Jessica Spagnolo

• MSW; PhD
• Professor at Université TÉLUQ

Background Social anxiety disorder (SAD) is one of the most prevalent anxiety disorders in Canada. Viable therapy options for the treatment of SAD include CBT being delivered virtually. In Australia, an innovative internet-delivered cognitive-behavioral therapy (iCBT) program for social anxiety has been developed, implemented, and demonstrated as e...

Objectives Few are the longitudinal studies on the changes in moderate or severe symptoms of anxiety or depression (MSS-ANXDEP) from before to during the COVID-19 pandemic in Canada. The aim was to study the change in MSS-ANXDEP and associated sociodemographic, economic, psychosocial, health behaviour and lifestyle, and clinical factors. Methods T...

Background Scarce are the studies focusing on initiation of new mental health service use (MHSU) and distinguishing individuals who have sought services but have been unsuccessful in accessing these. Aims Assessing the factors associated with initiating new MHSU as compared to no MHSU due to self-reported no need, no MHSU due to health system and...

Objectives Using Andersen’s model of health care seeking behavior, we examined the predisposing, enabling, and need factors associated with mental health service use (MHSU) during the first wave of the COVID-19 pandemic across Canada. Methods The sample included n = 45,542 participants in the 5 established regional cohorts of the Canadian Partners...

Digital therapeutics, consisting of digitally enabled interventions for mental health or substance use disorders, hold promise for expanding the access to evidence-based treatments for mental disorders globally. The success of digital therapeutics will require careful adaptations of the digital platforms and intervention content in order to meet th...

Objectives: The WHO's Mental Health Gap Action Programme Intervention Guide (mhGAP-IG) has been widely used in low and middle-income countries. We reviewed literature describing interventions and training programmes beyond the mhGAP-IG, in primary healthcare (PHC) and community-based healthcare (CBH). Design: We searched studies excluded from ou...

Background There was an increase in self-reported mental health needs during the COVID-19 pandemic in Canada, with research showing reduced access to mental health services in comparison to pre-pandemic levels. This paper explores 1) barriers and facilitating factors associated with mental health service delivery via primary care settings during th...

Background In 2016, Quebec, a Canadian province, implemented a program to improve access to specialized health services ( Accès priorisé aux services spécialisés (APSS)), which includes single regional access points for processing requests to such services via primary care ( Centre de répartition des demandes de services (CRDS)). Family physicians...

The Mental Health Gap Action Programme (mhGAP) Intervention Guide was developed to support evidence-based training offered to nonspecialists to further encourage the integration of mental health into primary care and community-based settings. This training programme was implemented in many countries of the Eastern Mediterranean Region (EMR). Tunisi...

Question: There is a large worldwide gap between the service need and provision for mental, neurological and substance use disorders. WHO's Mental Health Gap Action Programme (mhGAP) intervention guide (IG), provides evidence-based guidance and tools for assessment and integrated management of priority disorders. Our 2017 systematic review identif...

Background: The World Health Organization (WHO)'s Mental Health Gap Action Programme (mhGAP)-Intervention Guide (IG) aims to integrate mental health into primary care/community-based settings by equipping non-specialists with tools, training, and support to deliver evidence-based interventions. With the growing popularity of the mhGAP-IG, a system...

Canada's provinces are without a publicly funded psychotherapy program for common mental disorders despite evidence that psychological services help reduce the length and number of depressive episodes, symptoms of post-traumatic stress and associated negative outcomes (hospitalizations and suicide attempts). Studies also show that including psychol...

Background: Tunisia is a lower-middle-income country located in North Africa with strengths and challenges to its mental health system. Aims: We present an overview of available services, facilities, and human resources to offer mental health care in Tunisia. Methods: We conducted a cross-sectional study, where data for the year 2017 was collected...

This commentary aims to provide a glimpse into some of the early and continuing impacts of the COVID-19 pandemic on our global and public health projects: research in low-resourced settings; research with vulnerable populations, such as asylum seekers, Indigenous communities, children, and mental health service users; and research with healthcare p...

Background: Training based on the Mental Health Gap Action Programme (mhGAP) is being increasingly adopted by countries to enhance non-specialists’ mental health capacities. However, the influence of these enhanced capacities on referral rates to specialised mental health services remains unknown. Aims: We rely on findings from a longitudinal pilo...

Objectives We describe the knowledge translation strategies in two projects and share lessons learned about knowledge sharing and uptake.Methods To generate findings for dissemination: (1) the Republic of Côte d’Ivoire (RCI) project relied on a multiple case study design to document barriers and facilitators to implementing a community-led preventi...

In this article, Canadian psychotherapy researchers and teachers review the state of psychodynamic therapy (PDT) in Canada. We review the ways in which PDT has been implemented, developed and researched within the public and private sector, and how psychoanalytic and psychodynamic practitioners regionally have responded to the challenges of evidenc...

En France, les mineurs non accompagnés (MNA) rencontrent de multiples obstacles qui peuvent avoir des effets négatifs sur leur santé mentale. Les professionnels de la santé et du social qui participent à leur prise en charge doivent développer et mettre en œuvre des approches et outils adaptés aux réalités des mna et qui leur offrent un espace d’in...

To address the rise in mental health conditions in Tunisia, a training based on the Mental Health Gap Action Programme (mhGAP) Intervention Guide (IG) was offered to primary care physicians (PCPs) working in the Greater Tunis area. Non-specialists (such as PCPs)’ training is an internationally supported way to target untreated mental health symptom...

Purpose The purpose of this paper is twofold: first, assess the effects of the peers’ recovery narratives on service users’ perceived mental health recovery; and second, explore various stakeholders’ perspectives on the program, specifically its facilitators and barriers. Design/methodology/approach The study used a convergent mixed-method design....

Background: In low- and middle-income countries (LMICs), addressing the burden caused by mental health conditions, substance use disorders, and self-harm/suicide may be challenged by the limited number and/or unequal distribution of mental health personnel. Integrating mental health into primary care settings through the training of non-specialists...

Background: Tunisia is a lower-middle-income country located in North Africa. Since the 2010-2011 Revolution, a campaign of civil resistance to protest high levels of youth unemployment, difficult living conditions, and government corruption, a rise in mental health problems, substance use disorders, and suicide attempts/deaths has been recorded. T...

Background Primary care physicians (PCPs) working in mental health care in Tunisia often lack knowledge and skills needed to adequately address mental health-related issues. To address these lacunas, a training based on the Mental Health Gap Action Programme (mhGAP) Intervention Guide (IG) was offered to PCPs working in the Greater Tunis area betwe...

Tunisia is a North African lower-middle-income country. Since the 2010-2011 Revolution, a rise in mental health problems, substance use disorders, and suicide has been recorded. However, primary care physicians (PCPs), the most relied upon non-specialists who detect, treat, and manage mental health problems in primary care settings in the country,...

Background Non-specialists’ involvement in mental health care is encouraged in the field of global mental health to address the treatment gap caused by mental illness, especially in low- and middle-income countries. While primary care physicians (PCPs) are involved in mental health care in Tunisia, a lower-middle-income country in North Africa, it...

Background: In order to make mental health services more accessible, the Tunisian Ministry of Health, in collaboration with the School of Public Health at the University of Montreal, the World Health Organization office in Tunisia and the Montreal World Health Organization-Pan American Health Organization Collaborating Center for Research and Train...

A shortage of mental health specialists in Tunisia force general practitioners (GPs) to receive between 30-40% of mental health consultations despite difficulties in detecting, treating and managing mental illness. To address this challenge, the Tunisian Ministry of Health, in collaboration with the School of Public Health at the University of Mont...

Background: In low- and middle-income countries (LMICs), addressing the high prevalence of mental disorders is a challenge given the limited number and unequal distribution of specialists, as well as scarce resources allocated to mental health. The Mental Health Gap Action Programme (mhGAP) and its accompanying Intervention Guide (IG), developed b...

Blog post, available here: http://healthsystemsresearch.org/hsr2016/is-global-mental-health-under-represented-at-internationally-acclaimed-global-health-conferences/

This photo essay is available online: http://www.perspectivesmcgill.com/photo-essays/2016/8/12/mental-health-recovery-in-different-contexts-lessons-learned-from-the-field?rq=spagnolo

Governments of low- and middle-income countries (LMICs) are widely implementing performance-based financing (PBF) to improve healthcare services. However, it is unclear whether PBF provides good value for money compared to status quo or other interventions aimed at strengthening the healthcare system in LMICs. The objective of this systematic revie...

The article, published by the World Health Organization in the mhGAP Newsletter (May 2016), is available here: http://www.who.int/mental_health/mhgap/mhgap_tunisia/en/

What is Performance Based-Financing (PBF) ? It is a conditional payment made to healthcare providers after predefined performance results have been attained and verified. Financial incentives are expected to motivate providers to improve healthcare services. There is a rapid expansion of PBF in low-and middle-income countries (LMICs) to improve hea...

The deinstitutionalization movement in Canada began in the 1960s. It is defined as the process of discharging chronic mental health patients into the community in order for them to receive care from community mental health services. The deinstitutionalization movement is failing in Canada at this time for two main reasons: (1) the provinces' commun...