Cancer patients at The Scarborough Hospital (TSH) now have better access to mindfulness therapy, which reduces mood and anxiety symptoms, thanks to a new, first-in-Canada online therapy platform called iMindful. Created through a partnership between TSH and Centennial College, iMindful enables patients to access care on their own terms and on their own schedule – a welcome solution considering the unmet mental health needs of cancer patients.
The program features therapist-guided mindfulness modules, group chats, meditations developed by TSH e-therapists, Janany Jayanthikumar and Shawnna Balasingham, working with TSH Mental Health Patient Care Director Faiza Khalid-Khan, and a yoga practice developed by TSH Psychiatrist, Dr. Karen Shin. It also provides links to therapist-approved online resources like the Mental Health App Library, information on sleep hygiene, and more. Patients can even use iMindful to book video appointments with their therapist, or message their therapist using video or private chat.
“Major mental illness like depression is far more common in the cancer population than the general population, so we wanted to do something, and we did,” says Dr. David Gratzer (pictured), one of the psychiatrists involved in the development of iMindful. “We talk about people benefiting from psychiatric interventions when they’re in stress. What could be a greater stress than news that you have cancer?”
Like many hospitals, TSH offers a mindfulness program that people can attend in person. But participation rates were low due to a variety of issues, says Gratzer.
“The reality is that many of our patients dropped out or didn’t come. It’s easy to understand the patient perspective. You’re not feeling great. You’re spending tons of time in the hospital. Now you’re asked to spend even more time, and perhaps come back to the hospital on the week you’re not having chemo. We wanted to offer something that was evidence-based, that was thoughtful, and frankly that was convenient. Anywhere you have internet access, you can access our iMindful program.”
Gratzer stresses that mindfulness training has some solid evidence to support its efficacy. “In particular, there’s evidence that it works well in the cancer population. Our problem was getting people to attend in person.”
The idea for iMindful originated at a two-day hackathon organized by Centennial College’s Wearable, Interactive, and Mobile Technologies Access Centre in Health (WIMTACH), where Software Engineering Technology/Technician students were challenged to create apps that could provide low-cost healthcare solutions.
From there, the project was approved for funding from Centennial College via its College and Community Innovation grant from the Natural Sciences and Engineering Research Council of Canada. Three students were hired to further develop the concept under the guidance of Mihai Albu, WIMTACH Researcher and Professor with Centennial’s School of Engineering Technology and Applied Science (SETAS).
After meeting with members of TSH’s Mental Health department to better understand patient needs, the students developed iMindful with a focus on interaction and engagement. The project was a great success: iMindful was named “Best Web Application” at Centennial’s SETAS Technology Fair in April.
iMindful is part of TSH’s e-therapy model based on stepped care, and a referral to the program is required. Patients referred to TSH’s psycho-oncology program are triaged by a mental health registered nurse into the most appropriate level of support, based on their level of distress.
At present, the iMindful program is available to the Scarborough population with cancer. However, Gratzer hopes other hospitals will start offering the online program to their patients in the future.
“Say you’re getting your cancer treatment in Northern Ontario or other parts of the country where there aren’t many psychiatrists or therapists offering treatment. This project could still potentially help you because the way we connect with people is through the Internet rather than in person. Internet-assisted mindfulness therapy isn’t for everyone, of course. That said, many patients could potentially benefit. We see this as a Scarborough project with national implications.”