Increasing access to mental health support through virtual care

LHRI evaluates virtual care as an alternative access point for mental health support tor youths

Lead Organization: Lawson Health Research Institute (LHRI)

Program Name: TELEPROM-Y (TELEmedicine and Patient-Reported Outcome Measurement – Youth) Study

Area of Care: Youth Mental Health

Healthcare Partners: London Health Sciences Centre, St. Joseph’s Health Care London, Woodstock General Hospital, Community-based services including Youth Opportunities Unlimited, WAYS Mental Health Support and Leads Employment Services 

Vendor: Input Health

Objectives

  • Improve community integration of youth with mental health challenges  
  • Reduce health care system costs by effective and early intervention   
  • Reducing the need for in-person visits 
  • Improve access to mental health services 
  • Empower at-risk youth to effectively monitor mood and behaviour changes remotely

Eligibility Criteria: 

  • Aged 14 to 25 years 
  • Symptoms of anxiety and/or depression  
  • Receiving outpatient mental health services from a hospital-based mental health care program or youth identified with mental health challenges by community partners  

 

Model

The youth are instructed to download and install the application onto their smartphones. Mental health clinicians, from out-patient sites, on the other side of the application check in with youth and respond to concerns patients are raising through the app. The service is available during regular care hours, and crisis contact information is always accessible on the app.  The data inputted by youth – including self-reported moods and symptoms – become part of the patient’s medical record their mental health clinicians can access and review.  

Community partners can utilize the app to connect with youth participants and provide immediate support and assistance during regular care hours. 

The data collected from this program will be used to assess whether the technology is effective, efficient and acceptable to clinicians, community partners and youth to provide a virtual care delivery option to support youth community integration, improve mental health access and care. This program is primarily funded by the Ontario Centres of Excellence and supported by the London Health Science Foundation who has provided smartphones and by Rogers who has provided a discounted data plan.

Technology Type: The TELEprom-Y mobile program makes use of an electronic Collaborative Health Record, developed by InputHealth, which enables patients and their health care team talk via secure video link, message back and forth, and schedule in-person appointments, and allows study partners to view questionnaire results to guide care plan and case management support. 

Outcomes

The TELEprom-Y study is in progress therefore study results are not available. Initial feedback from study participants and partners indicate that youths feel empowered by the self-monitoring aspects of the program such as access to a phone to connect with case workers and clinicians virtually, ability to set reminders for appointments, use of questionnaires to self-monitor symptoms. Additionally, because the program offers a discounted data plan, vulnerable youth feel safer with the ability to access internet-based services.

The Lawson Health Research Institute will be undertaking an analysis of the following:

  • Effectiveness of intervention
  • Cost analysis when compared to usual care
  • Ethical analysis
  • Policy analysis

The pilot will also look at quality of life, depression, anxiety, use of services, emergency room visits, hospitalizations, encounters with the health care system and encounters with the judicial system.
 

Change Required to Support the Model

The technology-facilitated care model enables mental health clinicians and community partners to guide their interactions with youth based on their emerging needs (i.eschedule urgent clinic appointment, offer support/coaching for a job interview) with the goal to increase self-management and independence.  

Study utilizes smartphone as an assistive device required to reduce the “digital divide” experienced by the most vulnerable youth who previously had no access to a smartphone, increasing their cultural isolation and loneliness.  

Study clinicians and community partners have indicated that they would like to see and respond to patient data via their smartphone, instead of only being able to access patient data through their laptop or desktop computer 

Adoption Rate

Currently 89 patients are part of the Teleprom-Y study pilot. Lawson Health Research aims to enrol 120 youth.

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