How can we improve mental health inequities and access to care for vulnerable communities?
Farah Ahmad’s experience on the ground as a physician in Pakistan sparked her desire to study population health and the barriers to equitable access to healthcare, especially for socially stigmatized issues. Her focus on the areas of breast cancer screening, partner violence, and mental health in vulnerable communities allows her to collaborate with organizations across the city, and internationally, providing healthcare services to immigrants and refugees. Using an innovative eHealth approach, Ahmad is finding ways that technology can serve to break down barriers and get care to those who need it most.
I started my career in family medicine in Pakistan. I was working in an urban setting, mainly in the area of women’s health. I witnessed huge health disparities for people coming from low socioeconomic groups. That was the springboard for me to move from the clinical side to population health. I became very interested in finding solutions to address the large barriers to accessing healthcare in a timely and equitable manner.
When I migrated to Canada, I realized that there are many communities here that are experiencing barriers to health and wellbeing, so I started to work with immigrants, newcomers, and refugees.
I think engaging hard-to-reach populations and vulnerable communities requires a good understanding of sociocultural sensitivity. For that purpose, a few years ago I developed an intervention to address breast cancer screening among South Asian women. I developed a series of simple-language articles for local ethnic newspapers, applying also what theory tells us are barriers to the uptake of breast cancer screening. Many people contacted me afterward to use this model, and it has been acknowledged as a good practice to increase engagement for screening purposes.
Another example would be my work around partner violence. I use interactive eHealth tools to help improve discussions about and detection of partner violence in family practice. This research has been included in several large-scale systematic reviews, which are now informing policy directions around assessments for partner violence.
Complex problems need advanced solutions and an intersectional approach. That’s why working with different partners and different students, in different systems, enhances your chance of impact. I love doing research that policymakers can turn into action.
I believe my biggest contribution is my current work with interdisciplinary teams at Access Alliance Multicultural and Community Services to reduce barriers to accessing timely health care for common mental illnesses. Patients were given an iPad survey while they waited for their appointment, and we used it to assess common symptoms for depression, anxiety, Post-Traumatic Stress Disorder, and alcohol dependency, along with social determinants of health like housing, income level, language skills, and levels of social support. All of this cohesive knowledge is important for a primary care provider, but it can be hard to gather in a regular face-to-face interaction. Appointments are often rushed. When patients are asked socially sensitive questions, they may also worry that they will be judged by their practitioner. With this iPad tool, patients were able to complete those surveys on their own time through self-reflection, and they reported those symptoms after making very informed decisions.
Next for my research is comparing the different models of primary care in Ontario to find the best practices to address mental health issues. I’m also interested in examining the capacity of interactive technologies to support the identification of mental health issues. People can often identify physical problems themselves, but mental health is not very visible. Like screening for breast cancer, we need to find ways to identify early signs of a problem when there may not be any outward symptoms.