In a time of social distancing, mental health services must move online

At a time when mental health and addiction services may be needed most, the Nova Scotia Health Authority is having to find new ways to deliver that help.

Much of the health authority's in-person programming is suspended due to the COVID-19 pandemic response, which means relying more heavily on telephone and online resources.

"I think everybody would understand the degree of stress that everybody is under," Dr. Andrew Harris, the authority's senior medical director for mental health and addictions, told CBC's Information Morning Cape Breton.

"And particularly vulnerable are those people currently suffering from mental health problems. So our main goal is to provide service through this."

Nova Scotia now has 51 reported cases of the virus. Officials have ordered everything from bars to playgrounds to close, and have instituted strict measures including social distancing and self-isolation protocols.

Harris stressed that crisis services will continue to operate as usual.

But many non-crisis programs are on hold. They include:

• All group-based programs, group therapies/treatments and community outreach visits.
• Non-urgent home visits; adolescent outreach services (including CaperBase Outreach Services) and Schools Plus, offered in various schools across the province.
• New Hope Club in New Glasgow, Crossroads Clubhouse in Sydney, Beacon Program in Kentville, and Connections Dartmouth, Halifax and Sackville.
• Borderline personality disorder treatment program in Dartmouth, and mental health day-treatment program in Halifax.
• Addictions day-treatment/wellness programming at Strait Richmond Hospital in Cleveland and at Cape Breton Regional Hospital in Sydney.
• Driving while impaired and smoking/tobacco/nicotine cessation programming.

Conquering anxiety

In the meantime, the health authority said it continues to be committed to responding to people with a high quality of care, said Samantha Hodder, senior director of mental health and addictions programs.

"We have moved toward offering primarily our one-to-one therapies and treatments utilizing tele-mental health, which is either phone or through virtual care when it's available," she said.

One such resource is a new online program designed to help adults overcome symptoms of anxiety and depression. The health authority has accelerated the launch of ICAN (Conquer Anxiety and Nervousness), which is offered through the Strongest Families Institute, a charity that provides mental health services to adults and families.

The eight-week program combines online skill demonstration videos with weekly telephone support.

"Our trained coaches support people in their homes at times convenient to them," said Dr. Patricia Pottie, president of the institute. "We work through these life skills, implementing them, and customizing them to meet the specific needs of the people that we're helping."

People 18 years and older who are experiencing significant anxiety can self-refer for the ICAN program online, she said.

'There'll be a lot to do during the crisis'

While emergency rooms have seen a small drop in the number of people with acute mental illness (likely due to social distancing efforts) crisis lines and the provincial intake service are operating, said Harris.

"We're trying to reallocate some resource to bolster those, making sure that we can get back to people in a timely way when they are in crisis," he said.

Harris anticipates an increased demand for mental health supports as the pandemic evolves.

"Some people in certain situations may actually experience the trauma in a way that leads them to a post-traumatic sort of situation. So there'll be a lot to do during the crisis, but also a fair bit to do as a consequence of the crisis," he said.

Over the coming days and weeks, the health authority will make additional online tools and therapies available for patients and families, said Hodder. Tele-mental health work with outpatient clinicians will continue.

"We've had to change the way we do business," said Harris. "But the virtual methods that we will be moving to are well tried and have been shown to be equally as effective as face-to-face measures."

The provincial Mental Health Crisis Line is available 24/7 for anyone who is experiencing a mental health or addictions crisis, or for someone who is concerned about them. It is toll-free at 1-888-429-8167.