E-Go

A comprehensive vision of an online Mental Health System

M.Krausz MD, PhD, FRCPC

Mental illness & AddicCon

A MINORITY GETS HELP

What happens to the rest? Less than a third of all clients with severe symptoms get minimal care (NCS 2005)

Less than 10% of pa=ents see a specialist The sicker pa=ents are, the less likely they get appropriate care (At-Home study, BC Homelessness survey)

No equity of access

IF YOU ARE LIVING REMOTE, ARE POOR OR DISABLED YOU EXPERIENCE EXTREME BARRIERS AND EXCLUSION!

Reserves without health care and other supports Street entrenched youth

Homeless and on the streets Intravenous drug users

lity of where a person is and bring re to them. But it requires tremendous a and creativity and exibility and nce. Those arent things that systems nto their models of care.

ANDALL WHITE, A PSYCHIATRIST Pauls, agrees that B.C. has a long way n serving this particular population. titutionalization of long-term mental als happened across North America; jurisdictions responded by putting oney saved into community care. He to one model, Assertive Community ment, that originated in Madison, nsin, in the late 1960s and has been mented by health authorities across S. and Canada. Bill is trying valiantly e these people, but hes a one-man he says. We need to be doing it matically. ACT model is a bigger version of HSs roaming team. Its aimed at the omplex cases: people with chronic l illness and frequent hospitalization, nce abuse problems, no stable home, ossibly a criminal justice history. An eam is made up of 10 to 12 profess, including typically a nurse, a social r, a counsellor, an occupational ist, a psychiatrist, and a psychologist. member has a small caseload of up to ients; their job is to go out and nd erson as frequently as possible. At ne member of the team is available urs a day, seven days a week, and can d to a crisis. Theres no limit on how patient stays in the program. he late 1990s, the Ontario ministry of embraced this model, and there are 1 such teams across that province. with health treatment, the teams mployment and housing assistance, support and education, and subabuse services. The numbers are shing: people who used on average pital-bed-days a year were down after one year in ACT, 15 days after ears. In 2002-03, the program saved mated $82 million in hospital costs. ients were also more stable, with 70 t living in a home of their own after ment. gures from Ontario dont surprise Higenbottam, a psychologist and services manager who was responor mental health services provided by ncouver Richmond Health Board and s psychiatric residents the ACT model C. Higenbottams on a provincial

There are those who feel the kind of social documentary work Im doing is not productive, says photographer Phillps, and others who think reportage of the human condition has become a fast grab for dramatic images in the guise of social conscience. Ive spent 18 months in the DTES because of an insatiable interest in addiction and homelessness, but also because as a journalist I feel the stories here are relevant

The Web is the only place The only op=on for A signicant expansion of Addi=onal systems of support for pa=ents with mental illness and addic=on

Current state?

Linear translaCon

Possible start of an exci=ng paradigm shiZ

Same func=onality than wriYen text with 1-1 transfer

Low funcConality Lack of integraCon

Of func=ons With the exis=ng system of care Between programs

Good components Growing awareness

First good features Therapy programs BeYer access

More projects More interest

A comprehensive vision of an Online Mental Health System

Embedded in the system of care Independent use Informa=on Knowledge exchange Self assessment Con=nuous self assessment Online interven=on Online interven=on under supervision Peer communica=on Peer experts Family involvement Chat expert feedback Online consulta=on Skype/Google plus Tele health Interface MH system (Access) With a professional One to one with a professional

Psychological complexity Online inter- ven=on Online consulta=on Cont. self assessment Technical complexity

Game like

Online assessment Chat

Knowledge exchange Knowledge brokerage

Engagement

Answers

Assessment

Online consultaCon

IntervenCon

Access to resources

PaCents PaCents

Families

Peers

What core components and funcConaliCes of a future system can be envisioned?

 Engagement

Access point to digital interac=on

It needs to make it easy to engage and navigate

person centered not only problem focused

 Answers

It should provide answers from dierent perspecCves To the most burning quesCons

 Assessment

It shall allow to assess and compare symptoms

For a balanced view of the situaCon

 Consulta=on

It shall support online

OpportuniCes for dierent levels of consultaCon

 Interven=ons

The web can support

intervenCons from self help to psychotherapy

 Access to resources

Mental health system

It shall help to access

The mental health and addicCon system and other resources

Therapeu=c factors In Psychotherapy

Real help in problem solving Rela=onship

Reec=on and understanding of mo=va=on Resource ac=va=on and development

Clients perspective
Life line

enter

KE
Orientation
e.g. what is depression what treatments are there?

Assess e.g. BDI

Professional Feed back and you tube documentation

Reassess e.g.BDI BDI

Intervention

KE
My symptom related to the population?

Intervention Deprexis

 Life line

Family support

Web trialog

Life chart

Peer interacCon

ART window

SeXng context

Talking straight

Telling stories

Specic projects shall support develop a toolkit of resources and communica=on

 Focus on the client and his needs

Make it easy for him to beYer understand, beYer navigate and assess and develop coping strategies

By reframing experiences in a dierent background

From vision

TO REALITY

InternaConal network

Regional network

Coopera=on with Germany, Switzerland, Netherlands

Coopera=on with interested groups and experts

Youth impact project

E-Go plaZorm

Bell funding the crea=on of a system addressing mood disorder among youth

Development of a comprehensive hub for E Mental health

E-Mental Health conferences Vancouver

Deprexis pilot

Making Vancouver a mee=ng place for this development

Star=ng a CBT pilot

 The Youth Impact Project

Answers

Assessment

Advice

Access

IntervenCons

Self help

Survey on the current use of the web through youth with mental challenges as rst step

Easy access

The internet as system empowerment to provide beYer care to the majority of pa=ents

Appropriate care

If you have a vision

You can manage the storm

 Think dierent