The Mental Health of First Nations Children in Manitoba: A Population-Based Retrospective Cohort Study Using Linked Administrative Data: La santé mentale des enfants des Premières Nations au Manitoba : une étude de cohorte rétrospective dans la population, à l'aide de données administratives liées.

OBJECTIVE: First Nations children face a greater risk of experiencing mental disorders than other children from the general population because of family and societal factors, yet there is little research examining their mental health. This study compares diagnosed mental disorders and suicidal behaviours of First Nations children living on-reserve and off-reserve to all other children living in Manitoba. METHOD: The research team, which included First Nations and non-First Nations researchers, utilized population-based administrative data that linked de-identified individual-level records from the 2016 First Nations Research File to health and social information for children living in Manitoba. Adjusted rates and rate ratios of mental disorders and suicide behaviours were calculated using a generalized linear modelling approach to compare First Nations children (n = 40,574) and all other children (n = 197,109) and comparing First Nations children living on- and off-reserve. RESULTS: Compared with all other children, First Nations children had a higher prevalence of schizophrenia (adjusted rate ratio (aRR): 4.42, 95% confidence interval (CI), 3.36 to 5.82), attention-deficit hyperactivity disorder (ADHD; aRR: 1.21, 95% CI, 1.09 to 1.33), substance use disorders (aRR: 5.19; 95% CI, 4.25 to 6.33), hospitalizations for suicide attempts (aRR: 6.96; 95% CI, 4.36 to 11.13) and suicide deaths (aRR: 10.63; 95% CI, 7.08 to 15.95). The prevalence of ADHD and mood/anxiety disorders was significantly higher for First Nations children living off-reserve compared with on-reserve; in contrast, hospitalization rates for suicide attempts were twice as high on-reserve than off-reserve. When the comparison cohort was restricted to only other children in low-income areas, a higher prevalence of almost all disorders remained for First Nations children. CONCLUSION: Large disparities were found in mental health indicators between First Nations children and other children in Manitoba, demonstrating that considerable work is required to improve the mental well-being of First Nations children. Equitable access to culturally safe services is urgently needed and these services should be self-determined, planned, and implemented by First Nations people.

Orthopedic and ophthalmology surgical service forecast modelling in Manitoba: Research approach for a data linkage study.

Background: The healthcare system in Manitoba, Canada has faced long wait times for many surgical procedures and investigations, including orthopedic and ophthalmology surgeries. Wait times for surgical procedures is considered a significant barrier to accessing healthcare in Canada and can have negative health outcomes for patients. We developed models to forecast anticipated surgical procedure demands up to 2027. This paper explores the opportunities and challenges of using administrative data to describe forecasts of surgical service delivery. Methods: This study used whole population linked administrative health data to predict future orthopedic and ophthalmology surgical procedure demands up to 2027. Procedure codes (CCI) from hospital discharge abstracts and medical claims data were used in the modelling. A Seasonal Autoregressive Integrated Moving Average model provided the best fit to the data from April 1, 2004 to March 31, 2020. Results: Initial analyses of only hospital-based procedures excluded a significant portion of provider workload, namely those services provided in clinics. We identified 500,732 orthopedic procedures completed between April 1, 2004 and March 31, 2020 (349,171 procedures identified from hospital discharge abstracts and 151,561 procedures from medical claims). Procedure volumes for these services are expected to rise 17.7% from 2020 (36,542) to 2027 (43,011), including the forecasted 43.9% increase in clinic-based procedures. Of the 660,127 ophthalmology procedures completed between April 1, 2004 and March 31, 2020, 230,717 procedures were identified from hospital discharge abstracts and 429,410 from medical claims. Models forecasted a 27.7% increase from 2020 (69,598) to 2027 (88,893) with most procedures being performed in clinics. Conclusion: Researchers should consider including multiple datasets to add information that may have been missing from the presumed data source in their research approach. Confirming the completeness of the data is critical in modelling accurate predictions. Forecast modelling techniques have evolved but still require validation.

Paternal Perinatal Experiences during the COVID-19 Pandemic: A Framework Analysis of the Reddit Forum Predaddit.

During the COVID-19 pandemic, new parents were disproportionately affected by public health restrictions changing service accessibility and increasing stressors. However, minimal research has examined pandemic-related stressors and experiences of perinatal fathers in naturalistic anonymous settings. An important and novel way parents seek connection and information is through online forums, which increased during COVID-19. The current study qualitatively analyzed the experiences of perinatal fathers from September to December 2020 through the Framework Analytic Approach to identify unmet support needs during COVID-19 using the online forum predaddit on reddit. Five main themes in the thematic framework included forum use, COVID-19, psychosocial distress, family functioning, and child health and development, each with related subthemes. Findings highlight the utility of predaddit as a source of information for, and interactions of, fathers to inform mental health services. Overall, fathers used the forum to engage with other fathers during a time of social isolation and for support during the transition to parenthood. This manuscript highlights the unmet support needs of fathers during the perinatal period and the importance of including fathers in perinatal care, implementing routine perinatal mood screening for both parents, and developing programs to support fathers during this transition to promote family wellbeing.