Program Report: Implementing Mental Health Supports and Resources for Dialysis Patients Into Practice Through the Mind the Gap Project
15 affiliations
- 1Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
- 2Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
- 3Department of Medicine, University of Ottawa, Ottawa, ON, Canada
- 4Patient partner with Can-SOLVE-CKD Network, Canada
- 5Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- 6Alberta Kidney Care South, Alberta Health Services, Calgary, AB, Canada
- 7Chronic Disease Innovation Centre, Seven Oaks General Hospital, University of Manitoba, Winnipeg, MB, Canada
- 8Nova Scotia Health Renal Program, Nova Scotia Health Authority, Halifax, NS, Canada
- 9Department of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
- 10Faculty of Medicine, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
- 11Alberta Kidney Care North, Alberta Health Services, Edmonton, AB, Canada
- 12School of Nursing, Trinity Western University, Langley, BC, Canada
- 13Centre for Advancing Health Outcomes, Providence Health Care Research Institute, Vancouver, BC, Canada
- 14Sahlgrenska Academy & Centre for Person-centred Care, University of Gothenburg, Gothenburg, Sweden
- 15Division of Nephrology, Department of Medicine, Dalhousie University, Halifax, NS, Canada
Abstract
Purpose of Program: People receiving dialysis experience a high burden of mental health challenges. Few dialysis-specific resources exist to support their mental well-being. The Can-SOLVE CKD Network ‘Mind the Gap’ project team identified mental health care challenges for the dialysis population and explored strategies to integrate relevant support and resources into practice.
Sources of Information: Candidate interventions were a Dialectical Behavioural Therapy (DBT) Skills Training program implemented for people receiving hemodialysis in Manitoba and a provincial pathway for mental health care for people receiving all dialysis modalities at a system-level in Alberta. For this reason, we refer to both hemodialysis and dialysis in this report.
Methods: Mind the Gap’s two interventions were identified after input from diverse interest-holders including people with lived dialysis experience, their caregivers, and kidney and mental health care providers and leaders. Emphasis was placed on patient engagement, Equity, Diversity, Inclusion and Accessibility (EDI-A), and Indigenous cultural safety. The Knowledge to Action Framework informed implementation.
Key Findings: Looking across both interventions, at the person-level, barriers included stigma around asking about and accessing mental health resources, and the perspective that mental health care does not belong in dialysis care. To empower people on dialysis to advocate for their mental health needs, we developed resource lists of freely accessible, online mental health supports for Canadians receiving dialysis. From the DBT project, Indigenous patients and patient partners were more engaged when the Mind the Gap Indigenous Research Coordinator was involved in team interactions. At the healthcare provider-level, the importance of mental health care in dialysis populations was recognized but there was uncertainty as to who was responsible to address this. Champions in various roles, including patient partners, healthcare providers, and leaders, have been a constant strategic facilitator. Intervention-level facilitators for DBT included holding DBT sessions at a location away from the hemodialysis unit and obtaining funding for allied healthcare providers to complete DBT Skills training. Intervention-level facilitators for the provincial pathway for mental health care for people receiving dialysis included engaging hundreds of knowledge users in its development. At both the intervention and system-levels, barriers included the impact of interventions on clinical care resources or workflow and high turnover of program leadership.
Limitations: Our work reflects the perspectives of interest-holders in two Canadian provinces. Transferability of findings about mental healthcare challenges, available supports, and interventions to diverse dialysis populations across Canadian contexts requires further investigation.
Conclusion: All interest-holders expressed a compelling call to attend to mental health support needs in dialysis patients. The process involves numerous challenges, including stigma associated with people receiving dialysis accessing and healthcare providers engagement in mental health supports, time constraints, lack of relevant training among dialysis staff, and inflexible, siloed structures within healthcare systems. Blending mental health care with dialysis care is culturally novel and an important step to meaningfully support the emotional and mental well-being of people on dialysis.
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BibTeX
@article{schickmakaroff2026program,
title = {{Program Report: Implementing Mental Health Supports and Resources for Dialysis Patients Into Practice Through the Mind the Gap Project}},
author = {Kara Schick-Makaroff and Charlotte Berendonk and Ashley Seitz and Rommelson Aquino and Mark Canney and Joel Davidson and Reena Davis and Arlene Desjarlais and Priscila Ferreira da Silva and Denise Fillier and Owen Gaskill and Earl Halcrow and Oksana Harasemiw and Dawn Hau and Lisa Joya and Joanne Kappel and Scott Klarenbach and Jonathan Lee and Loretta Lee and Russell Malabanan and Michael McCormick and Primrose Mharapara and Frances Reintjes and Richard Sawatzky and Karthik Tennankore and Stephanie Thompson and Lauren Virostek and Clara Bohm},
journal = {Canadian Journal of Kidney Health and Disease},
year = {2026},
month = sep,
doi = {10.1177/20543581261487730},
url = {https://doi.org/10.1177/20543581261487730},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Program Report: Implementing Mental Health Supports and Resources for Dialysis Patients Into Practice Through the Mind the Gap Project
AU - Kara Schick-Makaroff
AU - Charlotte Berendonk
AU - Ashley Seitz
AU - Rommelson Aquino
AU - Mark Canney
AU - Joel Davidson
AU - Reena Davis
AU - Arlene Desjarlais
AU - Priscila Ferreira da Silva
AU - Denise Fillier
AU - Owen Gaskill
AU - Earl Halcrow
AU - Oksana Harasemiw
AU - Dawn Hau
AU - Lisa Joya
AU - Joanne Kappel
AU - Scott Klarenbach
AU - Jonathan Lee
AU - Loretta Lee
AU - Russell Malabanan
AU - Michael McCormick
AU - Primrose Mharapara
AU - Frances Reintjes
AU - Richard Sawatzky
AU - Karthik Tennankore
AU - Stephanie Thompson
AU - Lauren Virostek
AU - Clara Bohm
PY - 2026
DA - 2026/09/16
JO - Canadian Journal of Kidney Health and Disease
DO - 10.1177/20543581261487730
UR - https://doi.org/10.1177/20543581261487730
AB - Purpose of Program: People receiving dialysis experience a high burden of mental health challenges. Few dialysis-specific resources exist to support their mental well-being. The Can-SOLVE CKD Network ‘Mind the Gap’ project team identified mental health care challenges for the dialysis population and explored strategies to integrate relevant support and resources into practice. Sources of Information: Candidate interventions were a Dialectical Behavioural Therapy (DBT) Skills Training program implemented for people receiving hemodialysis in Manitoba and a provincial pathway for mental health care for people receiving all dialysis modalities at a system-level in Alberta. For this reason, we refer to both hemodialysis and dialysis in this report. Methods: Mind the Gap’s two interventions were identified after input from diverse interest-holders including people with lived dialysis experience, their caregivers, and kidney and mental health care providers and leaders. Emphasis was placed on patient engagement, Equity, Diversity, Inclusion and Accessibility (EDI-A), and Indigenous cultural safety. The Knowledge to Action Framework informed implementation. Key Findings: Looking across both interventions, at the person-level, barriers included stigma around asking about and accessing mental health resources, and the perspective that mental health care does not belong in dialysis care. To empower people on dialysis to advocate for their mental health needs, we developed resource lists of freely accessible, online mental health supports for Canadians receiving dialysis. From the DBT project, Indigenous patients and patient partners were more engaged when the Mind the Gap Indigenous Research Coordinator was involved in team interactions. At the healthcare provider-level, the importance of mental health care in dialysis populations was recognized but there was uncertainty as to who was responsible to address this. Champions in various roles, including patient partners, healthcare providers, and leaders, have been a constant strategic facilitator. Intervention-level facilitators for DBT included holding DBT sessions at a location away from the hemodialysis unit and obtaining funding for allied healthcare providers to complete DBT Skills training. Intervention-level facilitators for the provincial pathway for mental health care for people receiving dialysis included engaging hundreds of knowledge users in its development. At both the intervention and system-levels, barriers included the impact of interventions on clinical care resources or workflow and high turnover of program leadership. Limitations: Our work reflects the perspectives of interest-holders in two Canadian provinces. Transferability of findings about mental healthcare challenges, available supports, and interventions to diverse dialysis populations across Canadian contexts requires further investigation. Conclusion: All interest-holders expressed a compelling call to attend to mental health support needs in dialysis patients. The process involves numerous challenges, including stigma associated with people receiving dialysis accessing and healthcare providers engagement in mental health supports, time constraints, lack of relevant training among dialysis staff, and inflexible, siloed structures within healthcare systems. Blending mental health care with dialysis care is culturally novel and an important step to meaningfully support the emotional and mental well-being of people on dialysis.
SN - 2054-3581
ER -