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RESEARCH SPOTLIGHT: Women’s College Hospital

Big White Wall website at Women's College Hospitals

Bringing virtual mental healthcare to Ontario

Researchers at the Women’s College Hospital (WCH) Institute for Health System Solutions and Virtual Care are testing virtual mental health care that helps patients learn how to monitor and manage their symptoms and support others with similar problems – all while remaining anonymous. This is the largest comprehensive study of an online mental health service taking place now in Canada.

A new collaboration between the Ontario Telemedicine Network and Ontario hospitals is bringing an online service called the Big White Wall to the province and evaluating its potential as a strategy in mental healthcare. The Big White Wall is a website and app developed in the United Kingdom that allows those experiencing mental health concerns to share their feelings with peers in an anonymous community monitored by trained counsellors. The service also provides articles and courses with tips about improving your mental health.

One in five Canadians experience mental illness each year. Dr. Jennifer Hensel, a psychiatrist and lead scientist on the project says that virtual mental healthcare presents us with an exceptional opportunity to help more people access support, gain knowledge and remove barriers from stigma through greater anonymity. “There are so many people with mental health problems that our system’s capacity to provide enough care to everybody just isn’t there,” says Dr. Hensel.

In fact, the researchers are primarily focusing on recruiting patients who are on wait lists to receive mental health services. The pilot will recruit 1,000 patients aged 16 and up from WCH, Ontario Shores Centre for Mental Health Sciences and Lakeridge Health. Participants will be able to use the Big White Wall service to complement existing care.

Dr. Hensel is an Innovation Fellow at the WCH Institute for Health System Solutions and Virtual Care (WIHV), which investigates new ideas to improve health outcomes, both at the individual and population level, while reducing costs across the entire healthcare system. WIHV will evaluate the results of the pilot when it concludes in June of 2017.

The evaluation will assess whether access to the Big White Wall improves mental health recovery, lowers participants’ anxiety and depression levels, reduces calls to mental health crisis lines and decreases the number of emergency department visits for issues related to mental health.

The researchers hypothesize that the service will help participants to manage their own symptoms through these online resources. Dr. Hensel, who is also a research fellow of Women’s College Research Institute, says that self-management is a promising aspect of virtual care, particularly for the majority of people who seek mental health services for mild to moderate symptoms. “Helping people learn how to self-manage their problems, build their own goals and implement strategies is really important,” she said. She added that self-management is beneficial for maintaining mental health over the long-term, for example, preventing future episodes of depression.

Dr. Hensel says that Big White Wall is just one example of the virtual services that WIHV is testing to see whether it is worthy of being scaled up across the entire healthcare system. The aim of the pilot evaluation is to understand more about the people for whom apps like Big White Wall work and why. This can inform future approaches to online mental health treatment in Ontario.


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Women’s College Hospital is one of Ontario’s 24 research hospitals that contribute to a healthier, wealthier, smarter province. Look for other RESEARCH SPOTLIGHT posts on our Healthier, Wealthier, Smarter blog or join the conversation about why health research matters for Ontario on Twitter, using the hashtag #onHWS.