Improving access: Connecting people to services quickly through technology
Technology has fundamentally changed access to mental health and substance use health services, especially for individuals in underserved areas or experiencing other barriers to accessing care.
Thanks to the teamwork between clients, families, service providers, clinicians, scientists, researchers, administrators, technology experts and donors throughout our region, this past year saw continued growth in virtual service delivery.
These innovative virtual health solutions are easing access and bringing new possibilities to people in the Ottawa region, and beyond.
“The encouraging news is that there’s more hope as the door is opening wider with the emergence of innovative care and related services and supports,” says lived experience transformative leader and former chair of The Royal’s Family Advisory Council, Michèle Langlois. “We’re committed to busting those barriers. We’re approaching them and tackling them one at a time with a goal to achieve more equitable, innovative ways to connect with, engage, and deliver care, services and support that meet people’s needs.”
The Royal’s RAAM clinic has a ‘digital front door’ – and it’s wide open
For individuals seeking support for substance use health, getting help is as easy as walking through the “digital front door.” And, it couldn’t have come at a better time.
Recent findings show Rapid Access Addiction Medicine (RAAM) clinics improve outcomes and reduce opioid- and alcohol-related emergency department visits, hospitalizations, and deaths.
Transitioning the RAAM clinic to a virtual environment helped address the growing need for substance use health and mental health treatment. Before the pandemic, The Royal’s RAAM clinic followed a traditional walk-in model. Services at the clinic include assessment and triage to the appropriate level of care, substance use and mental health treatment, withdrawal management, harm reduction, connection to primary care and navigation to community services (navigation services provided in partnership with AccessMHA; www.accessmha.ca).
Due to pandemic restrictions, clients were not able to walk-in to the RAAM clinic. “The processes we put in place due to COVID created delays and barriers to access, which is not ideal when someone is ready to do to something about their substance use health,” says Dr. Melanie Willows, addiction medicine physician, clinical director with the substance use and concurrent disorders program at The Royal and co-creator of the RAAM clinic.
“We knew we had to find a solution.”
The answer came from a new “digital front door” to improve rapid access to care and expand reach.
Developed by a team of clients, service providers, clinicians, scientists, researchers, and administrators, this new virtual model enhances care delivery and essentially replicates the experience of an in-person visit, but virtually, from wherever the person is at.
All that’s needed is an internet connection and a device with a camera. Community partnerships provide connectivity and support for clients without internet access.
“This is now one of the most accessible health solutions in the region,” says Dr. Kim Corace, vice-president, innovation and transformation, and co-creator of the RAAM clinic at The Royal’s substance use and concurrent disorders (SUCD) program.
Individuals connect with the RAAM clinic by “checking in” at theroyal.accessRAAM.ca during clinic hours (if it’s after hours, they’re redirected to other resources). After “entering” the digital front door, they meet by video with a clinician who assesses their needs and goals. Individuals may also be connected virtually with other members of the health care team such as an addictions counsellor, social worker, nurse, or physician, among others.
The RAAM digital front door also allows the individual’s loved one or support worker to attend the appointment. With a catchment area that includes Ottawa and surrounding areas, the virtual RAAM clinic casts a wider net and can help more people.
With more than 50 RAAM clinics across the province, it’s an idea that is also scalable. The digital front door solution has been shared with 15+ other RAAM clinics in Ontario, and more clinics across the country want it.
“Digital health is about thinking outside the box and using technology to improve the overall care experience. It’s about access, care and outcomes, rather than just a single session,” adds Dr. Corace.
For more information about RAAM go to: theroyal.ca/patient-care-information/clinics-services-programs/substance-use-and-concurrent-disorders.
Prompt Care Clinic helping fill mental health care gap in Ottawa region
The Royal’s Prompt Care Clinic began as a short-term response to a mounting mental health crisis early in the COVID-19 pandemic, but has since evolved into much more. Today, the clinic is helping fill a significant gap in mental health and substance use services for the Ottawa region.
Years before she managed the Prompt Care Clinic, Haley Ashe worked as a mental health nurse in Ottawa emergency rooms.
“I saw the gaps firsthand. Patients would come in with serious mental health concerns that didn’t qualify for acute care – but there wasn’t anywhere else for them to go,” she recalls.
“By the time people seek mental health support, they’re already in a state of distress. We know early intervention makes an enormous difference, but trying to find services available in a reasonable timeframe often felt impossible.”
Motivated by those experiences, Ashe became a key player in a new plan to fill this gap in mental health care.
A silver lining in a global pandemic
When the COVID-19 pandemic hit, many services closed their doors. Life stressors skyrocketed while access to mental health resources dwindled.
The Royal, in collaboration with The Ottawa Hospital, stepped in to improve access to care. It began with a temporary endeavour called C-PROMPT, which grew from idea to reality in two weeks, bolstered by emergency funding from the philanthropic community.
In just over three months, it received more than 850 referrals. “It was clear to us that this service was desperately needed in our region,” says Ashe.
In January 2021, the Prompt Care Clinic opened as a service funded by philanthropy for adults 18-65 experiencing mild to moderate mental health challenges. It received financial support from The Royal’s donors and corporate sponsors, including an ongoing partnership with the LOVE YOU by Shoppers Drug Mart Run for Women. More than half of the clinic’s clients are women, with anxiety and depression being the most common diagnoses. And while the Prompt Care Clinic serves all constituents of this region’s population, youth are disproportionately represented as its clients. Since January 2021, close to 500 youth aged 18 to 24 years old were referred to this temporary Prompt Care Clinic.
“Patients are referred to us by their physician or nurse practitioner, and usually they’re experiencing symptoms that are beyond what their primary health care provider is able to support them with, but not so severe that they require acute or emergency care,” says Ashe.
Until recently, the clinic has been completely virtual, but later this fall will move to 250 City Centre and begin offering in-person appointments as well. The location is easily accessible by public transit, just a short walk from Bayview Station.
“Finally, I felt that there was a chance for me”
Whether someone has been struggling long-term with mental health challenges or developed new challenges due to the stressors of the pandemic, the Prompt Care Clinic is making a meaningful difference in the lives of those across the region.
“I’ve lost all my friends. I fought my depression for so long. I don’t want to give up, but there are days… I’ve been on sick leave since 2011,” says one client who had been trying to access services for a long time. “My doctor referred me to The Royal’s Prompt Care Clinic. Finally, I felt that there was a chance for me.”
Another client, Jessica, had been living with depression and anxiety before the pandemic. As a teacher and mom of two, it became more than she could manage as the stressors piled up.
“My family doctor was out of ideas for treatment and I needed urgent help. I had tried to get ongoing treatment from a psychologist but after more than a year on a waitlist, had yet to receive care.”
Her doctor referred her to the Prompt Care Clinic, and within several weeks she met with a psychiatrist who helped her set up a care plan.
The clinic has already seen more than 2,500 clients, most of whom have never before accessed mental health care. On average, clients of the Prompt Care Clinic wait less than two weeks to see a specialist.
“Prompt access to care means better outcomes,” says Ashe. “This clinic is an investment in our future. It’s the embodiment of hope.”
For more information visit theroyal.ca/PROMPT.
How The Royal amplified the need for housing with mental health supports
Communities nationwide are facing a housing and homelessness crisis, and Ottawa is no exception. For people living with a mental health issue, there’s an extra hurdle to jump because there isn’t enough housing with mental health support. This means many people stay in the hospital longer than they would need to if they had supportive housing or leave the hospital only to see their mental health decline in the absence of support.
Meanwhile, roughly half of unhoused people in Canada are living with mental illness.
“We can’t separate conversations about mental health from those about housing,” says Joanne Bezzubetz, president and CEO of The Royal.
“We felt the need to raise the profile of this issue and advocate for greater awareness of the issue and meaningful investments in supportive housing for people living with mental illness.”
Within these advocacy efforts, The Royal underscored the issue to elected officials, published a statement on the need for supportive housing, amplified the work of our community partners, and facilitated an important public conversation about evidence-based supportive housing.
The case for supportive housing
Housing with mental health support is an evidence-based investment that changes lives. At Home/Chez Soi – a four-year study in five Canadian cities – clearly demonstrated that housing with mental health supports works to end homelessness and transform lives. It also showed that it’s a sound investment – over a period of two years, the study found that every $10 spent on housing saved taxpayers $21.72. It also improves outcomes for people living with mental illness in numerous domains, including their symptoms, community involvement, and overall quality of life.
The Royal partnered with Alliance to End Homelessness Ottawa in endorsing and amplifying their #StartsWithHome campaign to advocate for increased access to affordable housing in Ottawa. Through social media content that garnered 19,000 impressions, we drove traffic to the campaign and highlighted the issues of supportive housing through storytelling. This included sharing a video and article featuring Anita Manley, a mental health advocate, volunteer, and member of The Royal’s board of trustees. Her lived expertise lent a powerful voice to the need for supportive housing.
“It’s significant to have the weight of The Royal’s leadership focused on advocacy in this way,” says Kaite Burkholder Harris, executive director of the Alliance to End Homelessness Ottawa. “We look forward to partnering together more.”
Making space for a public discussion
The Royal’s Under the Lens conversation series is a space for an in-depth look at critical issues that aren’t discussed enough. On March 9, 2022, the event focused on mental health and housing. Bezzubetz facilitated a virtual conversation between community partners and experts, including representatives from the Alliance to End Homelessness Ottawa, The Royal, the Youth Services Bureau, Anita Manley, and Dr. Tim Aubry, a researcher at the University of Ottawa.
The discussion was collaborative and invigorating, with 116 individuals representing numerous organizations and areas of expertise participating.
“The need for supportive housing is ongoing, and we will continue our efforts to advocate for it at every level,” says Bezzubetz. “We will continue to work with our community partners and use our voice and reputation to make it loud and clear that housing with mental health supports saves and improves lives.”