Research led by York improves access to mental health care for immigrants
A team led by York University researcher Professor Farah Ahmad has developed a new interactive eHealth tool to facilitate the pre-consult assessment of mental health disorders for immigrants and refugees.
The campus-community initiative was funded by the Canadian Institutes of Health Research and included investigators from York University (Ahmad, Liane Ginsburg, Serban Dinca-Panaitescu, Peggy Ng), Access Alliance Multicultural Health and Community Centre (Yogendra Shakya, Cliff Ledwos), Center for Addiction and Mental Health (Kwame Mecknzie), Women’s College Hospital (Meb Rashid) and University of Toronto (Wendy Lou).
The tool addresses disparities in access to mental health care for vulnerable ethnocultural and immigrant groups by providing additional support through interactive, computer-based self-assessments.
“The study found such a tool not only effective in improving mental health discussion and detection in the intervention group compared to the usual care, but (that) its acceptance among members of ethnocultural and immigrant communities studied at a Toronto based Community Health Centre is high,” said Ahmad.
The assessment helps to indicate common mental health illnesses (e.g. depression, anxiety, post-traumatic stress disorder), and is also equipped to assess social conditions and generate point-of-care individualized reports for the patients and clinicians.
The results, reported in the randomized controlled trial and published in CMAJ Open (http://cmajopen.ca/content/5/1/E190.full) on March 3, 2017, show the tool improved mental health discussion by 18 per cent and clinical detection of symptoms by 11 per cent in the group using the interactive tool compared to usual care.
Ahmad said patients using the tool reported minimal technological difficulties and agreed with the tool’s benefits. The family physicians and nurse practitioners interviewed after the trial also found the tool useful, as reported in BMC Health Services Research journal. In another article published in the Canadian Family Physician, the research team noted the high burden of common mental disorders in the studied population.
Given the potential of the tool to overcome stigma associated with mental health concerns and the needs of the community, Ahmad and her team plan for a multi-site trial to find an effective model of care that could be generalized across several community health centres that serve vulnerable populations.
“Interactive eHealth tools hold potential to reduce communication barriers and time challenges for both patients and providers to engage in discussions around mental health concerns,” said Dinca-Panaitescu.
There is a need to identify innovative ways to reduce stigma around professional help-seeking for mental health concerns, said Ahmad.
This work would not have been possible without the tremendous support of Access Alliance and the clinic’s staff,” she said.
“Adoption of such tools at the system level could address access challenges while generating granulated data to inform practice and policy,” said Ginsburg.
With a global rise in mental health illness, such as depression and generalized anxiety, the World Health Organization predicts depression will rank first in the burden of diseases for high-income countries by 2030. Such innovative models of care could reduce growing disparities in accessing timely care though primary care settings.