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Exploring mobile software to better support youth mental health
Mental health services are rooted in relationships. When it comes to delivery, and specifically community-based and outpatient services, connection and communication between the individual and care provider need to be the focus.
When we think of youth in particular, technology is a regular form of communication for them.
“Our research team at Lawson is looking at how technology can assist in the delivery of mental health services for youth in a way that still supports the important components of treatment,” says Dr. Cheryl Forchuk, Assistant Scientific Director at Lawson. “In our work with youth, they’ve talked about wanting the technology they are already using integrated into their care.”
In the health care sector, the use of technology needs to be carefully tested and implemented, to ensure it is not only meeting the needs of those using it but also that it complies with the standards for privacy and security.
On February 7, 2019, Lawson Health Research Institute and InputHealth welcomed community members and stakeholders for the announcement of a new health care technology solution that is being researched by Dr. Forchuk and her team, with generous contributions from the provincial government.
TELEPROM-Y is a mobile-based TELEMedicine and Patient-Reported Outcome Measurement Youth study aiming to improve access to specialized services and reduce inpatient mental health admissions for youth. The initiative is one of 11 that received funding from Ontario’s second round of the Health Technologies Fund (HTF), a program of the Ontario Ministry of Health and Long-Term Care administered by Ontario Centres of Excellence.
TELEPROM-Y received $395,109 in provincial funding with $494,630 in matching contributions for a total investment of $889,739.
InputHealth’s CEO Damon Ramsay and Chief Medical Officer Puneet Seth, along with Jennifer Moles from the Ontario Centres of Excellence were on hand with Dr. Cheryl Forchuk to hear more about how the technology and funding will help support youth. Project contributors Woodstock General Hospital and Youth Opportunities Unlimited (Y.O.U.) also attended the announcement.
This project is taking a unique approach to creating connections with youth. Researchers will use an electronic Collaborative Health Record (CHR) developed by InputHealth, an innovative Canadian digital health software company, which allows for secure communication. Patients will have access to virtual visits, prompts and reminders, text or email messages, and educational materials delivered by phone.
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InputHealth's Puneet Seth and Damon Ramsay provided a demonstration of the software being used in the study.
Dr. Forchuk explains that “the study is focusing on an important transitional period. The majority of mental illnesses occur between the ages of 16 to 25 years old.” The research team is recruiting participants between these ages who have symptoms of anxiety and/or depression, and are receiving outpatient services from a hospital-based mental health care program at London Health Sciences Centre, St. Joseph’s Health Care London and Woodstock General Hospital, or community-based services from partner organizations.
A key aspect is to assess whether the technology is effective and efficient, while acceptable to both the staff and youth using the app.
“Careful evaluation is essential to make sure we are doing the right things for the people we serve,” adds Dr. Forchuk, who is also the Beryl and Richard Ivey Research Chair in Aging, Mental Health, Rehabilitation and Recovery.
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The mobile software will also be evaluated on its ability to improve the ease of access to care; monitor mood and behaviour changes for earlier intervention; enhance information exchange between patient and health care provider; and, support the overall experience for the youth.
Other project contributors include St. Michael’s Hospital Centre for Excellence in Economic Analysis Research, The Forge (McMaster University), Thunder Bay Regional Health Sciences Centre and Western University.
The study extends previous findings from the Youth Mental Health Engagement Network study (Y-MHEN), which developed, delivered and evaluated an interactive web-based personal health record, the Lawson SMART Record (LSR), to assist mental health patients in managing their care and connecting with care providers.
The Health Technologies Fund is a program of the Ontario Ministry of Health and Long-term Care and is administered by the Ontario Centres of Excellence. Program supports the development of made in Ontario health technologies by accelerating evaluating, procurement, adoption and diffusion within the Ontario health system.
Scientist
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Family environment influences emotional well-being of children with epilepsy
LONDON, ON – Children with epilepsy have a higher risk of developing emotional and behavioural disorders, including depression, anxiety and poor self-esteem, yet it has been difficult for researchers to pinpoint why this occurs. In a new study, researchers at Children’s Health Research Institute (CHRI), a program of Lawson Health Research Institute, have found that family environment influences the relationship between clinical characteristics of epilepsy at diagnosis and children's emotional well-being two years later.
Emotional well-being is a broad measure of emotional functioning that includes multiple aspects of mental health, such as depression, anxiety, anger, happiness, or confidence. The researchers studied a group of children aged four to 12 with new-onset epilepsy, investigating factors at the time of diagnosis and their impact on the emotional well-being of the children two years later. The study focused on the role of the family environment, an area that has not been well-studied.
Results showed that clinical factors related directly to the children’s epilepsy, such as the type of epilepsy and frequency of seizures, were not associated with emotional well-being. Instead, several family characteristics, including family stresses, functioning and resources, were strongly associated with emotional well-being.
“This is important for how we think about patient care,” says Dr. Kathy Speechley, principal investigator on the study, Chair of the Children’s Health & Therapeutics Division at CHRI and a professor at Western University’s Schulich School of Medicine & Dentistry. “Treating the physical symptoms of chronic disease alone often does not result in significant improvements in quality of life. We need to examine other avenues for care.”
“From the time of diagnosis forward, it’s important for the health care team to take a broader, family-centred approach beyond controlling a child’s seizures. This means developing a better understanding of what day-to-day life is like for families living with childhood epilepsy, including their stressors, how well they are functioning and the resources they have to aid their adaptation to stressful life events,” says Dr. Shane Goodwin, first author on the study, which was conducted while he was a PhD candidate in the Department of Epidemiology & Biostatistics at Schulich Medicine & Dentistry and a trainee at CHRI. He is currently a postdoctoral fellow at the University of Waterloo.
One example of a family-centered approach to care the researchers point to is referring patients and their families to support programs, such as Clinic to Community in Southwestern Ontario. The Clinic to Community program is funded by the Ontario Brain Institute, and provides information about epilepsy and a network of support services.
The researchers completed the study using data from the Health-Related Quality of Life in Children with Epilepsy Study (HERQULES), a multicenter prospective cohort study based in Children’s Hospital at London Health Sciences Centre.
They will now continue to analyze data from the same group of patients as they progress toward adulthood and will develop intervention trials aimed at supporting families’ successful adaptation to life with epilepsy.
The study received funding from the Canadian Institutes of Health Research and the Children’s Health Foundation.
Drs. Kathy Speechley and Shane Goodwin will be available for interviews and photos on Wednesday, January 24 between 1:30 p.m. and 5:00 p.m.
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About Lawson Health Research Institute
Lawson Health Research Institute is one of Canada’s top hospital-based research institutes, tackling the most pressing challenges in health care. As the research institute of London Health Sciences Centre and St. Joseph’s Health Care London, our innovation happens where care is delivered. Lawson research teams are at the leading-edge of science with the goal of improving health and the delivery of care for patients. Working in partnership with Western University, our researchers are encouraged to pursue their curiosity, collaborate often and share their discoveries widely. Research conducted through Lawson makes a difference in the lives of patients, families and communities around the world. To learn more, visit www.lawsonresearch.ca.
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Celine Zadorsky
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T: 519-685-8500 ext. 73502
Celine.zadorsky@lhsc.on.ca
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