Perceptions on barriers, facilitators, and recommendations related to mental health service delivery during the COVID-19 pandemic in Quebec, Canada: a qualitative descriptive study.

BACKGROUND: There was an increase in self-reported mental health needs during the COVID-19 pandemic in Canada, with research showing reduced access to mental health services in comparison to pre-pandemic levels. This paper explores 1) barriers and facilitating factors associated with mental health service delivery via primary care settings during the first two pandemic waves in Quebec, Canada, and 2) recommendations to addressing these barriers. METHODS: A qualitative descriptive study design was used. Semi-structured interviews with 20 participants (health managers, family physicians, mental health clinicians) were conducted and coded using a thematic analysis approach. RESULTS: Barriers and facilitating factors were organized according to Chaudoir et al. (2013)'s framework of structural, organizational, provider- and patient-related, as well as innovation (technological modalities for service delivery) categories. Barriers included relocation of mental health staff to non-mental health related COVID-19 tasks (structural); mental health service interruption (organizational); mental health staff on preventive/medical leave (provider); the pandemic's effect on consultations (i.e., perceptions of increased demand) (patients); and challenges with the use of technological modalities (innovation). Facilitating factors included reinforcements to mental health care teams (structural); perceptions of reductions in wait times for mental health evaluations during the second wave due to diminished FP referrals in the first wave, as well as supports (i.e., management, private sector, mental health trained staff) for mental health service delivery (organizational); staff's mental health consultation practices (provider); and advantages in increasing the use of technological modalities in practice (innovation). CONCLUSIONS: To our knowledge, this is the first study to explore barriers and facilitating factors to mental health service delivery during the pandemic in Quebec, Canada. Some barriers identified were caused by the pandemic, such as the relocation of staff to non-mental health services and mental health service interruption. Offering services virtually seemed to facilitate mental health service delivery only for certain population groups. Recommendations related to building and strengthening human and technological capacity during the pandemic can inform mental health practices and policies to improve mental health service delivery in primary care settings and access to mental health services via access points.

Getting better my way: Feasibility study of a self-management support tool for people with mood and anxiety disorders.

OBJECTIVE: Self-management support is recognized as an important component of the management of mood and anxiety disorders. The goal of this feasibility study was to evaluate the acceptability, implementation and perceived usefulness of a new comprehensive self-management tool (Getting better my way) in four care settings in Quebec, Canada. METHOD: Care providers offered the tool to people with difficulties related to mood or anxiety disorders during a 7-month period. A sample of 71 participants filled out an online survey and 27 accepted to participate in a follow-up interview. Focus groups were conducted with 82 care providers. RESULTS: Satisfaction ratings were high for the tool overall, the likelihood of recommending it to friends, its attractiveness and interest, and its completion time. Perceived usefulness was high overall and was not related to most demographic and clinical variables. No adverse effects were reported. CONCLUSION AND IMPLICATIONS FOR PRACTICE: The study highlights that Getting better my way is a comprehensive recovery-oriented tool, considered useful, acceptable and feasible to use in a variety of settings offering services for mood and anxiety disorders. (PsycINFO Database Record (c) 2019 APA, all rights reserved).