Implementing collaborative and integrated approaches to addressing mental health needs in primary care

Background: Integrated and collaborative models of mental healthcare have been widely demonstrated to improve patient outcomes, but are challenging to implement. In Ontario, Canada, the introduction of a neighbourhood model of primary care with a commitment to 100% attachment of all patients is strengthening attachment and access to interprofessional team based care, and offers the potential of a strong foundation for collaborative care.

The presenters have successfully implemented programs that adapt collaborative care to population health needs in diverse local, regional, and provincial contexts, often through intersectoral collaboration. They bring expertise including clinical, research, and administrative/policy.

Audience: Geared towards those seeking to implement integrated mental health care in primary care settings, this workshop will equip participants with tools to reflect on their integration initiative, including its alignment to evidence along with next steps to further system improvement. We welcome diverse perspectives including people with lived and living experience, clinicians, scholars, and leaders/decision-makers.

Approach: Presentation (30 minutes)

• Introduce the neighborhood model of primary care, an approach to primary care attachment and integration that establishes interdisciplinary primary care as the foundation of local health and social service integration
• Review evidence for integrated/collaborative mental healthcare, including core elements and outcomes
• Share case studies of implementing collaborative care for depression and anxiety in primary care settings, including:

o a digitally enabled care pathway for children and youth that supports primary care practitioners to identify anxiety and depression early, uses the best available evidence to inform care, and seamlessly connects patients to local child and youth specialist service providers.

o a population health-based, “whole person” approach that integrates mental health care pathways and specific ‘triggers’ within treatment pathways for chronic medical conditions such as COPD and/or chronic heart failure.

• a province-wide initiative to facilitate collaborative care, through analysis of the current state of interprofessional mental health care in primary care settings and an intersectoral effort to align a provincial psychotherapy program with the needs of primary care providers and their patients.

Interactive table work and large-group discussion (60 minutes)

• Working in small groups with support from facilitators, participants will use evidence-informed integrated care implementation tools, worksheets, and “think-pair-share” activities to reflect on their own program or program idea, and identify next steps to deepen practice

o Depending on idea/program maturity, participants may choose to focus on defining/refining the population served, assessing the alignment of the current state with evidence, exploring interest-holders engagement, or planning and carrying out measurement, as examples.

• Participants will share insights and next steps with the broader group
• Presenters will conclude by summarizing emerging themes and reflections

Outcomes:

Participants will: 1) understand the neighbourhood model of primary care, collaborative mental health care, and opportunities for alignment across these approaches; 2) identify 1-2 next steps for their program or program idea, that align with evidence and are appropriate to context and program maturity; 3) access new networks and inspiration. Overall, participants will learn practical strategies to advance evidence-informed collaborative mental healthcare initiatives at various stages.