Supporting our sector’s ongoing adoption of virtual care with evidence-based tools and resources is one of our strategic priorities. Technology has the potential to address many of Ontario’s access-to-care issues, including wait times, culture and language, stigma, geography and health literacy.

Quality guideline for virtual walk-in services

At the beginning of 2020, we assembled an advisory committee of experts to co-develop a quality guideline for virtual walk-in services in the child and youth mental health sector. The arrival of the pandemic made this work much timelier as research limitations and the rapid transition to virtual care made it challenging to plan and implement evidence-based practices and policies as quickly as they were needed. Rooted in implementation science, the guideline discusses key implementation drivers, and provides both a checklist of key steps and considerations and a list of recommended further readings.

Evaluation of virtual care

Early in the pandemic, as agencies throughout the province shifted to deliver care using a range of technologies, we set out on an evaluation project with Children’s Mental Health Ontario to learn about the process of implementing virtual care and the impacts on clients and service providers. Our goal was to understand what worked well and identify areas for improvement to help service providers continue to add or improve virtual mental health service options for the children, young people and families they serve.

Additional resources

We’re supporting the child and youth mental health sector’s ongoing efforts to plan, deliver and evaluate quality virtual care by generating relevant evidence summaries and webinars.

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Evidence summaries

Virtual group therapy (March 2021)

As organizations in Ontario’s community-based child and youth mental health sector continue to integrate virtual care options into their regular suite of services, many are excited by the opportunities presented by virtual group therapy. There are however several barriers that prevent widespread uptake, including limited research on implementation and effectiveness. This document summarizes the latest evidence on how to deliver virtual group therapy for children and young people with mental health challenges and how to deal with common challenges.

Download the PDF

Evaluating and improving e-mental health services (November 2020)

To ensure high-quality care, and to plan for longer-term implementation of e-mental health services for children and youth, agencies are encouraged to evaluate current virtual care offerings. Understanding what has worked well, challenges and how these have been addressed will enable the sector, post-pandemic, to take deliberate steps to adding virtual care options to their suite of mental health services for families. This document presents guidelines to help agencies evaluate the virtual care services they provide.

Download the PDF

Internet-based cognitive behavioural therapy (April 2020)

Internet-delivered cognitive behavioural therapy (iCBT) is a structured form of psychotherapy in which clients receive psychological support through email or online modules. The level of therapist support involved in guiding therapy, the duration, and specific program elements vary across individual programs. Overall, the evidence suggests that iCBT is an effective alternative (or complement, in some cases) to traditional in-person cognitive behavioural therapy (CBT), while addressing common access barriers associated with in-person CBT (e.g., perceived stigma, cost, geographical access in rural and remote areas, wait times).

Download the PDF

Supporting virtual teams and remote clinical supervision (April 2020)

The COVID-19 pandemic has had a significant impact on the way community-based child and youth mental health agencies provide support to families. To comply with orders of the emergency declaration in Ontario (March 17, 2020; extended on March 30, 2020) and associated efforts to promote physical distancing, many agencies are delivering professional services through virtual visits and telephone, having rapidly transitioned to using online platforms and tools that allow service providers to work from home. This sudden adjustment to a new way of working brings novel challenges for supervisors and teams.

To support our community partners during this challenging time, the Centre and Children’s Mental Health Ontario (CMHO) scanned the academic and grey literature for practical guidance for supervisors managing virtual teams. The content and resources shared in this document were not collected through an exhaustive search or systematic review, and reflect information available at the time of writing.

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E-mental health services (April 2020)

The emergence of COVID-19 in populations across the globe has had a significant impact on the delivery of face-to-face child and youth mental health services in Ontario. In order to continue to meet the needs of children, youth and families, many service-providing agencies are rapidly moving to deliver care through telecommunication technologies. To support our community partners during this challenging time, the Centre and Children’s Mental Health Ontario (CMHO) have compiled:

  • information about ongoing work our organizations are leading to support the delivery of high-quality e-mental health services for Ontario’s children and youth; and
  • links to practice guidelines, toolkits and other resources published by professional colleges, associations and institutions relevant to the delivery of e-mental health services in Ontario. 

Download the PDF

Privacy considerations for delivering e-mental health services (April 2020)

The emergence of COVID-19 in populations across the globe has had a significant impact on the delivery of face-to-face child and youth mental health services in Ontario. In order to continue to meet the needs of children, youth and families, many service-providing agencies are rapidly moving to deliver care through telecommunication technologies. To support our community partners during this challenging time, the Centre of Excellence for Child and Youth Mental Health (the Centre) and Children’s Mental Health Ontario (CMHO) have compiled:

  • a summary of privacy considerations that outline the main governing bodies and legislation that should be consulted when delivering virtual care; and
  • links to practice guidelines, toolkits and other resources published by professional colleges, associations and institutions relevant to the privacy considerations for the delivery of e-mental health services in Ontario.

Download the PDF

Webinars

Three approaches to ongoing monitoring and evaluation (March 2021)

Following our October 2020 webinar summarizing the findings of the province-wide evaluation of our sector’s transition to virtual care, this webinar features panelists sharing three different approaches to the ongoing monitoring and evaluation of virtual care in child and youth mental health. This includes a developmental evaluation and two mixed-method evaluations looking at client and caregiver perceptions, in one case, and client and staff surveys in the other.

The webinar recording is available here.

Virtual realities: Responding to complex child and youth mental health needs during a pandemic (February 2021)

Hear from clinical experts with a long history of responding to the complex mental health needs of children and young people. Learn from their experiences about applying typical risk assessment and management skills in a virtual setting and ensuring safe and equitable virtual care while encountering increasing levels of mental health problems and high-risk situations.

The webinar recording is available here.

Evaluation of virtual care (October 2020)

On October 26, 2020, we joined forces with Children’s Mental Health Ontario to present a webinar outlining a province-wide evaluation of virtual care conducted between April and September 2020. Throughout the webinar we discussed what was working well, what wasn’t and how agencies and services providers can improve virtual services going forward.

The recording is available here.

Managing high-risk situations in virtual care (June 6, 2020)

On June 6, 2020, the Centre, School Mental Health Ontario and Youth Wellness Hubs Ontario presented a webinar on High intensity virtual care as part of the Virtual Care Learning Series.

As the COVID-19 pandemic is ongoing and affecting many aspects of our lives, service providers in schools and community-based child and youth mental health settings are continuing to provide services through virtual care to support Ontario’s children, youth and families. In some instances, practitioners are encountering or are alert to high risk situations (like family violence, concerns about abuse, suicidal behavior) and are wondering about how best to manage these types of challenging scenarios virtually.

In this webinar, a panel of experienced virtual care clinicians answered questions from mental health professionals serving children, youth, and families throughout Ontario about how best to provide high intensity mental health services virtually, including a focus on:

  • Technical and practical aspects of delivering virtual care in times of crisis
  • Assessing and managing risky situations
  • Considerations for creating appropriate pathways to care that address high-risk situations
  • Clinician self-care

The recording is available here. 

Virtual care 101 for child and youth mental health (April 25, 2020)

On April 25, 2020 the Centre and School Mental Health Ontario co-hosted a webinar as an introduction to virtual mental health care delivery to child and youth mental health service providers working in community-based or school settings.

This webinar focused on responding to stakeholder questions in five key areas: getting ready to deliver virtual care; ethics, privacy and legal considerations when delivering virtual care; engaging with clients in virtual care; clinical considerations (including risk assessment); and generally increasing comfort and troubleshooting issues when delivering virtual care.

The recording is available here.