TY - JOUR
AU - D. Sarakbi
AU - D. Groll
AU - J. Tranmer
AU - R. Kessler
AU - K. Sears
A1 - 
AB - BACKGROUND: Quality integrated care, which involves primary care and mental health clinicians working together, can help identify and treat adolescent depression early. We explored systemic barriers to quality integrated care at the provincial level in Ontario, Canada using a learning system approach. METHODS: Two Ontario Health Teams (OHTs), regional networks designed to support integrated care, completed the Practice Integration Profile (PIP) and participated in focus groups. RESULTS: The OHTs had a median PIP score of 69 out of 100. Among the PIP domains, the lowest median score was case identification (50), and the highest one was workspace (100). The focus groups generated 180 statements mapped to the PIP domains. Workflow had the highest number of coded statements (59, 32.8%). DISCUSSION: While the primary care practices included mental health clinicians on-site, the findings highlighted systemic barriers with adhering to the integrated care pathway for adolescent depression. These include limited access to mental health expertise for assessment and diagnosis, long wait times for treatment, and shortages of clinicians trained in evidence-based behavioral therapies. These challenges contributed to the reliance on antidepressants as the first line of treatment due to their accessibility rather than evidence-based guidelines. CONCLUSION: Primary care practices, within regional networks such as OHTs, can form learning systems to continuously identify the strategies needed to support quality integrated care for adolescent depression based on real-world data.
AD - Health Quality Programs, Queen's University, Ontario, Canada.; Department of Psychiatry and Psychology, Queen's University, Ontario, Canada.; School of Nursing and Department of Public Health Sciences, Queen's University, Ontario, Canada.; Department of Family Medicine, University of Colorado, Colorado, United States.; School of Nursing and Health Quality Programs, Queen's University, Ontario, Canada.
AN - 38312480
BT - Int J Integr Care
C5 - Healthcare Disparities; Education & Workforce
CP - 1
DA - Jan-Mar
DO - 10.5334/ijic.7685
DP - NLM
ET - 20240201
IS - 1
JF - Int J Integr Care
LA - eng
N2 - BACKGROUND: Quality integrated care, which involves primary care and mental health clinicians working together, can help identify and treat adolescent depression early. We explored systemic barriers to quality integrated care at the provincial level in Ontario, Canada using a learning system approach. METHODS: Two Ontario Health Teams (OHTs), regional networks designed to support integrated care, completed the Practice Integration Profile (PIP) and participated in focus groups. RESULTS: The OHTs had a median PIP score of 69 out of 100. Among the PIP domains, the lowest median score was case identification (50), and the highest one was workspace (100). The focus groups generated 180 statements mapped to the PIP domains. Workflow had the highest number of coded statements (59, 32.8%). DISCUSSION: While the primary care practices included mental health clinicians on-site, the findings highlighted systemic barriers with adhering to the integrated care pathway for adolescent depression. These include limited access to mental health expertise for assessment and diagnosis, long wait times for treatment, and shortages of clinicians trained in evidence-based behavioral therapies. These challenges contributed to the reliance on antidepressants as the first line of treatment due to their accessibility rather than evidence-based guidelines. CONCLUSION: Primary care practices, within regional networks such as OHTs, can form learning systems to continuously identify the strategies needed to support quality integrated care for adolescent depression based on real-world data.
PY - 2024
SN - 1568-4156 (Print)
SP - 6
ST - Supporting Quality Integrated Care for Adolescent Depression in Primary Care: A Learning System Approach
T1 - Supporting Quality Integrated Care for Adolescent Depression in Primary Care: A Learning System Approach
T2 - Int J Integr Care
TI - Supporting Quality Integrated Care for Adolescent Depression in Primary Care: A Learning System Approach
U1 - Healthcare Disparities; Education & Workforce
U3 - 10.5334/ijic.7685
VL - 24
VO - 1568-4156 (Print)
Y1 - 2024
ER -