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Background: Timely and comprehensive treatment in the form of early psychosis intervention (EPI) has become the standard of care for youth with psychosis. While EPI services were designed to be delivered in person, the COVID-19 pandemic required many EPI programs to rapidly transition to virtual delivery, with little evidence to guide intervention adaptations or to support the effectiveness and satisfaction with virtual EPI services. Objective: This study aims to explore the adaptations required to deliver NAVIGATE, a model of coordinated specialty care used in EPI, in a virtual format. This study will evaluate implementation of the NAVIGATE model delivered virtually by describing the nature of the adaptations to the intervention, assessing fidelity to the EPI model and the satisfaction of clients, family members, and care providers. We will investigate barriers and facilitators to virtual NAVIGATE implementation, service engagement, and health equity impacts of this work. Methods: The Centre for Addiction and Mental Health (Toronto, Ontario, Canada) transitioned to delivering NAVIGATE virtually early in the COVID-19 pandemic. The Framework for Reporting Adaptations and Modifications for Evidence-Based Interventions will be used to describe the adaptations required to deliver NAVIGATE virtually. Fidelity to the EPI model will be measured using the First Episode Psychosis Services Fidelity Scale and fidelity to NAVIGATE will be assessed by investigating adherence to its core components. Implementation facilitators and barriers will be explored using semistructured interviews with providers informed by the Consolidated Framework for Implementation Research. Satisfaction with virtually delivered NAVIGATE will be assessed with virtual client and provider experience surveys and qualitative interviews with clients, family members, and providers. Service engagement data will be collected through review of medical records, and potential impacts of virtually delivered NAVIGATE on different population groups will be assessed with the Health Equity Impact Assessment. Results: Virtual clinical delivery of NAVIGATE started in March 2020 with additional adaptations and data collection is ongoing. Data will be analyzed using descriptive statistics and survival analysis for quantitative data. Qualitative data will be analyzed using thematic content analysis. Integration of qualitative and quantitative data will occur at the data collection, interpretation, and reporting levels following a convergent design. Conclusions: This study will provide information regarding the type of intervention adaptations required for virtual delivery of NAVIGATE for youth with early psychosis, ensuring access to high-quality care for this population during the pandemic and beyond by guiding future implementation in similar contexts. [ABSTRACT FROM AUTHOR]

Background: Integrated primary care teams are ideally positioned to support the mental health care needs arising during the COVID-19 pandemic. Understanding how COVID-19 has affected mental health care delivery within primary care settings will be critical to inform future policy and practice decisions during the later phases of the pandemic and beyond. The objective of our study was to describe the impact of the COVID-19 pandemic on primary care teams' delivery of mental health care. Methods: A qualitative study using focus groups conducted with primary care teams in Ontario, Canada. Focus group data was analysed using thematic analysis. Results: We conducted 11 focus groups with 10 primary care teams and a total of 48 participants. With respect to the impact of the COVID-19 pandemic on mental health care in primary care teams, we identified three key themes: i) the high demand for mental health care, ii) the rapid transformation to virtual care, and iii) the impact on providers. Conclusions: From the outset of the COVID-19 pandemic, primary care quickly responded to the rising mental health care demands of their patients. Despite the numerous challenges they faced with the rapid transition to virtual care, primary care teams have persevered. It is essential that policy and decision-makers take note of the toll that these demands have placed on providers. There is an immediate need to enhance primary care's capacity for mental health care for the duration of the pandemic and beyond. [ABSTRACT FROM AUTHOR]

Introduction: Primary care is the first point of access for health services and primary care teams play a central role in the coordination and integration of mental health services. The pandemic has seen a rising demand for mental health services and primary care teams are well positioned to address these needs. With the pandemic, primary care teams have made a transition to virtual care, however the impact on how teams collaborate to provide mental health care is unclear. The aim of the study is to understand primary care teams' experiences with collaboration related to mental health care during the COVID-19 pandemic. Aims Objectives Theory or Methods: A descriptive qualitative research design was employed. Family Health Teams (FHTs) are an interprofessional primary care model in Ontario. Using purposeful sampling, we sent invitational letters to executive directors of FHTs across all five Ontario Health regions. Focus groups were conducted with interprofessional healthcare providers providing mental health services in FHTs. Virtual focus groups, led by trained facilitators examined the delivery of collaborative mental health services and its impact on patients during the COVID-19 pandemic. The focus groups were audiorecorded and transcribed verbatim. Thematic analysis was used for data analysis and occurred in parallel with data collection. Highlights or Results or Key Findings: Eleven focus groups with 10 FHTs were conducted, with a total of 48 participants. Focus groups were conducted with two FHTs in each of the five Ontario Health regions. Three themes were identified in the data: i) pre-pandemic team functioning, ii) new communication processes, iii) collaboration. Teams were able to maximize collaboration from this rapid transition with the advantage of well-established team-based models prior to the pandemic. Teams created new processes for collaboration to adapt to the virtual changes via new channels of communication such as texting, video meetings and phone calls. Collaboration expanded beyond the FHT and into the communities as teams virtually collaborated with community partners. Nevertheless, some participants found virtual collaboration to be isolating due to the lack of in person communications and unscheduled hallway conversations that could only emerge in a co-located in-person setting. Conclusions: While teams found new ways of communicating, the overall experience of shifting to a virtual team was isolation with less overall collaboration. Virtual team-based communication will likely be a mode of collaboration moving forward, and its advantages and disadvantages will need to be considered. Implications for applicability/transferability sustainability and limitations: As virtual care becomes an integral way of delivering primary care, it will be crucial to understand and learn its impact on collaboration within teams. This will influence how health care providers support each other and in communities as many regions work to strengthen collaborations within Ontario Health Teams. [ABSTRACT FROM AUTHOR]