A pilot project aimed at reducing wait times for mental health services in Newfoundland and Labrador is being touted as an early success with possible lessons for other Canadian jurisdictions.
The Mental Health Commission of Canada released its report with the Government of Newfoundland and Labrador and Memorial University this week, writing that the findings would be shared with other provincial and territorial health ministers.
“In conjunction with strong political will and leadership, the lessons learned from this project … can be adopted to successfully apply this approach in other provinces and territories to improve access to mental health care for all,” the report said.
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Psychologist Peter Cornish led the Stepped Care 2.0 program, which he initially developed for students at Memorial University, drawing from a model in the United Kingdom.
Cornish said his approach was developed to help professionals and patients navigate the complicated mental health system and identify tools that may work best for them, so people with vastly different needs are not waiting “in the same line.”
The goal is to shorten wait times while treating more people, some of whom may require simpler solutions, like peer support or phone counselling, rather than weeks of therapy.
“If somebody wants help, we think they should be able to get it the same day,” Cornish said in a phone interview Tuesday.
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“We want to capture that motivation. When they’re asking for help, the worst thing we can do is tell them to wait.”
Run out of 17 sites across the province, the program assessed patients the day they walked into a clinic and developed treatment plans, including whether the intensity of treatment should be stepped up or down.
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Cornish said his model is geared towards an individual’s treatment preferences and is more flexible than the traditional stepped care model that requires people try one treatment option before moving to the next.
The report indicated digital mental health tools, such as therapy assistance and relaxation apps, were well-received, with 79 per cent of people surveyed saying the tools met at least some of their needs. It also noted that none of the respondents found e-mental health tools made their problems worse.
Some service providers expressed doubts over the changes, but many felt greater training would increase comfort levels.
Providers told researchers they appreciated having more time and flexibility to work with clients and reported patients showing greater awareness of options available to them.
Stepped Care 2.0 is partially credited in the report for a 68 per cent reduction in wait times for mental health and addictions services in the province between 2017 and 2018.
The report assessed the 17 sites that first adopted the same-day appointment model, but Cornish said the number has since expanded to over 50 locations in the province.
The report released Monday also looked at the overall success of Stepped Care 2.0, as it works with other elements of the province’s mental health and addictions action plan, referencing the popular Doorways program that offers immediate walk-in therapy sessions.
Researchers found that greater access to services also led to organic, community-led initiatives around mental health – Cornish said one focus group member brought up a community-led “knit and talk” group that practitioners hadn’t been aware of.
The next step is developing a system for tracking what methods a patient has used and how those methods have helped them. Cornish said such a system would allow pratictioners to suggest more creative treatments, drawing on assets that are already available in their communities.
“It’s not so much that we have to change what psychologists, social workers and all the other professionals are doing, it’s that we can bring other resources in to complement them,” Cornish said.
Newfoundland and Labrador is the first province to use a stepped care model, though similar programs are used on smaller scales in British Columbia and Ontario. Cornish’s initial model at Memorial University was also adopted at McGill University in Montreal and George Washington University in Washington, D.C.
The demonstration project team has lined up $1.2 million in funding from the Canadian Institutes of Health Research to develop a technology platform aimed at improving mental health care access in Newfoundland and Labrador and Nova Scotia.
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