Care navigation addresses issues of tele-mental health acceptability and uptake in rural and remote Australian communities.

Autor: Fisher OJ; Health Services Research, Wesley Research Institute, Brisbane, Queensland, Australia.; Faculty of Health, Charles Darwin University, Darwin, Northern Territory, Australia., McGrath K; Health Services Research, Wesley Research Institute, Brisbane, Queensland, Australia.; Isaac Navicare Hub, Wesley Research Institute, Moranbah, Queensland, Australia., Grogan C; Health Services Research, Wesley Research Institute, Brisbane, Queensland, Australia., Cockshaw W; Health Services Research, Wesley Research Institute, Brisbane, Queensland, Australia.; Faculty of Health, Charles Darwin University, Darwin, Northern Territory, Australia., Leggatt-Cook C; Family and Disability Services, UnitingCare Queensland, Brisbane, Queensland, Australia.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2024 Apr 04; Vol. 19 (4), pp. e0298655. Date of Electronic Publication: 2024 Apr 04 (Print Publication: 2024).
DOI: 10.1371/journal.pone.0298655
Abstrakt: Introduction: People living in rural and remote areas face substantial barriers to accessing timely and appropriate mental health services. In the Bowen Basin region of Queensland, Australia, barriers include: limited local providers, long waiting lists, unreliable telecommunication, and reluctance to trial telehealth. Isaac Navicare is a new, community co-designed care navigation service which addresses these barriers by coupling care navigation with supported telehealth, and referrals to mental health providers and other supports. We aimed to understand the reach and effectiveness of Isaac Navicare in improving access to mental health services and address an evidence gap on strategies for improving telehealth acceptability.
Methods: This mixed-methods implementation science evaluation used the RE-AIM Framework. It involved a client database review, survey and semi-structured interviews with service users during the 12-month pilot from November 2021.
Results: 197 clients (128 adults, 69 minors) were referred to Navicare during the pilot. Half of adult clients were unemployed, meaning referral options were limited to low-cost or bulk-billed services. Participants described Navicare as supportive and effective in helping to access timely and appropriate mental health supports. Most clients who expressed a treatment modality preference selected face-to-face (n = 111, 85.4%), however most referrals were for telehealth (n = 103, 66.0%) due to a lack of suitable alternatives. The rapport and trust developed with the care navigator was critical for increasing willingness to trial telehealth. Barriers to telehealth included privacy issues, technical difficulties, unreliable internet/phone, and perceived difficulties developing therapeutic rapport. The supported telehealth site was under-utilised. The majority (88.3%, n = 182) of referrals to Navicare were from local health or community service providers or schools.
Discussion: Coupling supportive, individualised care navigation with tele-mental health provider options resulted in increased uptake and acceptance of telehealth. Many barriers could be addressed through better preparation of clients and improving promotion and uptake of the supported telehealth site.
Conclusion: Attitudes towards telehealth have changed during the COVID-19 pandemic, however although the need exists, barriers remain to uptake. Telehealth alone is not enough. Coupling telehealth with other supports such as care navigation improves acceptance and uptake.
Competing Interests: The authors OF, CG and KM acknowledge a potential conflict of interest due to their roles in the design (OF) or service delivery (KM and CG) of Isaac Navicare. To minimise any impact of this potential bias, CL-C was invited to be a member of the research team external to the project with no conflict of interest to declare. CL-C reviewed a selection of transcripts along with the quantitative data to ensure the authenticity of the results presented, and the accurate interpretation of these data. CL-C also contributed to the development of the manuscript. The funder, Mitsubishi Development Pty Ltd. has no ownership of intellectual property, patents, products in development, marketed products, or access to client data collected during the normal operation of Isaac Navicare. The funder also has no access to, or ownership of research data collected during this study. This commercial affiliation does not alter our adherence to PLOS ONE policies on sharing data and materials.
(Copyright: © 2024 Fisher et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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