Mental health collaborative care: a synopsis of the Rural and Isolated Toolkit.

CONTEXT: For those residing in rural and isolated parts of Canada, obtaining quality mental health services is often an unfulfilled wish. Rural and isolated communities share the problems of health status and access to care. Health deteriorates the greater the distance from urban areas in the following dimensions: lower life expectancy than the national average; higher rates of disability, violence, poisoning, suicide and accidental death; and more mental and physical health issues than those who live in urban areas. The Canadian Collaborative Mental Health Initiative (CCMHI) was formed to provide, in part, a practical means to encouraging collaborations between primary care and mental health providers. ISSUE: This article provides a synopsis of the Rural and Isolated (R&I) toolkit developed through the CCMHI, which was intended to develop primary care and mental health collaboration in such areas. This toolkit was developed using focus group discussions with mental health providers, and surveys completed by providers and consumers. LESSONS LEARNED: Key messages from the consultative process included: access to services; interprofessional education; consumer involvement; research and evaluation; models of collaboration; ethics; funding; and policy and legislation. A flow diagram was devised to detail the synthesis and practical application of the toolkit, as well as the challenges, key questions and principles of implementation associated with collaborative care initiatives in rural and isolated regions.

Rigour in qualitative research: mechanisms for control.

Qualitative researchers have been criticised for a perceived failure to demonstrate methodological rigour. Kimberley D Ryan-Nicholls and Constance I Will offer cautionary recommendations related to the mechanisms for control of methodological rigour in qualitative inquiry.

Collaborative mental health in rural and isolated Canada: stakeholder feedback.

This article presents research findings from the Rural and Isolated Working Group, one of six groups established by the Canadian Collaborative Mental Health Initiative (CCMHI). Funded through Health Canada's Primary Health Care Transition Fund, the goal of the CCMHI is to improve the mental health and well-being of Canadians by increasing collaboration among primary health care and mental health care providers, consumers, families, and caregivers. Qualitative data obtained from mental health care providers and consumers across all regions of Canada are presented in this article. Policy and regulation problems, barriers to mental health care access, service providers' perspectives of the challenges to consumer involvement, and solutions for addressing these issues are discussed. The article concludes by identifying how this research has informed and influenced initial steps toward mental health promotion and treatment of mental illness in rural and isolated Canada.

Limited clinical site availability, outstanding mental health needs and barriers to faculty practice: A proposal for resolution.

A Canadian university is experiencing increasing difficulty in accessing appropriate clinical experiences for undergraduate psychiatric nursing students. Meanwhile, many nursing faculty are experiencing an increased desire for clinical practice opportunities. Concurrently a gap in mental health service delivery exists for those residents who experience severe and persistent mental illness (SPMI). This paper proposes a solution through establishment of a mental health promotion clinic as a mechanism for managing issues concerning clinical site availability, faculty clinical practice, and mental health service provision for persons experiencing SPMI.

Educational needs of psychiatric nurses for continuing competency.

BACKGROUND: Practice setting diversification has created an increased need for psychiatric nurses to assume more independent roles, while at the same time being able to demonstrate the corresponding degree of competency to practice. Psychiatric nurses were invited to share their perceptions concerning changes occurring in mental health care, proactive strategies for participating in these changes, and educational opportunities to ensure continuing competency to practice. METHOD: Focus groups were conducted with psychiatric nurses located in various Regional Health Authorities in southern and central regions of Manitoba, Canada. RESULTS: Research findings suggest that psychiatric nurses are primarily concerned with balancing the requirement to demonstrate continuing competence to practice with the challenges associated with the evolving mental healthcare system. CONCLUSION: If the requirement for continuing competence is to be reasonable and achievable, it will be essential that the program generate insight into the necessity for such a program to be implemented and acquire support among the registered psychiatric nurse membership.

Providers' perceptions of how rural consumers access and use mental health services.

This article describes the third phase of a research study undertaken within a Canadian provincial regional health authority to explore and analyze mental health services and other resources used by rural consumers after discharge from inpatient mental health programs. The focus of this article is the qualitative research findings obtained from mental health service providers and members of allied agencies. This article will discuss the literature on rural consumers' access and use of mental health programs and services; describe the context and method used to conduct the focus groups with rural service providers; characterize access and use problems from the service providers' perspectives; and suggest strategies to address these problems.