Abstract
BackgroundDue to regional, professional, and resource limitations, access to mental health care for Canada’s Indigenous peoples can be difficult. Telemental health (TMH) offers the opportunity to provide care across vast distances and has been proven to be as effective as face-to-face services. To our knowledge, there has been no qualitative study exploring the experiences of TMH staff serving the Indigenous peoples in Northern Quebec, Canada; which is the purpose of this study.MethodsUsing a qualitative descriptive design, the entire staff of a TMH clinic was recruited, comprising of four psychiatrists and four support staff. Individual semi-structured interviews were conducted through videoconferencing, and results were thematically analyzed.ResultsTo address the mental health gap in Northern communities, all psychiatrists believe in the necessity of in-person care and note the synergistic effect of combining in-person care and TMH services. This approach to care allows psychiatrists to maintain both an insider and outsider identity. However, if a patient’s condition requires hospitalization, then the TMH staff face a new set of information sharing and communication challenges with the inpatient staff. TMH staff believe that the provision of culturally sensitive care to Northern patients at the inpatient unit is progressing; however, more work needs to be done. Despite the strong collegial atmosphere within the clinic and collective efforts to provide quality TMH services, all participants express a sense of frustration with the paper-based and scattered documentation system.ConclusionThe TMH team works in cohesion to offer TMH services to Indigenous peoples; yet, automatization is needed to improve the workflow efficiency within the clinic and collaboration with the Northern clinics. More research is needed on the functioning of TMH teams and the separate but important roles of each team member.
Highlights
Due to regional, professional, and resource limitations, access to mental health care for Canada’s Indigenous peoples can be difficult
A total of four psychiatrists, two liaison nurses, one clinical secretary and one manager, representing the four psychiatrists and four support staff working at the Telemental health (TMH) clinic, are included in the study
In the TMH clinic, there was a historical upgrade of the videoconferencing software to individual desktops, but the organizational structure, management and leadership supporting the delivery of the services remain ongoing concerns
Summary
Professional, and resource limitations, access to mental health care for Canada’s Indigenous peoples can be difficult. There has been no qualitative study exploring the experiences of TMH staff serving the Indigenous peoples in Northern Quebec, Canada; which is the purpose of this study. As for the use of TMH in the Indigenous Canadian context, researchers have found that cultural rapport can be built, albeit with some difficulty [14, 15] To further strengthen this rapport, researchers [15, 16] recommend providers to visit the Indigenous communities, in order to foster an understanding of the local land and the historical, cultural and social context of their patients. No qualitative study has explored the experiences of both psychiatrists and support staff working in a TMH clinic within the Indigenous Northern Quebec context
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