The Canadian Journal of Community Mental Health has released a special supplement issue focused on the Systems Enhancement Evaluation Initiative (SEEI). SEEI evaluated the impact of a $167 million investment made by Ontario’s Ministry of Health and Long-Term Care (MOHLTC) towards community mental health services in the province. Mental Health Notes continues to explore the articles from the special issue, today looking at studies involving continuity of care in court support programs and early intervention programs for psychosis.
The first article investigates how continuity of care was affected by the MOHLTC’s new investments in the community mental health system and the factors that contribute to these changes in court support programs and early intervention programs for psychosis. The SEEI study reported in the article looks at three major characteristics of continuity of care — orderliness, temporality and cross-sectorality — in seven regions across the province. The results show a growth in enrolment and access to court support programs and early intervention programs. However, there were significant decreases over time related to the appropriateness, timeliness, comprehensiveness, and coordination of services for court support programs. Similar decreases, however, are not seen for early intervention program clients, for whom gaps in services, and medical and case management needs were relatively well met. Yet the authors found a consistent mismatch between the need for and use of employment, education, and recreation support services.
In a related qualitative study, the authors examine continuity of care for 45 clients and 22 family members of early intervention or court support programs. Overall, researchers found clients’ and families’ perspectives on continuity of care to be remarkably similar. Important considerations for both clients and families included service timeliness, coordination, comprehensiveness, accessibility and intensity. In describing why they were satisfied or dissatisfied with a program, clients’ perceptions about the degree of fit with a particular worker figured prominently. Family involvement also seemed to play a key role in facilitating coordination. In regard to coordination, however, findings were mixed, with some participants perceiving it to be present, while others did not. The study also showed that service comprehensiveness included more than just mental health services, it also included the social determinants of health, such as housing, income, employment/education and social support. Finally, clients were generally appreciative of mechanisms that made program staff easily accessible, although access in rural areas was still reported to be a problem due to transport challenges.
The next issue of Mental Health Notes will profile a set of articles in the SEEI special issue that examine ACT fidelity in Ontario and service access and match in South eastern Ontario following the funding enhancement.
See “Examining the Effects of Enhanced Funding for Specialized Community Mental Health Programs on Continuity of Care,” Canadian Journal of Community Mental Health (2010; 29 [Supplement 5]: 23-40), available at www.metapress.com, and “Continuity of Care in Early Intervention Programs and Court Support Programs: Giving Voice to Service Recipients and Their Families,” Canadian Journal of Community Mental Health (2010; 29 [Supplement 5]: 41-51), available atwww.metapress.com. Full contents of the SEEI Special Supplement Issue of the Canadian Journal of Community Mental Health are available at www.metapress.com.
For more information about SEEI please contact Heather Bullock atheather_bullock@camh.net.