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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.

Introduction: Project Extension for Community Healthcare Outcomes (Project ECHO®) is a global-guided practice initiative aimed at building primary care capacity and improving health care quality for underserved populations. This tele-education model brings together primary care providers and subject-matter specialists in online communities of practice to share knowledge, discuss complexities in patient care, and collaborate to reduce health disparities. Methods: Using co-generated clinical care recommendations from ECHO Ontario Mental Health, a mental health focused ECHO program, we explored alignment of recommendations across the Institute of Medicine's (IOM) six domains of health care quality to characterize its impact. A total of 417 recommendations, made for 32 patient cases, were analyzed using a modified directed content analysis method. Each recommendation was coded with one or multiple codes, representing each of the six IOM domains. Key examples of recommendations within each domain are described. Results: An average of 13 recommendations were generated per patient case. The effective domain occurred at least once in each complete set of patient care recommendations. The next highest occurring domain was safe (71.9%), followed by patient-centered (68.8%), efficient (40.6%), equitable (18.8%), and timely (12.5%). Recommendation distribution across the entire data set was effective (97.8%), safe (15.6%), patient-centered (12.0%), efficient (3.6%), equitable (1.9%), and timely (1.4%). Discussion: As the first study to characterize ECHO's impact using health care quality domains, the study highlights ECHO's significant focus on effective, safe, and patient-centered care. These findings can inform ways for ECHO to target quality improvement and measure impact in additional health care quality domains, such as efficient, equitable, and timely. [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]

Background: Telepsychiatry is an increasingly used model of mental health care that connects patients with psychiatrists at a distance via videoconference. Telepsychiatry is an effective clinical intervention that improves access to quality care in regions with limited resources or in clinical situations where in-person care is unavailable.Objective: This study aims to develop a validated survey tool to measure patient experience and satisfaction with telepsychiatry based on the quality of care domains. This study also seeks to understand which health service outcomes were most strongly correlated with overall satisfaction in the context of telepsychiatry.Methods: The survey created in this study was developed and validated with a panel of subject matter and process experts and was piloted with 274 patients who received clinical consultations through the TeleMental Health Program at the Centre for Addiction and Mental Health. Factor analysis was used to determine correlations between questions and quality of care domains and was also used to assess model fit.Results: The study provides a validated survey to measure patient satisfaction and experience with telepsychiatry across 4 domains: access and timeliness, appropriateness, effectiveness, and safety. Both safety and access and timeliness were found to be statistically significant predictors of satisfaction in our sample.Conclusions: By situating patient satisfaction and experience within this framework, the survey facilitates patient data collection and interpretation through a clinical quality lens. [ABSTRACT FROM AUTHOR]