Better care through an optimized mental health services continuum (Eastern Townships, Québec, Canada): A systematic and multisource literature review

Int J Health Plann Manage. 2019 Jan;34(1):e111-e130. doi: 10.1002/hpm.2687. Epub 2018 Oct 31.

Abstract

Introduction: In 2014, the health authorities of the Eastern Townships (Québec, Canada) commissioned an evaluation of the mental health admission system for adults (GASMA) to identify the best GASMA organizational or structural elements and optimize the mental health services continuum.

Methods: To develop better services, seven indicators (ie, accessibility to services, integration of levels of services, user satisfaction, guidance and management time, evaluation tools, professional composition, and interprofessional collaboration) were examined through four evaluation questions. A three-step systematic and multisource evaluation was realized. A systematic review of the scientific and gray literature was performed. This evaluation also included key informant opinions to contextualize results from this review.

Results: Results from 91 scientific articles, 40 gray literature documents, and 10 interviews highlighted determinants and barriers associated with the examined indicators. From these results, 24 preliminary recommendations were formulated and discussed in a steering committee. These recommendations were then weighted and validated. This served to formulate three final recommendations.

Conclusion: To optimize the regional mental health services continuum, stakeholders should (1) implement a single-window access for adults with mental health needs, (2) develop alternative services based on users' needs, and (3) test the effectiveness of new methods, initiatives, and tools.

Keywords: health services research; mental health services; quality of health care; review.

Publication types

  • Systematic Review

MeSH terms

  • Continuity of Patient Care* / organization & administration
  • Humans
  • Mental Disorders / therapy
  • Mental Health Services* / organization & administration
  • Quality Improvement / organization & administration
  • Quebec