Current Barriers to Accessing Mental Healthcare Resources for Inflammatory Arthritis Patients and How to Improve Support
Bibliographic record
Abstract
Objectives To understand perspectives of inflammatory arthritis (IA) patients and healthcare providers on barriers to accessing mental healthcare resources and identify facilitators to better support patients at rheumatology clinic visits. Methods Semi-structured interviews and focus groups were conducted with patients, allied healthcare professionals, and rheumatologists until saturation of responses was reached. Patients with IA reporting varied levels of anxiety and depression were recruited from the Rheum4U Precision Health Registry using purposive sampling. Healthcare providers were from 2 rheumatology clinics in Calgary. Surveys with closed-ended questions were completed by patients on their use of mental healthcare resources and healthcare providers on supporting their patients with accessing resources. The sessions explored barriers to accessing mental healthcare resources and facilitators that could support patients. Inductive thematic analysis was used to code perceived barriers and facilitators to accessing mental healthcare resources. Results Six patients, 2 allied health professionals, 5 nurses, and 3 rheumatologists participated in semi-structured interviews and focus groups. Four patients reported having anxiety/depression and 3 said they would like to discuss their mental health at rheumatology clinic visits. Key findings included: Patient challenges: patients have trouble initiating conversations about their mental health. While a social worker can assist in navigating resources, some patients are unaware of this resource. Healthcare provider constraints and attitudes: healthcare providers indicated they lack the time and support staff to discuss mental health with their patients. While some healthcare providers expressed concern about not screening for their patients’ mental health, other providers believed addressing mental health concerns is out of scope. Systemic issues: healthcare providers discussed long wait times for mental health specialists and both patients and healthcare providers had difficulties navigating available resources. Supports needed: healthcare providers expressed a need for a ‘toolkit’ to better support their patients’ mental health and additional training on this topic. A Venn diagram illustrating barriers and facilitators perceived by patients, allied health professionals and rheumatologists is shown in Figure 1. Conclusion Patients and providers expressed lack of clarity about the availability of mental health resources. There is variability in provider attitudes toward addressing mental health concerns during rheumatology appointments. Both patients and providers identified systemic issues in accessing mental healthcare resources. Quick screening, support from allied health professionals at the clinic, and a quick reference guide that incorporates existing workflow could potentially help improve access to mental healthcare resources for patients with IA.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.018 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.005 | 0.002 |
| Scholarly communication | 0.005 | 0.003 |
| Open science | 0.002 | 0.004 |
| Research integrity | 0.002 | 0.004 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".