Research Snapshot: Mental health and addictions capacity building for community health centres in Ontario

What you need to know

A training program for staff in primary care organizations increased participants’ knowledge related to mental health and addictions and enhanced their willingness to see patients with mental health and/or addiction problems. There were some positive changes in attitudes towards these patients, but these were less meaningful than the changes in knowledge and skills.

 

This Research Snapshot looks at the article, "Mental health and addictions capacity building for community health centres in Ontario,” by Akwatu Khenti and colleagues, published in Canadian Family Physician in 2017. Read it below or download the PDF.

Research Snapshots are brief, clear language summaries of research articles, presented in a user-friendly format.

What is this research about?

adults sitting in a classroom, listening to a person at the front of the classCommunity health centres are primary care facilities that treat people who frequently come from lower income neighbourhoods. For many people with mental health or addictions (MH/A) problems, the community health centre (CHC) is their only point of contact with the health system. For this reason, primary healthcare professionals have an unparalleled opportunity to treat these individuals. Ontario researchers evaluated the effectiveness of a training program designed to build the knowledge and skills of primary healthcare professionals related to MH/A.

What did the researchers do?

The researchers implemented a training program with primary care staff in ten Ontario community health centres. About half were clinical front-line staff (such as family physicians, nurses, nurse practitioners, and mental health counselors). Close to a quarter were community health workers, while the rest were directors and managers, administrative staff, and other professionals.

The training program had five components:

  • A needs assessment to assess the knowledge and skills of front-line staff related to MH/A and organizational capacity at each CHC to support and sustain the program.
  • Inter-professional education – Included six three-hour learning modules presenting research and internationally recognized best practices related to MH/A, screening and assessment, collaborative care, health promotion, family and community involvement, and self-care for CHC professionals. Included sessions to address the specific needs identified at each centre.
  • Mentoring – Helped participants to integrate the training into their practices while receiving ongoing support. Included professional support through case consultation and an online platform.
  • Development of an organizational action plan – This fostered inclusion of clients with MH/A challenges and provision services for these challenges within their overall strategic plan. These plans also helped lay the foundation for an ongoing collaborative partnership between the individual centres and CAMH.
  • Development of a primary healthcare resource manual to improve team-work in MH/A. It provided practical and concrete information about common MH/A problems, the issues affecting access to care, and alternative frameworks for approaching patient care.

Evaluations were done immediately after participants completed the training.

What did the researchers find?

After participating in the training program, there was a statistically significant increase in knowledge across all fields. There was also an overall improvement among all participants in terms of their willingness to see patients with MH/A problems.

There were some positive changes in attitudes towards these patients, but these were less meaningful than the changes in knowledge and skills.

Limitations and next steps

Some participants found the training program too basic while others thought the training was too short. Also, some participants found the regular evaluations were excessive.  In future, it might be more useful to leave some time for implementation before evaluation. Finally, participants were asked to evaluate their own progress, a subjective process that might bias findings.

Attitudes and perceptions usually take time to change, even after knowledge and skills have improved. Longer-term evaluations will need to assess changes in attitudes over time and how these affect outcomes for patients and families.

About the researchers

Akwatu Khenti,1 Fiona C. Thomas,2 Sirad Mohamoud,3 Pablo Diaz,4 Oriana Vaccarino,5 Kate Dunbar,6 Jaime C. Sapag7

  1. Office of Transformative Global Health (OTGH) in the Institute for Mental Health Policy Research (IMHPR) at the Centre for Addiction and Mental Health (CAMH); Dalla Lana School of Public Health at the University of Toronto, Toronto, ON
  2. Community-Engaged Research on Culture and Health Laboratory in the Department of Psychology at Ryerson University, Toronto, ON
  3. Ontario Ministry of Economic Development, Job Creation and Trade, Toronto, ON
  4. Schizophrenia Program at CAMH; Department of Psychiatry at University of Toronto, Toronto, ON
  5. Applied Social Psychology at University of Guelph, Guelph, ON
  6. IMHPR at CAMH, Toronto, ON 
  7. OTGH at CAMH; Dalla Lana School of Public Health at the University of Toronto, Toronto, ON

Keywords

First nations, Aboriginal, social determinants of health, culture, resilience, racial discrimination, racism, race, stress

This Research Snapshot was written by Nimira Lalani based on the article “Mental health and addictions capacity building for community health centres in Ontario” published in Canadian Family Physician in 2017.