The uncertainty of living through a pandemic that’s disrupted almost every part of daily life has more people feeling stressed, anxious and depressed. A study by the Centers for Disease Control and Prevention shows that U.S. adults have reported considerably elevated adverse mental health conditions, such as increased substance use and suicidal ideation, due to COVID-19.
In this Q&A, we talk to Lydia Sequeira, health informatics doctoral candidate at the Centre for Addiction and Mental Health (CAMH) in Toronto. Lydia discusses how CAMH, Canada’s largest mental health teaching hospital, is using data-driven technology as a tool for suicide prevention and improving mental health outcomes.
Q: How has COVID-19 impacted care demand and delivery at CAMH, and how have you adapted?
A: COVID-19 has impacted the mental health field across Canada. A poll from the Angus Reid Institute found 50% of Canadians reported worsening mental health since the pandemic began. Researchers at CAMH and Delvinia Technologies conducted a survey showing an increase in anxiety, binge drinking, loneliness and depression over the course of the pandemic.
CAMH has made a strong effort to expand virtual care services and capacity in order to meet the increased demand and need for mental health support. Our telemental health team has supported clinicians across the hospital in delivering a high volume of quality virtual care. Our information technology team has worked tirelessly to implement video conferencing across the hospital.
One of the biggest challenges we’ve faced is patient volume. From March to April 2020, CAMH’s virtual care visits increased by 750% -- from about 350 per month to almost 3,000 a month. That truly shows there's been a lot of hard work from the telemental health team, the IT team and several other teams across the hospital.
We’ve adapted by improving access to resources for the general public beyond patients and their family members. The CAMH COVID-19 mental health hub has information on how to manage stress and anxiety and several other resources to help the public, depending on the condition or challenge they're facing. In addition, there's a companion mobile app that features self-assessments, discussion boards and a variety of coping tools for patients.
We’re also using technology to help patients stay in touch with family and loved ones and to facilitate virtual care sessions. CAMH received a tablet donation, which made it possible for every inpatient bed to receive a tablet. In addition, Cisco Canada generously contributed about $2 million in technology and funding to support CAMH research and development to help build new models of care.
While COVID-19 has presented an influx in mental health concerns, the challenges presented by the virus have revealed how we can offer patients more flexibility in scheduling their appointments and follow-ups, so they can receive care wherever they are. Wait times are now shorter, and there’s more seamless communication between patients and clinicians.
Q: The latest statistics show that roughly 800,000 people die from suicide each year. How is your team using data, analytics and technology tools to assist with suicide prevention? How well do these methods work and what benefits have you observed?
A: As a Ph.D. candidate, I've been involved in projects that use technology to assist with suicide prevention efforts. The first is a suicide safety planning app that launches soon. The app is called Hope by CAMH and offers patients and their family members accessible, convenient safety planning that's always with them on their phones. Along with the safety planning piece, there are wellness activities, crisis resources and information about suicide.
Another ongoing project I’m working on is validating the suicide risk algorithm developed by the Cerner Math team. My team has taken the algorithm and translated it into our electronic health record (EHR), mapping the different variables in the Cerner Math algorithm across the EHR fields at CAMH.
There’s other important work happening that I haven't been part of, such as the development of e-learning modules that cover suicide awareness and self-reflection, suicide risk assessment and care planning and interventions for adults at risk for suicide. An EHR suicide risk documentation form was created in-house using best practices to inform and improve the clinical competencies of CAMH health professionals. Also, within our EHR, treatment plans are automatically triggered when a patient is assessed as being high-risk of suicide.
Q: What are the biggest benefits of having technology and data assist you in the work you're doing?
A: Having things like the EHR and suicide risk assessment documentation form are so helpful to streamlining workflows. Our clinicians are extremely busy, and there's so much happening on the units on a day-to-day basis. With the example of the suicide safety planning app, if that information was being provided on paper, it could easily be lost and inaccessible. Maximizing technology to help make care more efficient, safe and convenient is key.
Q: The pandemic has taken a mental toll on care providers on the front lines. How is CAMH looking out for the well-being of its clinicians?
A: CAMH has stepped up for not only its clinicians, but also for staff and researchers like me. For health care providers, there’s an online resource hub and access to psychotherapy and psychiatric services. Through this hub, they're also supporting clinicians outside of CAMH's walls. The hospital is one of five organizations funded by Ontario’s Ministry of Health to deliver services to front line health care workers.
There's also the ECHO COVID-19 virtual training and capacity building model for health care providers. More than 500 providers and residents have registered for the program, and they report that it's helped with their resiliency and with fostering a sense of community among clinicians having similar experiences. CAMH also supplies a virtual fitness platform called Wellbeats for the staff, which helps us stay active at home, channel stress and build a routine.
Q: What are some of the top lessons you've learned so far from the pandemic, and how do you anticipate the pandemic shaping the future of mental health care?
A: Whether it's working from home or wearing a mask, we’ve all had to deal with changes to our daily lives and behaviors. It’s amazing how our bodies and minds have slowly learned to adapt.
The pandemic has helped my team leverage technology in a way we haven't before. We’ve done whiteboarding and team building virtually. It’s been a learning experience to do everything through a screen. But it's also brought us closer.
There's a need to move toward more innovative digital tools that can reach a wider range of people, quicker. There are companies offering virtual or digital mental health solutions and they're reporting more users.
My research team at CAMH worked on a project funded by the Canadian Institute of Health Research to mobilize digital mental health resources to the public. We did an academic review of the current tools and resources available, and we also got feedback from a variety of participants. We identified over 100 different digital resources specific to mental health and the COVID-19 pandemic.
Now, we're in the process of launching that final resource list to the public. I hope initiatives like this educate the public on how to leverage and maximize the tools already available to help with mental health conditions.
Q: How can the industry move forward together in tackling suicide prevention and the mental health crisis that we’re facing?
A: The theme of this year’s World Suicide Prevention Day was “Working together to prevent suicide.” That's an important message because we all play a key role in suicide prevention ─ whether by having open conversations, listening to someone, being compassionate or helping someone on their journey to finding professional help. It's important to remember that we can still reach out and we can still listen even in this physically distant time.
CAMH has a new campaign called "Not Suicide, Not Today,” to try to change the conversation and highlight suicide and mental health statistics and facts. We’re working toward a future where hopefully no one loses their life or their loved one because of a mental health condition.
If you or a loved one are struggling and in need of support, please contact the Suicide Prevention Lifeline at 1-800-273-8255 or visit their website at SuicidePreventionLifeline.org for more confidential and free resources.
At Cerner, we believe that behavioral health solutions should help provide a seamless and personalized experience to all mental health patients. Learn more here.
More like this:
- Ep. 191: Technology as a lifeline for suicide prevention – Listen time: 22:48
- Adapting mental health care to meet the demands of COVID-19 – 6-minute read