Building accessible mental health care systems to improve patient outcomes

Last weekend, I attended two mental health focused events in our community.

I’m writing this article to share with you a huge challenge faced by some London youth and consider how better service integration & improved user experience can be used to improve health care services and other complex systems.

Nspire Western, featuring mental health leaders in London community.

Challenge: For London youth struggling with their mental health, it can be tough to know where to seek appropriate health care services in the city. Where do London youth go when they need help with mental health and other related challenges? Solution: To bring services together under one roof, a diverse team is building a ‘one-stop shop’ youth mental health center called the Youth Wellness Hub.

This challenge-solution pair is one of many examples across mental health care services where a focus on better service integration & improved user experience can improve patient outcomes.

A fragmented system can be improved with non-traditional partnerships.

The Ministry of Health’s funding models have developed many strong, yet siloed organizations which duplicate each other’s services. In addition to being confusing to navigate, individual electronic health record (EHR) systems make it hard for organizations to share information. Shifting mindsets from organizations each protecting their own resources towards integrating services will put patient outcomes first and spend health care dollars more efficiently.

On campus: Western is putting Student Health Services, the Wellness Education Centre, and Student Psychological Services in one integrated centre in Thames Hall. As we speak, they’re piloting a shared EHR on campus which means that students won’t need to re-tell sensitive mental health stories over and over again when moving between services.

In the community: CMHA Crisis Centre on Huron St. provides immediate crisis assessment, intervention, stabilization and links to community resources. They run satellite services at London Health Sciences Centre, Western, and Fanshawe campuses employing volunteers (lots of students, if you’re interested) to be open 24/7. Police and paramedics can bring individuals in need there, redirecting cases to the right resource to best support them.

Think outside the box: Often having an education, stable housing and being employed denote stability and a sense of purpose in life. Sometimes when someone is mentally ill they do not have either a job or funds for housing available. What if housing was seen as a medical need or an intervention? Panelist Jodi discussed how it costs 612$ for a tertiary hospital bed but only $30 for affordable supported housing. Another panelist Steve discussed how over half the youth he works with have no more than a high school education and can’t find employment. He told a story about someone who would have taken their life if it weren’t for a call that got them a job.

Placing the user’s needs at the core can make health care systems better.

Ask your users: The tech industry is obsessed with design-first, human-centric products and I hope to see this attitude change in the near future of health care. Lori talked about asking users why they didn’t enjoy group interventions for mental health and discovered key desires for drop-in accessibility and user-driven content. She increased attendance by serving classes based around user interests and then getting participants to eventually teach classes.

Think global: Different countries have various methods of providing for user needs — Morgan talked about driving innovation by hearing from patients and providers around the world. That’s how he found out about Big White Wall, an online mental health community forum started in the UK and now supported in both Canada and New Zealand. Morgan discusses how most care for mental illnesses is largely provided at home; the circle of care between providers and caregivers needs to be connected in order to give the user the best combined care experience.

Consider marginalized populations: Talking to people involved with building a Youth Wellness Hub, I realized how the service would be for university versus non-university youth. Despite fragmented services, I know where to go for support in our Western bubble if I was facing mental health challenges. Someone without a home, without internet access, not in school, suffering from addiction — where would they go to get help with their situation? How do we design accessible systems for marginalized populations? This problem is real, challenging, and right next door.

Health care isn’t the only space that benefits from new system integration and user-driven design. To build better products, startups, even club events, ask: who is using your product, what do they need and want, and how can you best offer them this experience?

Panelists

Steve J Cordes— Executive Director, Youth Opportunities Unlimited; Morgan Rosenberg — CEO, Founder, SupportsHealth; Lori Hassall — Director, Crisis and Short Term Interventions — Canadian Mental Health Association Middlesex; Elizabeth Osuch — Associate Professor and Dr. Joseph Rea Chair in Mood Disorders, Schulich School of Medicine and Dentistry; Chair/Medical Director, First Episode Mood and Anxiety Program; Cynthia Gibson — Director of Western Student Health Services; Viraj Mehta — Psychiatrist — St. Joseph’s Health Care London; Jodi Younger — Vice President Patient Care & Quality, St Joseph’s Health Care London

Other thanks: Lauren Cipriano, Lisa Bitacola, and Nspire Western organizing team

Thanks for reading!

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