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Adult - Anxiety

(PS2-10) Care Beyond the Clinic: A Qualitative Investigation of Facilitators to Anxiety Care for Racialized Individuals

Friday, November 15, 2024
10:00 AM – 11:00 AM EST
Location: Franklin Hall, Level 4, Marriott Downtown
Abstract Text:

Background: Anxiety and related disorders are highly prevalent, yet many individuals report difficulties with accessing effective anxiety care, such as cognitive-behavioural therapy (CBT) (e.g., Statistics Canada, 2023). Racialized communities (i.e., people of colour) experience significant barriers to anxiety care (e.g., assessment and intervention), despite reporting comparable or elevated symptoms of clinical anxiety (e.g., Chiu et al., 2018). Research on access to care for racialized individuals with clinical anxiety is lacking (e.g., Alarachi et al., in preparation), which further widens mental health disparities. Additionally, existing studies investigate access to care inadequacies, rather than emphasizing strategies that are successful in the field.

Objectives: To address this gap, the current study employed a strengths-focused approach to investigate facilitators to anxiety care from the perspectives of racialized clients and generate innovative recommendations directly from CBT consumers to improve the delivery of equitable, effective, and safe treatment.

Methods: Nineteen adults (N=19; female=4, male=5) aged 20 to 65 (M= 38.70, SD= 13.38) with clinical anxiety were recruited from a publicly funded adult anxiety outpatient clinic. Participants self-reported a variety of racialized identities (South-Asian=5, East-Asian=3, Black=4, Biracial=3, Hispanic=3, and Middle Eastern=1). All participants completed a phenomenological semi-structured interview to query their lived experiences with accessing care for clinical anxiety. Participants were also asked to describe facilitators for seeking care within their identified ethnic communities and recommendations for improving access. Initial codes were derived using NVivo, followed by reflexive thematic analysis to identify the main themes.

Results: Qualitative coding produced 336 codes, with 118 codes related to facilitators and recommendations. Six main themes related to facilitators emerged from the data: 1) This Works: Effective System and Treatment practices; 2) I Know Where to Go and How to Get There; 3) Clinician Factors; 4) Social Support Matters; 5) Influences from the Community; and 6) Individual Characteristics. Five main themes related to recommendations for improved access to care emerged: 1) Intentional Outreach; 2) Increased Advocacy & Accountability; 3) System Fixes; 4) In-House Changes: Improving Clinical Care; and 5) Care Beyond the Clinic.

Discussion: The results of this study corroborate existing research suggesting that mental health literacy, education, and positive clinician factors (e.g., cultural safety, providing clients autonomy) protect against barriers to care for racialized individuals. Clinical implications include continued advocacy and accountability from the mental health system in providing anti-racist care. Moreover, recommendation themes indicate that reducing barriers to care requires innovative efforts beyond the clinic and into community settings where racialized clients may feel safer. These results highlight the importance of incorporating racialized stakeholders in driving changes in CBT practices and research.