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Building Provincial Mental Health Capacity in Primary Care: An Evaluation of a Project ECHO Mental Health Program

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Abstract

Objective

Project Extension for Community Healthcare Outcomes (Project ECHO©) addresses urban-rural disparities in access to specialist care by building primary care provider (PCP) capacity through tele-education. Evidence supporting the use of this model for mental health care is limited. Therefore, this study evaluated a mental health and addictions-focused ECHO program. Primary outcome measures were PCP knowledge and perceived self-efficacy. Secondary objectives included: satisfaction, engagement, and sense of professional isolation. PCP knowledge and self-efficacy were hypothesized to improve with participation.

Methods

Using Moore’s evaluation framework, we evaluated the ECHO program on participant engagement, satisfaction, learning, and competence. A pre-post design and weekly questionnaires measured primary and secondary outcomes, respectively.

Results

Knowledge test performance and self-efficacy ratings improved post-ECHO (knowledge change was significant, p < 0.001, d = 1.13; self-efficacy approached significance; p = 0.056, d = 0.57). Attrition rate was low (7.7%) and satisfaction ratings were high across all domains, with spokes reporting reduced feelings of isolation.

Discussion

This is the first study to report objective mental health outcomes related to Project ECHO. The results indicate high-participant retention is achievable, and provide preliminary evidence for increased knowledge and self-efficacy. These findings suggest this intervention may improve mental health management in primary care.

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Acknowledgements

We would like to thank the Spoke sites for the participation in this program evaluation. ECHO Ontario Mental Health at the Centre for Addiction and Mental Health and the University of Toronto Program was funded by the Ontario Ministry of Health and Long-Term Care.

Author information

Authors and Affiliations

  1. University of Toronto, Toronto, Ontario, Canada

    Sanjeev Sockalingam & Eva Serhal

  2. University Health Network, Toronto, Ontario, Canada

    Sanjeev Sockalingam & Allison Crawford

  3. Centre for Mental Health and Addictions (CAMH), Toronto, Ontario, Canada

    Amanda Arena, Eva Serhal, Linda Mohri, Javed Alloo & Allison Crawford

Authors
  1. Sanjeev Sockalingam
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  2. Amanda Arena
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  3. Eva Serhal
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  4. Linda Mohri
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  5. Javed Alloo
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  6. Allison Crawford
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Corresponding author

Correspondence to Sanjeev Sockalingam.

Ethics declarations

This study was reviewed by the Centre for Addiction and Mental Health (CAMH) Research Ethics Board and all evaluation measures were in accordance with the CAMH criteria for program evaluation and as such a full Research Ethics Board approval was waived.

Disclosures

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Funding Sources

This program was funded by the Ontario Ministry of Health and Long-Term Care.

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Sockalingam, S., Arena, A., Serhal, E. et al. Building Provincial Mental Health Capacity in Primary Care: An Evaluation of a Project ECHO Mental Health Program. Acad Psychiatry 42, 451–457 (2018). https://doi.org/10.1007/s40596-017-0735-z

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  • DOI: https://doi.org/10.1007/s40596-017-0735-z

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