Tremblay Stephanie M, Lal Shalini, Ferro Mark A, Anaby Dana
School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.
Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Quebec, Canada.
Child Care Health Dev. 2025 Jul;51(4):e70102. doi: 10.1111/cch.70102.
Youth mental health is becoming a priority, but models for organizing services in physical rehabilitation centres to meet the growing needs of youth with chronic physical disabilities and mental health problems are scarce. Initial research revealed barriers faced by youth, families and rehabilitation specialists when accessing or providing mental health services for this population. This study explores managers' perspectives on challenges, strengths and opportunities for mental health service delivery and integration in physical rehabilitation at the organizational level.
Two semistructured focus groups were conducted with nine managers across five organizations offering rehabilitation services in a large Canadian city. Data were analysed using inductive and deductive thematic analysis.
Barriers and facilitators expressed by managers fell into three categories: (1) available clinical resources for mental health (access to mental health specialists within internal team and internal organizational structures and mandates), (2) clinician workforce capacity (internal mental health knowledge and professional development for staff in physical rehabilitation and external mental health professionals' knowledge in physical disability) and (3) links and partnerships with key players (working in silos, external organizational structures and procedures and actions to improve pathways to access mental health services across external programs and organizations).
Managers' insights can guide the development of policies and advocacy for change at the organizational level to support mental health service delivery within physical rehabilitation. This can be done by building capacity on mental health knowledge and skills of rehabilitation teams and establishing collaborative partnerships and well-coordinated procedures within and outside of their organizations.
青少年心理健康正成为一项优先事项,但在物理康复中心组织服务以满足患有慢性身体残疾和心理健康问题的青少年日益增长的需求的模式却很匮乏。初步研究揭示了青少年、家庭和康复专家在为这一人群获取或提供心理健康服务时所面临的障碍。本研究探讨了管理人员在组织层面上对心理健康服务提供与整合在物理康复中的挑战、优势和机遇的看法。
对加拿大一个大城市中提供康复服务的五个组织的九名管理人员进行了两次半结构化焦点小组访谈。使用归纳和演绎主题分析法对数据进行了分析。
管理人员表达的障碍和促进因素分为三类:(1)心理健康的可用临床资源(内部团队以及内部组织结构和任务规定内获取心理健康专家的机会),(2)临床医生劳动力能力(物理康复工作人员的内部心理健康知识和专业发展以及外部心理健康专业人员对身体残疾的了解),以及(3)与关键参与者的联系和伙伴关系(各自为政、外部组织结构和程序以及改善跨外部项目和组织获取心理健康服务途径的行动)。
管理人员的见解可以指导组织层面政策的制定和倡导变革,以支持物理康复中的心理健康服务提供。这可以通过培养康复团队的心理健康知识和技能,以及在其组织内部和外部建立合作伙伴关系和协调良好的程序来实现。