Collaborative Networks: a Pragmatic and Innovative Approach to Meet the Mental Health and Addictions Care Crisis

Summary: In this highly interactive workshop, participants will learn how a unique implementation of the University of Washington AIMS Centre Collaborative Care Model (CoCM) for Mental Health and Addictions, within an interdisciplinary primary care setting, can improve access, clinical outcomes, and patient satisfaction by leveraging a population health approach, care management, and digital health technologies through creation of a network across organizations using existing resources. Background and Context: Mental health and substance use disorders are the leading cause of years lost to disability globally (Whiteford, 2013) and have significantly increased due to the impacts of the COVID-19 pandemic. Within the London-Middlesex region we are in crisis with local emergency rooms and psychiatric inpatient programs that are chronically over-capacity. London Canada is a mid-sized city within a largely rural county. Hospital based mental health services are organized between two large academic hospitals with acute services at one and tertiary care at another. There is also a small regional hospital without dedicated psychiatric services. There are several community and mental health addiction services but limited access to community psychiatry. Primary care has experienced significant challenges accessing psychiatry with wait times often over a year, and a fragmented mental health system that they find hard to navigate, with limited communication and coordination. Collaborative or integrated care has a strong research base demonstrating better short- and long-term clinical outcomes, across a variety of settings, for primary care patients with depression and anxiety, and was seen as an opportunity to improve access and care. Audience: Patient/family caregivers, clinicians, health leaders, policy makers Workshop Outline (90 minutes) Implementation and Evaluation Model (30 minutes) This workshop will introduce our unique model of collaborative mental health care which incorporates traditional collaborative care elements, a population health focus grounded in measurement-based care, the use of care manager roles, and virtual care technologies. Our model builds a virtual team with linkages between acute and tertiary care psychiatry, primary care, and community mental health and addictions creating an integrated care delivery network, within existing resources. Our methodology incorporates social innovation, and human centred design (partnering with patients/family caregivers, clinicians, and health care leaders). We have developed a framework for sustainably capturing real-world evaluation outcomes (patient/provider/program/system outcomes) that will inform future spread and scale of the model. Engagement of Participants – Living Lab (45 minutes) + Take Aways (15 minutes) The workshop will function as a living lab for participants to contribute to the development of a value proposition canvas while discussing two patient journey maps - our current state of a fragmented, difficult-to-access mental health and addiction system, and our future state of a coordinated collaborative primary mental health care network embedded within a larger stepped and staged care model. The workshop will include discussion of how this model aligns with current mental health and addiction policy within Ontario and the Ontario Health Team strategy. Participants will be asked to identify how a collaborative network approach could be used to address a population health need within their own settings and context.

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