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E-mental health report released, touted as roadmap for reducing wait times and improving care for patients

ST. JOHN'S, N.L. —

The Mental Health Commission of Canada (MHCC) released a report Monday on its Newfoundland and Labrador Stepped Care 2.0 E-Mental Health Demonstration Project.

The project is being applauded as a contributing factor in the reduction of wait times in mental health and addiction counselling services in the province by 68 per cent.  

A news conference was held at Memorial University’s Signal Hill Campus Monday afternoon.

The 18-month project was carried out over 17 sites (15 community-based locations and two primary health-care clinics) across Newfoundland and Labrador since being launched in September 2017.

The purpose of the project was to identify ways to improve access to publicly funded mental health services through the implementation and evaluation of Stepped Care 2.0. 

The project also highlighted best practices to follow and pitfalls to avoid when integrating e-mental interventions into the public system, filling an important knowledge gap.

The MHCC partnered with Memorial University, the provincial government and the province’s four regional health authorities, and the Canadian and Consumers’ Health Awareness Network of NL (CHANNAL).

“Newfoundland and Labrador is leading the country with its work in mental health and addictions,” Health Minister John Haggie said.

“We are pleased to have had the opportunity to collaborate on this initiative.”

A news release states the Stepped Care 2.0 is an evidence-based system that organizes care according to the least intensive and most effective options, so clients are given the greatest likelihood of improvement with the most cost-effective, minimally invasive intervention. Treatment intensity can either be “stepped up” or “stepped down” based on client need, with the “2.0 update” of an added technological – or e-mental health – element. 

“Sixty-seven per cent of the e-mental health tools were given a rating of ‘good’ or ‘excellent’ by clients, while providers reported a significantly increased comfort level with incorporating these technologies into their conventional practice,” the release stated.

The report states that, “The introduction of Stepped Care 2.0 is part of a mental-health system transformation taking place across Newfoundland and Labrador.

“Based on the model developed and implemented in the U.K., stepped care offers an evidence-based, client-centred stage system of care that prioritizes the most effective and least intensive treatment.”

The Canadian model was originally developed for students at Memorial University by Peter Cornish, the director of student wellness and counselling centre at the university. Cornish was contracted as the lead researcher on the MHCC project.

“When someone says they are stressed, or they are not feeling happy, then society tends to say, ‘OK, go see a psychologist.’ However, not everyone needs to see a therapist all the time,” Cornish said.

“The Stepped Care 2.0 model brings in many other ‘low intensity’ options for the client that are readily available in the community, but which we’re often not making use of.”

The report states that, “initially, N.L.’s Stepped Care 2.0 training sought to integrate recovery-oriented practices. More recently, it has become a more coherent and accessible system of care through the integration of e-mental health programs into each stage of care. These programs allow clients to access mental health care how, when and where they prefer to receive it. 

The news release states the lessons learned from the report are being shared with provincial and national decision-makers, as well as with mental health leaders visiting St. John’s this week for a satellite meeting of the International Initiative for Mental Health Leadership. 

“By showcasing a home-grown success story to a global audience, the MHCC, the Government of Newfoundland and Labrador, and Memorial University are a road map for improved access to mental health care and addiction services in other provinces and territories, and around the world,” the release states.

Louise Bradley, president and CEO of the MHCC, said she first learned about e-mental health in New Zealand.

“My home province of Newfoundland and Labrador may be small, but with Stepped Care 2.0, we’ve shown home-grown innovation that has the potential to change how we deliver care across the country,” Bradley said. “I could not be prouder that we’ve got visiting mental health leaders from New Zealand in attendance today, the country where I first learned about e-mental health. It’s clear we took those lessons to heart and, in showcasing our progress, have come full circle.” 

The Stepped Care 2.0 model contributed to the reduction in wait times by 68 per cent, with some communities reporting no waitlists.

After the completion of the demonstration project, the team secured $1.2 million in funding from the Canadian Institutes of Health Research (CIHR) to develop a technology platform and evaluate its potential for significantly improving mental health care and access in Newfoundland and Labrador and Nova Scotia. 

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