Abstract
Background
Older adults with mental health (MH) challenges often face significant barriers when navigating complex healthcare systems, especially during critical transitions, such as hospital discharge. These challenges are compounded by comorbid physical illnesses, cognitive impairments, and social determinants of health.
Objectives
This qualitative study aimed to gain insights from patients and providers on factors influencing the implementation of an innovative occupational therapy (OT) led Patient Navigation Program (PNP) supporting older adults with complex MH care needs.
Methods
We conducted a qualitative study that was informed by the Consolidated Framework for Implementation Research. Data were collected through semi-structured interviews and focus groups.
Results
Seven patients and caregivers, and 17 healthcare professionals who served as the MH PNP or collaborated with the MH PNP participated in the study. MH Navigators offered valuable, specialized skills to address gaps in MH and functional outcomes among older adults and were highly effective at bridging hospital and community care. However, the success of such a role depends on alignment across organizations, sufficient professional support, clear role expectations, and integrated team structures. Significant barriers for implementation included organizational cultural differences, system constraints, and the high complexity of patient needs.
Conclusion
The OT-led MH PNP holds significant promise for optimizing care delivery for older adults with MH care needs by bridging gaps in the healthcare system and fostering better continuity of care. Insights from this study can refine navigation processes, enhance interprofessional collaboration, improve patient experiences, and provide valuable guidance for implementing MH navigation programs at other sites.