Mental Health of Young People with Physical Disabilities
We conducted a series of projects at the intersection of mental health and physical disabilities. Two scoping reviews set the stage for a deeper dive into current practices in physical rehabilitation centers in Montreal. The projects are summarized below.
1. Mental health problems among adolescents and young adults with childhood-onset physical disabilities: A scoping review
Project Summary
The first scoping review led by Dr. Shalini Lal synthesized knowledge on the co-occurrence, impact, and type of mental health problems experienced by young people with childhood-onset physical disabilities, and their access to mental health services. It is the first phase of a larger research project aiming to improve the mental health outcomes of young people affected by childhood-onset physical disabilities.
Click here to view the first scoping review: https://pubmed.ncbi.nlm.nih.gov/36189015/
The second scoping review and the following 3 studies made up the thesis of YMHTech and ASPIRE lab student Stephanie Tremblay, supervised by Drs. Dana Anaby and Shalini Lal using a multimethod research design, with qualitative research methods to provide a comprehensive perspective on the topic.
2. Organization of rehabilitation services for youth with physical disabilities and mental health problems: A scoping review
Project Summary
Building on the scoping review mentioned above, we sought to map out how rehabilitation services were organized and delivered with regard to access to mental health services for youth with physical disabilities who also had emerging mental health concerns. Sixteen articles were retained, with two models found: the Biopsychosocial, Collaborative, Agency-Based Service Integration Approach (including psychiatry in a pediatric rehabilitation hospital) and the Client Network Consultation (an interagency collaboration in mental health care for children with complex healthcare needs). Twelve key principles to guide service organization and delivery were identified and categorized into collaboration and coordination, training and support, and delivery of care.
Click here to view the second scoping review: https://pubmed.ncbi.nlm.nih.gov/36891032/
3. Mental health practices in rehabilitation for youth with physical disabilities: A chart review study
Project Summary
This study examined current interprofessional rehabilitation practices for physical and mental health services. Youth (aged 15–24) who had a physical disability and mental health problems were identified, and 60 chart reviews were used to identify practices. Mental health-related diagnoses/symptoms, assessments, goals, interventions, and referrals were extracted. Many of the charts listed more than one mental health problem, suggesting the complexity of their condition. While some mental health goals/interventions were documented, problems were often not reported or addressed in this context. Further attention can be directed to the needs of youth with physical disabilities and co-occurring mental health problems as they are not fully addressed by current interdisciplinary rehabilitation practices.
Click here to view the chart review study: https://pubmed.ncbi.nlm.nih.gov/38666597/
4. Services Addressing Mental Health Needs of Youth in Physical Rehabilitation: Perspectives of Clinicians, Youth, and Family Members
Project Summary
We interviewed 22 youth, family members, and rehabilitation professionals to better understand their experience receiving or delivering services addressing mental health. This study provides insights into barriers to mental health care, highlighting important aspects to consider. Clinicians can be better equipped to address mental health in rehabilitation settings via training opportunities and peer and organizational support, in addition to establishing links with external partners. Organizations can also create pathways to deliver well-coordinated mental health services in a more accessible way.
Click here to view the interview study: https://pubmed.ncbi.nlm.nih.gov/39629880/
5. Manager perspectives on services addressing mental health needs of youth in physical rehabilitation
Project Summary
This focus group explored managers’ perspectives on challenges, strengths, and opportunities for mental health service delivery and integration in physical rehabilitation at the organizational level. Two semi-structured focus groups were conducted with nine managers across five organizations offering rehabilitation services in a large Canadian city. 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.
Click here to view the focus group with managers study: https://onlinelibrary.wiley.com/doi/10.1111/cch.70102
6. Thesis
Project Summary
This manuscript-based dissertation, encompassing the above-mentioned studies sought to better understand current practices and services targeting mental health for youth aged 15-24 receiving rehabilitation services. Specifically, it aimed to 1) synthesize existing evidence about models of service delivery for youth with physical disabilities experiencing mental health problems, 2) describe rehabilitation practices and procedures addressing mental health, 3) better understand the needs, supports, challenges and potential solutions to optimize rehabilitation services from the perspectives of youth with physical and mental health problems, family members, and clinicians, and 4) gain insights on organizational contexts from managers’ perspectives.
Click here to view the full thesis dissertation by Stephanie Marie Tremblay: https://escholarship.mcgill.ca/concern/theses/p26772443
Funders
These projects are partially supported through operational funds from the Canada Research Chairs Program awarded to Shalini Lal, PhD. As a PhD student, Stephanie M. Tremblay received the Fonds de la recherche en santé du Québec (FRQS) doctoral bursary as well as a CHILD-BRIGHT Graduate Student Fellowship in Patient-Oriented Research. She also received multiple awards during her training, including the Thelma Cardwell Scholarship from the Canadian Occupational Therapy Foundation, the Judith Kornbluth Gelfand Fellowship in Pediatric Rehabilitation, the Beverlea Tallant Occupational Therapy Mental Health Research Award, and the Graduate Excellence Fellowship from McGill University. There was no specific grant funding for these projects.
If you would like to further support the advancement of research pertaining to youth with physical disabilities experiencing mental health problems, contact us at: ymhtechlab@gmail.com.
Partners and Collaborators
These projects are conducted in collaboration with Dr. Dana Anaby from McGill University and Dr. Mark A. Ferro from the University of Waterloo.
Contact person
Shalini Lal, Ph.D., M.Sc., B.Sc.O.T. (Reg. QC)
Email: ymhtechlab@gmail.com
