Adu Medard K, da Luz Dias Raquel, Nkrumah Samuel Obeng, Agyapong Belinda, Ezeanozie Ngozi, Eboreime Ejemai, Obuobi-Donkor Gloria, Sridharan Sanjana, Morrison Jason, Taylor Bryanne, MacKinnon Monica, Awara Mahmoud, Wozney Lori, Agyapong Vincent I O
Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada.
Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2R3, Canada.
J Clin Med. 2025 Apr 1;14(7):2412. doi: 10.3390/jcm14072412.
To address the growing demand for mental health services, Nova Scotia Health introduced the Rapid Access Stabilization Program (RASP) through its Mental Health and Addictions Program (MHAP) in April 2023. RASP is designed to help reduce long wait times, frequent emergency department visits, and admissions to provide early intervention for individuals experiencing mental health problems. The RASP focuses on rapid access and early mental health intervention, aiming to prevent the worsening of patients' symptoms, improve access to psychiatric care, and reduce service pressures on programs like the Community Mental Health Program (CMHP), which provide more extended, ongoing mental health support. This study compared participants' sociodemographic and clinical profiles in the RASP and the CMHP. Data were collected from 1392 participants accessing mental health support either through the RASP or CMHP. A comparative analysis of sociodemographic factors (e.g., age, education, and income) and clinical characteristics (e.g., depression, anxiety, resilience, and substance use) was conducted. Chi-square tests and independent sample -tests were used to evaluate the mean differences between the groups. Significant sociodemographic and clinical differences emerged between the RASP and CMHP participants. The RASP group was older (M = 40.10 vs. 34.52 years) and more socioeconomically stable, with higher rates of employment (55.3% vs. 47.9%) and homeownership (36.5% vs. 17.7%). In contrast, the CMHP group had higher unemployment (25.7% vs. 16.5%) and lower income levels, with 47.5% earning <CAD 29,590 compared to 30.3% in the RASP group. Clinical profiles differed markedly: depression was more prevalent in the RASP (48.2% vs. 19.3%), whereas the CMHP had higher rates of psychosis (10.6% vs. 2.5%) and substance use disorder (7.8% vs. 1.9%). The RASP participants exhibited higher anxiety (GAD-7: M = 14.17 vs. 11.81) and depression symptoms (PHQ-9: M = 16.62 vs. 14.20) but lower resilience (BRS: M = 2.47 vs. 2.77). The CMHP participants had more adverse childhood experiences (ACE: M = 3.92 vs. 3.16) and lower suicidal intent (81.4% vs. 99.4% had no intention to act). The findings highlighted the unique profiles between the RASP and CMHP participants, suggesting the need for program-specific interventions. While the CMHP participants may benefit from integrated social support and trauma-informed care, the RASP participants may require cognitive behavioral therapy and resilience-building interventions. Tailoring mental health services to meet these unique needs could enhance program effectiveness and patient outcomes across both groups.
为满足对心理健康服务日益增长的需求，新斯科舍省卫生局于2023年4月通过其心理健康与成瘾项目（MHAP）推出了快速接入稳定项目（RASP）。RASP旨在帮助减少长时间等待、频繁前往急诊科以及住院情况，以便为有心理健康问题的个人提供早期干预。RASP专注于快速接入和早期心理健康干预，旨在防止患者症状恶化，改善精神科护理的可及性，并减轻社区心理健康项目（CMHP）等提供更长期、持续心理健康支持的项目所面临的服务压力。本研究比较了RASP和CMHP参与者的社会人口统计学和临床特征。数据收集自1392名通过RASP或CMHP获得心理健康支持的参与者。对社会人口统计学因素（如年龄、教育程度和收入）和临床特征（如抑郁、焦虑、心理韧性和物质使用情况）进行了比较分析。使用卡方检验和独立样本t检验来评估两组之间的均值差异。RASP和CMHP参与者之间出现了显著的社会人口统计学和临床差异。RASP组年龄更大（平均年龄M = 40.10岁，而CMHP组为34.52岁），社会经济状况更稳定，就业率更高（55.3%对47.9%），自有住房率更高（36.5%对17.7%）。相比之下，CMHP组失业率更高（25.7%对16.5%），收入水平更低，47.5%的人收入低于29,590加元，而RASP组这一比例为30.3%。临床特征明显不同：抑郁在RASP组中更为普遍（48.2%对19.3%），而CMHP组精神病（10.6%对2.5%）和物质使用障碍（7.8%对1.9%）的发生率更高。RASP参与者表现出更高的焦虑（广泛性焦虑量表GAD - 7：平均得分M = 14.17对11.81）和抑郁症状（患者健康问卷PHQ - 9：平均得分M = 16.62对14.20），但心理韧性较低（简短心理韧性量表BRS：平均得分M = 2.47对2.77）。CMHP参与者有更多不良童年经历（儿童期不良经历量表ACE：平均得分M = 3.92对3.16），自杀意图较低（81.4%对99.4%无自杀意图）。研究结果突出了RASP和CMHP参与者之间的独特特征，表明需要针对特定项目的干预措施。虽然CMHP参与者可能受益于综合社会支持和创伤知情护理，但RASP参与者可能需要认知行为疗法和心理韧性培养干预措施。根据这些独特需求调整心理健康服务可以提高两个项目的有效性和患者治疗效果。
