mental Health Care

“…Services provided at the clinic are entirely paid for by the provincial health insurance program. PC providers can be accessed on an as-needed basis and the wait time for counselling services was about 42 days [24]. Private (i.e., not publicly funded) mental health care services are available for those who have private insurance or are willing to pay out of pocket.…”

“…It was hypothesized that SMHC enhances accessibility of mental health services in part by reducing stigma [23] and by improving timely access to care [24]. Counseling needs are the least likely mental health needs to be met, and men were less likely than their female counterparts to describe having a mental health care need that was met (males: 8.8%; females: 14.4%) or partially met (males: 2.7%; females 4.6%) [25].…”

Reducing severity of comorbid psychiatric symptoms in an epilepsy clinic using a colocation model: Results of a pilot intervention

“…Integrated, colocated, and collaborative models of care involving or integrating mental health in primary care or specialty clinics are currently rare but may soon become increasingly widespread [16]. Collaborative care models consist of team-oriented, multidisciplinary interventions to deliver care by systematically improving care coordination via organizational leadership support, evidence-based provider decision-making, and clinical information systems [17].…”