Adu, Medard2025-08-262025-08-262025-08-23https://hdl.handle.net/10222/85396My doctoral research focuses on evaluating the Rapid Access and Stabilization Program (RASP), a new mental health service model in Nova Scotia designed to reduce wait times, enhance timely access to psychiatric care, and lessen reliance on emergency services. Using a multi-method, theory-driven program evaluation guided by the Donabedian Quality Framework, Andersen’s Behavioural Model, and Levesque’s Access Framework, the study examined changes in psychiatric access, wait times, patient profiles, satisfaction, and post-intake acute service use. Findings show that RASP substantially increased psychiatric access; the program had about a 1230% increase in access to psychiatric consultation in its first year compared to pre-implementation. RASP users reported very high satisfaction, with over 97% recommending the program. While decreases in acute service use compared to controls were not statistically significant after correction, the program demonstrated promising early success in delivering timely and patient-centered mental health care.Abstract Background: In response to traditionally long wait times for access to mental health support in Nova Scotia, the Rapid Access and Stabilization Program (RASP) was introduced by Nova Scotia Health and Dalhousie University’s Department of Psychiatry to increase access, lessen reliance on emergency services, and provide early intervention for people in need. Aims: This project evaluates the program by (1) assessing changes in psychiatric access and wait times pre-post RASP implementation; (2) comparing sociodemographic and clinical characteristics of RASP and Community Mental Health Program (CMHP) users; (3) examining post-intake acute service use between RASP and a control group, and (4) evaluating RASP user satisfaction factors associated with acute service use one year post RASP assessment. Methods: This multi-method, theory-driven program evaluation was guided by Donabedian’s Quality Framework, Andersen's Behavioural Model, and Levesque's Access Framework. Structured intake surveys, post-consultation satisfaction questionnaires, and administrative health records were among the data sources. Descriptive statistics, chi-square/Fisher's tests, t-tests, and ANCOVA were used in the quantitative analyses. Findings: RASP provided consultations to 960 distinct patients in its first year, representing a 1226% increase in the number of Primary Healthcare Provider-referred patients who gained access to psychiatric consultations compared with the year pre-RASP implementation. RASP users were more likely to be homeowners (36.5% vs. 17.7%), employed (55.3% vs. 47.9%), older, and had higher rates of anxiety and depression compared to CMHP users. Conversely, CMHP participants experienced more negative childhood experiences, substance abuse (7.8%), psychosis (10.6%), and unemployment, and had higher rates of suicidal intentions. The level of patient satisfaction for RASP users was high (mean score: 9.31/10, SD = 1.42), with over 97% recommending the program. Twelfth months post-intake referral, although the differences were not statistically significant, on average, RASP users used acute services less frequently than controls. Following Bonferroni correction, the initial associations between acute service use, housing, and education were no longer significant. Conclusions: RASP showed early success in boosting psychiatric access and achieved high patient satisfaction. Rapid-access models have the potential to improve timely, equitable, and person-centred mental health care, though decreases in acute service use were statistically nonsignificant.enRapid accessMental health