Supporting Mental Health in Ontario, Canada

Episode Summary

Hear how Ontario Shores Centre for Mental Health Sciences in Whitby, Ontario engages patients (and their care providers!) with technology and humanity.

Episode Transcription

Title: Supporting Mental Health in Ontario, Canada

Guests: Sanaz Riahi, RN, PhD, Vice President, Practice, Academics and Chief Nursing Executive, Ontario Shores Centre for Mental Health Sciences 

Host: Christine Parent, Associate Vice President, MEDITECH


Sanaz: Doesn't matter what your diagnosis is, you are a human being first. How do we support you, provide treatment with you, and really empower you? 

Christine: Welcome to another episode of MEDITECH Podcasts. 

We're the leader in healthcare technology empowering you to be a more informed healthcare consumer and provider. Hear the latest from our friends and colleagues on topics we think you should know about. 

Today, I'm joined by Sanaz Riahi, RN, PhD, the Vice President, Practice Academics, and Chief Nursing Executive at Ontario Shores Center for Mental Health Sciences. In her role, she works collaboratively with internal and external stakeholders with the utilization of technology and health systems to support, promote, and advance a quality interprofessional practice environment that optimizes outcomes for patients, staff, and the organization. Let's dive in. 

The global population has been facing increased mental health issues in substance use during the COVID-19 pandemic. To help meet this challenge, Ontario Shores has joined with other Ontario organizations to form the 'Everything Is Not Okay' campaign. Tell us about this work. 

Sanaz: As we all can appreciate, the pandemic has taken a significant toll on the population at large. Ontario's leading mental health and addictions organizations including Ontario Shores have come together to really say, "Everything is not okay and really highlighting the impact of COVID-19 and the pandemic on the mental health of children, youth, and adults.

The campaign is really calling for that immediate action by all levels of government for us to help reduce wait times to access mental health care and addiction services. Even before the pandemic, there was a mental health and addictions crisis in Ontario around a misalignment for demand and access. The pandemic certainly didn't help. It has really exacerbated the issues at hand.

We know that the realities of the pandemic have really played a significant part. People are dying. A lot of people are losing loved ones, people are losing their jobs, having to have implications of working from home, and doing child care simultaneously are just some of those examples that are taking a toll on people's wellness and their mental health. With that said, I think we just want to continue to advocate for mental health care system.

To just highlight that, although everything wasn't okay, it continues to not be okay. If it's okay to just to give some a couple of stark realities of what that really means. We know in Ontario alone, 28,000 kids, children, and youth are on waitlists to get mental health care. At times, some of them are waiting for over two and a half years to receive that care. We know with the pandemic there is approximately 74 of Ontarians that are really raising their hands and saying that my mental health and addiction challenges have gotten worse. Those are significant numbers and this campaign is really to highlight these issues and to say we need more support to be able to provide care for people in need. 

Christine: Can you talk about initiatives that have stemmed from the 'Everything's Not Okay campaign and how it's helping to reach underserved and diverse populations? 

Sanaz: The campaign itself is fairly new. I would say we really got together, probably, in the new year in January and put this campaign out after recognizing and being able to collect some of the data, but there are a number of initiatives underway that have been, even prior to this campaign, that certainly support mental health care, and then, also those that are underserved and diverse populations. One of them being our structured psychotherapy program. Ontario Shores implemented this along with three other mental health hospitals in the province in collaboration with our government's Ministry of Health.

Really, with the goal to be able to expand the availability of psychotherapy services to those that are suffering from depression and anxiety. We know that those are some of the key issues people are also facing in the pandemic as well. The program provides really evidence-based short-term cognitive behavior therapy. When we talk about expanding services. I want to put that a little bit in context of Ontario to demonstrate that not everyone could just get these services without paying out of pocket historically. A lot of people, if they want to get psychotherapy, they would have to pay out of their own pockets if they didn't have benefits through their work that would cover such treatments. Expanding this program through the Ministry of Health is really allowing people to be able to look at the Ontario insurance that everybody gets as a citizen and use those opportunities to be able to get free psychotherapy. To me, that is us reaching out to populations that, historically, wouldn't have access but certainly in greater need. We know just to talk a little bit about the inequities within society but as a result of the pandemic being further heightened. 

We know that there's lots of racial and social-economic inequities in rates of COVID in hospitalizations and mortalities that have been identified both in Canada but also internationally. There's been lots of publications and communications and media that you can see around some of the social determinants of health, such as gender, your socio-economic positions, homelessness, incarcerations, just to name some of those determinants that are really impacting your risk factors of getting COVID, the severity of the level of the infection. 

At the end of the day, the level of mortality, as well that, when you're experiencing these inequities, there's a higher chance that you're going to actually die from COVID. That's really not okay. We also know women are getting so much more impacted in the pandemic, just simply because of child care issues and juggling work and how do we support them from their mental health perspective. We, at Ontario Shores, have a women's clinic that we continue to serve those with mental health issues and really have partnered with Shoppers Drug Mart, which is one of our lead pharmacies here in Ontario that have supported us in implementing this program. That's another way for us to support some of the inequities of what we're seeing further even during the pandemic. 

Christine: I will agree with you that the pandemic brought and highlighted the access and service issue on the underserved in the diverse communities. We're seeing that not only with services but also sometimes with devices with the virtual care being rolled out.

It's definitely something that needs to be tackled. It is across the globe. It's not just a US issue or a Canadian issue, it is something that needs to be addressed. 

Sanaz: Absolutely. 

Christine: How would you define the concept of patient empowerment? and what does that mean to you?

Sanaz: Recently, I was looking at World Health Organization and they have, I think, one of the most simple yet most powerful definitions around patient empowerment where they identify it as a process through which people gain greater control over decisions and actions affecting their health. What that means for me and kind of the work that we do at Ontario Shores is how do we partner with patients in their mental health care, provide them with choices, provide them with knowledge and education so that they can make informed decisions. Especially, in mental health care, I would say, there has always been historically a stigma towards those with mental illness. The care that they receive tends to be more paternalistic in nature where you do to people and tell them what to do. 

For us, it becomes really important to see the person that we're serving as the expert in their own experience and really help navigate them through their recovery and mental health. We certainly have taken on the recovery model of care and adopted that in the care that we provide. What that really means is empowering people doesn't matter what your diagnosis is you are a human being first and you're having a really difficult time in life and how do we support you, provide treatment with you, and really empower you to be able to not only be engaged in the care that you're receiving, but also give you information about your mental health care and help you understand your own trajectory. I think that empowers people in their recovery in healthcare period and in mental health care, certainly, when we talk about our organization. 

Christine: I love that by the way. I was in a conference with some of your peers and we were talking about the Consumer Inpatient Portal that you brought up in Ontario Shores. You were one of the first ones in Canada to go LIVE with the Patient Portal. I have to commend you because you were dealing with mental health data. That was, you talk about stigma, that was a big area to get over I think both for the staff to make sure that it was okay to share but the stories that came from your organization over teenagers that were admitted for inpatient care and their families were able to actually see what was going on made all the difference in their health and being able to connect with what was going on. I applaud you. I know it's a big journey and you continue to advance. Congratulations on that front. 

Sanaz: Thank you. 

Christine: What are some ways Ontario Shores supports the mental health of its own caregivers and staff? I know this has been a stressful time for your own organization. How have you made sure that you had support for your caregivers and staff?

Sanaz:  It's a really good question and one that we continue to reflect on almost on a daily basis.

As you can imagine, people are just tired. Staff are just tired and exhausted. They've been rising up during this pandemic for over a year now every single day. For us, we're in a third wave. Things are still not looking as hopeful as we were hoping it was going to, especially, with vaccine distribution and so forth. For us, it's so important to be able to support our staff in their sense of well-being and their resiliency. We try to have a variety of activities. We have lots of resources available to staff to be able to go and to support their well-being. For example, providing them with psychotherapy for free, if they're feeling like that's something that's helpful for them, whether it's virtual or whether it's in person. Kind of, there's a whole process that we have in place. Also, for our leaders providing with education and support so they can support their direct care staff, as well. Rising up has been a symbol for us of how we do things around here, especially, since the pandemic. That's kind of become our service culture, people constantly rising up. That's what we want people to do but how we support them really becomes key in continuing that. We have 'Rising Up' Wednesdays, where we wear rising up t-shirts. It is about how to promote people to live well and work well. Having mindful activities, whether it's virtual meet, nowadays, virtual meetings. To be able to support mindfulness activities or giving them tidbits of self-care are really important and we continue to do that.

Our CEO, which I always commend him for. It's very important for him to have open communication and transparent communication continuously with our staff. Whether through forums, whether through email, really communicating with staff and just acknowledging the hardships that people are feeling, whether in their personal life or at work and really demonstrating the gratitude we have for all the work that they do. I think that's also important that has been helpful for our staff. All of the senior member team, we try to go on to the units on a weekly basis, visit as many units as we can, to just check in with people to see how they're doing. We still show up to work because for us it's important to come to work even though maybe our jobs are not direct care staff and it may not entail us having to be on-site. For us, it's about demonstrating we're all in this together. That's our nurses, our physicians, our allied health team members, they have to be here. We have people to serve and people to care for. We want to be here with them and recognize it's not easy. We like to celebrate. We love food. Before the pandemic, we used to always have cake for whatever occasions we could. Now, certainly, we can't have cake now, but we do have these personalized treats we have for staff on occasions to be able to just appreciate what they do and giving them wellness gifts.

Our latest wellness gift was giving everyone a Fitbit. Really, kind of, supporting their well-being. Really trying all that we can do to build resiliency to support people in their well-being. I think we have to be able to ensure we have a resilient workforce to be able to then do the work at hand which is really caring for those that need us the most in their life in mental health care. 

Christine: Thanks for tuning in. In our next episode, we'll continue our conversation with Sanaz Riahi from Ontario Shores. She will share insights on the future of consumer-facing apps and portals, advice for those entering the medical field, and her personal experience of being in lockdown with a newborn baby. 

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