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Open Access Program Structure and Continuity of Mental Health Care Structure des programmes et continuité des soins de santé mentale

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Continuity has been a much discussed but under-researched objective of mental health care, in part due to measurement challenges. A small body of research has identified program features associated with continuity, based on measures of service use. A recent planning project provided an opportunity to examine the effects of these features on continuity using a new self-report continuity measure. Nine program features were measured and linear regression analyses were used to assess the relationship between these features and continuity, controlling for client characteristics. Client continuity was higher in programs that offered some night or weekend coverage and lower in programs that provided more care in the community. This latter finding was unexpected and may represent program efforts to engage individuals experiencing difficulties with service access. The association between each of the other 7 program features and continuity was not significant. Possible explanations for this finding are explored.

French
La continuité en tant qu'objectif est un sujet fort débattu dans le domaine des soins de santé mentale mais encore peu étudié, en partie à cause des difficultés que sa mesure pose. Un petit nombre de projets de recherche ont permis d'établir, en évaluant le degré d'utilisation des services, les caractéristiques des programmes que l'on peut associer à la continuité. Récemment, un projet de planification a fourni l'occasion d'étudier, à l'aide d'un nouvel instrument d'auto-évaluation, l'effet de ces facteurs sur la continuité. On a mesuré neuf caractéristiques et fait appel à la régression linéaire pour analyser leur incidence sur la continuité, tout en tenant compte également des caractéristiques des clients. On a constaté que les programmes fournissant certains services le soir ou la fin de semaine affichaient un degré de continuité élevé et que ceux où l'on fournissait davantage de soins dans le milieu affichaient un degré moindre. Cette dernière observation était inattendue et reflète peut-être les efforts que l'on consacre pour tenter de joindre des personnes ayant de la difficulté à accéder aux services. Le lien entre les sept autres caractéristiques et la continuité n'était pas significatif. Les chercheurs explorent les raisons susceptibles d'expliquer cette conclusion.

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Keywords: CONTINUITY OF CARE; MENTAL HEALTH; PROGRAM STRUCTURE

Document Type: Research Article

Publication date: 2004-06-01

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