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Introduction: The COVID19 pandemic caused a shift towards virtual delivery of care as it was considered the safer means of care delivery. Simultaneously, it caused a rise in mental health and addiction issues due to stress and isolation. This shift to virtual care disproportionately impacted marginalized populations or those who live with inadequate social determinants of health such as poverty. This is mainly because their susceptibility to mental health and addiction issues is higher and their ability to afford virtual care is less. Consequently, innovative approaches that aim at enhancing access to virtual mental health and addiction services gained a growing importance. Aims, Objectives, Theory or Methods: We describe the co-design, implementation and evaluation of the first five months of a tablet lending program. Burlington Ontario Health Team (an integrated care network) created this program in response to a gap analysis that was conducted with its partner organizations to identify the community needs regarding mental health and addictions amid the pandemic. All the components of the program were co-designed with community and patient partners with a vision to improve access to virtual mental health and addiction care. A quintuple aim evaluation framework with indicators assessing clients’ and providers’ experiences, health outcomes, utilization and equity was co-developed.Highlights or Results or Key Findings: The program was launched in November 2021. Referral to the program would happen via any healthcare provider, family caregiver or self-referral. The referral would be received by a dedicated system navigator who would schedule an intake meeting with the client. In this meeting, the navigator would go with the client through an intake assessment, tablet lending agreement, explain for them how to use the tablet and navigate the apps on it including a service catalogue summarizing key online mental health and addiction self help materials and low barrier virtual care services available in the community. All tablets come with complimentary internet access so clients do not have to worry about paying for internet or use public Wi-Fi that can compromise their privacy. Whenever clients need help using the tablet or navigating services, they can reach out to the system navigator who provides ongoing support over the duration of the program.Conclusion: Improving Access to Mental Health and Addictions Services for marginalized populations requires planning innovative approaches. Ideally, these approaches are co-designed with all stakeholders, tailored to the community needs and meet clients where they are at. These innovative approaches have the potential to fill a critical gap in many healthcare systems.Implications for applicability/transferability, sustainability, and limitations: By describing the design and implementation of this innovative program alongside the results of evaluating its inaugural phase, we are proposing a model of care that can be transferred to other integrated care networks that aim at enhancing access to mental health and addiction services for marginalized populations. |
