A research project screening patients for mental health, especially depression, using e-health technology has earned a York Faculty of Health researcher a recent one-year Canadian Institutes of Health Research catalyst grant for e-health innovations.
Professor Farah Ahmad, the co-principal investigator with Cliff Ledwos, director of Primary Health Care and Special Initiatives at Access Alliance Multicultural Health & Community Services, and her team received $89, 933to follow up on the results of a pilot project that saw computer tablets being used to break down barriers to often undetected mental and social needs of refugees. (See the Sept. 7, 2012 issue of YFile.)
“We are developing and evaluating a user-friendly, touch-screen, multi-language Interactive Computer-Assisted Screening (iCAS) tool for common mental health conditions, including depression,” says Ahmad of York’s School of Health Policy & Management.
Four million (12 per cent) Canadians experience a major depressive episode in their lifetime. Yet, people experiencing depression delay seeking care and clinicians detect only 50 per cent of cases. This is alarming considering the availability of effective care for depression, says Ahmad.
“The iCAS screening will be completed by patients during their waiting time and the tool will generate tailored messages for both patients and clinicians prior to the medical visit. The tool will also assess patients’ social context to assist in pathways to care.”
To this end, interactive computer-assisted screening for depression has the potential to optimize existing practices and improve the quality of care by meeting the needs of patients by addressing social sensitivity and language proficiency and clinicians who are facing time constraints.
For evaluation, a mixed-method approach is planned with usability testing, pilot randomized trial and qualitative interviews with clinicians, says Ahmad. “The randomized trial will evaluate the impact of the iCAS on the process-of-care, compared to usual care, in increasing clinician detection of depression, which is the primary outcome, but also, the enablement of the patient to cope with illness.”
Although, the current project will focus on English and Spanish versions of iCAS, the aim is to expand the tool in the future to multiple community health centres and to diverse language groups.
“We anticipate that system-wide diffusion of an effective, efficient and acceptable iCAS system would create capacity to measure mental health and identify trends at the population level, while allowing comparisons by jurisdictions, communities and social conditions to inform health policy,” says Ahmad. “An evidence-based loop would be created to enhance front-line health-care quality, as well as population health.”