Tailoring technology: Mental healthcare should fit like a glove

There is perhaps nothing more intimate than that which lies within our minds. Our thoughts, perceptions, moods and desires represent the very fabric of what makes each of us individual human beings. Mental health is thus a deeply personal and unique experience.

With the growing ubiquity of apps and technologies that seek to help manage our health and well-being, it is important to acknowledge the distinct needs of mental healthcare. Despite being a health technology company (InputHealth) composed of a diverse team whose experiences range from being healthcare providers to working in management and administration at the frontlines of care, we too have been humbled by the variation in needs that arise with building and deploying solutions for mental health.

Our platform, the Collaborative Health Record (CHR), is being utilized by hundreds of healthcare providers across Canada and the world, including dozens of clinics and organizations that are involved in delivering mental healthcare. Our experience in working closely with these organizations has allowed us to refine the CHR to meet the evolving needs of care delivery in a mental health setting.

We are currently involved in a large project in southwest Ontario called TELEPROM-Y (TELEmedicine and Patient-Reported Outcome Measurement in Youth). This initiative, which has been funded by the Ontario Centres of Excellence, involves the use of our CHR platform in numerous outpatient mental health centres in and around London, Ont., to support the ability of care providers to connect and engage with youth receiving mental healthcare through a mobile app interface.

The project involves validation and research that is being led by Dr. Cheryl Forchuk and her team at the Lawson Health Research Institute, involving the recruitment of over 100 youths in the southwest Ontario region. The project started at the beginning of this year and will run for 24 months.

The CHR serves as a toolbox with which care providers and youth can keep in touch by selecting various technologies. For example, some youth may prefer to only use secure instant messaging to speak with their care providers, while others may wish to have the option to occasionally use video conferencing. This idea of choice is central to the function and application of the technology, and is supported by data from previous work done by Dr. Forchuk.

Similarly, we have been working with centres of excellence in mental healthcare in BC, including the Mood Disorders Association of BC (MDABC) and the Canadian Mental Health Association (CMHA) BC.

Through our pioneering work with MDABC, we have been able to demonstrate that technology can help streamline the delivery of rapid access to mental health counseling and services, including group therapy.

The results have been both greater participation by patients (as seen through a reduction of no-shows rates from 30% to 5%) as well as an improved ability for the organization to deliver care to more people (with number of patients seen per year going from 1,600 to 3,500 with the same number of staff).

Our work with CMHA-BC has involved an entirely different model of care through its BounceBack program. Through the use of “BounceBack Coaches,” adults and youth with mild to moderate depression and anxiety can receive personalized education and therapy to help manage their symptoms.

This successful program enables people to choose the way they’d like to receive treatment, and the options include self-directed learning through web-based courses and video/text/in-person engagement with a coach, with the process streamlined through the CHR.

In an attempt to push the envelope of choice further, we are integrating a learning management system that will provide organizations with the ability to deploy web-based courses to patients directly through the CHR.

Yet another tool in the digital toolbox of the CHR, this furthers the paradigm shift that a health record system can be go beyond being a static documentation system to being a dynamic platform that is designed to facilitate personalized care.

Patients are able to self-report symptoms and mood scores through their own devices, when the organization using the CHR is able to support this form of communication. The key factor here being that the limitation of how a communication platform is utilized should not be coming from technology itself.

By providing options and allowing people to choose how they wish to engage with their care based on comfort, preference and readiness, we take important steps forward in moving mental healthcare beyond a one-size-fits-all model.

Puneet Seth, MD, is Chief Medical Officer at InputHealth Systems Inc. Alison Brunskill is Client Success Manager at InputHealth.