Dr. Diane McIntosh, Chenny Xia, others in panel on Mental Healthcare at 2023 Healthcare Summit

Dr. Diane McIntosh, Chenny Xia, others in panel on Mental Healthcare at 2023 Healthcare Summit

um I hope you’re all enjoying this amazing conference it’s always a highlight every year I am uh my name is Wendy gerbert and I’m the president and CEO of Life Sciences BC and I’m thrilled to be here and I’m actually going to let my panelists introduce themselves so I’m going to turn first to you Michelle can you say a few words about yourself and you should have a mic somewhere oh yeah I do checking can you hear us can you hear me now not quite here we go so Michelle rodri I have the privilege of being the CEO of the Mental Health commission of Canada we are a nonprofit organization that runs arms SL from Health Canada we work with provinces and territories with practitioners to really improve access to ment Health Services glad to be here today okay make sure oh mine’s working I want to say Mental Health commission of Canada does some incredible work so I’m honored to be here with the two of you two of you Dian Macintosh I’m a psychiatrist I was a pharmacist before medical school so go pharmacist and uh right now I’m working on an Innovative technology that is called rabits hi I’m I’m shenny I’m the co-founder in CE of got care we are a network of 30,000 community healthcare workers across the country and we collaborate with primary care hospital distress teams as well as Community Care Providers to really address low Acuity needs right in the home setting hi and I’m Dr Matthew Chow I’m a psychiatrist and chief mental health officer at Tellis Health Tellis health is um Canada’s largest digital Health company and one of the world’s largest providers of mental health and well-being services with about something like 100,000 clinicians um covering uh more than 60 million people worldwide okay thank you thank you all for joining us as you can see we have an amazing panel here who have a deep breath of experience on this topic I I think you can’t go a day without talking about mental health right now whether it’s in the news amongst co-workers employers individual family members um and it’s a big gigantic topic that we have 57 minutes to talk about so obviously we’re going to be scratching the surface and um um so what we wanted to start with was just what is the scope of the issue and and how did we get here and I I want to start with you SE thank you for that um so how are we doing you here yeah how are we doing as uh a country as provinces and as communities uh so let’s start with um some of the more serious mental heal problems and illnesses uh recent stat scan data demonstrated that that the percentage of Canadians 15 years and older who met the diagnostic criteria for a major depressive disorder bipolar disorder and generalized anxiety has increased and double as a matter of fact over the last 10 years that was from 2012 to 2022 and with Co it only has Amplified the situation now if you’re looking at more mod mental health problems again we’ve tracked a great increase unfortunately over the pandemic period and uh most recently we have felt the impact of High um challenges within our economy so people are really struggling uh struggling to house themselves properly struggling to meet ends and that has translated into serious mental health problems unfortunately one and three are able to access Services uh it’s a bit higher for people who are able to access medication and the fact that we don’t have a real system in Canada means that psychotherapies are not available to a great deal of folks so uh on one side uh there’s a large increase in demand and on the service side we’re simply not do the challenge and to complicate elements is we have three block prayers uh who are very involved in this space private companies who are doing great work such as Tellis and other providers uh there’s a large Cadre of community organization who provide superb Services often they rely on philanthropy to be able to continue to offer those services and then we have the publicly uh paid services that are struggling with um a system of care that that is perhaps not meeting the needs of patients I’ll stop there okay thanks Matt maybe I’m going to let you uh jump in on this to the how did we how did we get here and what’s the scope of the problem yeah so to add to the the scoping issue know Tellis Health um produces a mental health index every month what we’ve seen is throughout the pandemic a persistently elevated level of mental health risk um in Canada in the US and globally and that elevated mental health risk has actually persisted um throughout the pandemic into into this period that we’re now I don’t want to call it post pandemic but something that’s not the acute phase of the pandemic um that that elevated mental health risk has continued where in Canada you know at least a third of folks would be considered an elevated or high mental health risk and that’s among all um employees in Canada uh recently we partnered with a large Global insurer to look at Asia the asiia Pacific region and what we found that was 40% of people working in Asia are at very high mental health risk um which again is incredibly elevated um compared to to pre-pandemic times so so this is a Canadian phenomenon it is also an international phenomenon and we’re seeing other other countries and regions that typically didn’t really think about mental health as an issue now I’m starting to to see that um and to bring it closer to home I was just sitting next door a session about Pharmacy and I was just about to get up to ask a question and I actually had to stop because someone texted me with an acute mental health issue that that needed my my attention and that happens every day continuously um because there is such a disconnected gap between the demand for mental health services and actual service um Service uh delivery you know I see a number of of um Family Medicine and Primary Care colleagues in the audience today my sister is a family physician and she tells me that the majority of her practice now is mental health related you know as a family doctor in Calgary um and then a a pediatric colleague that I ran into recently at a Gala told me that 95% of her work 95% of her work as a general pediatrician in the community in Vancouver is mental health work for which she was not trained um but she’s doing a valiant job but that that you know speaks to to the state of mental health in in Canada today thank you and as you said quite a fragmented system so even to navigate it when you’re even within the system is is quite challenging Diane maybe you could um jump in with your experiences in the scope of the problem as well and maybe I’ll get a little more granular than what we’ve heard right now so one of the major challenges we face right now where we do have an increase and it is well documented in uh anxiety and depression but there is a lot of misdiagnosis going on and one is over diagnosing what is normal anxiety also the normal or not misdiagnosing of personality disorders which uh if if you want want to see me with a bee in my Bonnet that’s one thing that really drives me crazy it’s easy to just label someone as a personality disorder rather than actually figuring out what is underlying that because once you’re labeled that way then you’re seen as as different and uh often you don’t receive care the other side of the misdiagnosis is truly missing bipolar disorder which is missed about 95% of the time by psychiatrists by family practitioners All Care Providers um ADHD is often misdiagnosed and and they ride together frequently so we have a a an education aspect there and a lack of training to Matt already alluded to and if you don’t have the training and conf you don’t have the conf confidence to make those choices to pick the right treatments and you’re less likely to personalize treatment choices there is lack of psychiatric guidance for Primary Care uh practitioners and we don’t have enough Primary Care practitioners who practices are filled with psychiatric challenges and so that is that is a major challenge there’s also a lack of knowledge and I did hear from someone I can’t remember who and their their work is on trying to um make all of the Community Resources accessible to clinicians because often if I’m trying to find lowcost or no cost care from a psychotherapeutic perspective I can’t find it and there are resources out there but it’s really hard to find them and finally my other B in my Bonnet is about treatment inqu Equity that we have health Canada um approved choices often approved many years before by the FDA with mountains of data that can take years or never before we have access to them so only people who have um private plans or have a whack of dough in their pockets are able to access some of these newer and often better tolerated treatments thank you Diane that’s a lot to unpack which we will through the um through the discussion chamie maybe you can weigh in yeah sure I think agree with all my colleagues here and the one thing I would add is really just diving into the client experience a bit more um and the best way I can do this is just through a story so uh before Co I would say about 70% of the clients we saw had an underlying Mental Health Challenge that they were dealing with now it’s 100% 100% across the country and we hear day-to-day challenges around their just this almost this learned helplessness um and I have one person in mind these initials are Aro um who missed in six months missed all of his special appointments specialist appointments he missed all of them he just thought what’s the point and I feel this increasing sentiment across clients across the country that is really really concerning because the moment that people lose this agency and this sense of their ability to advocate for themselves how are they going to navigate the system right like that is really the thing we have to really protect and with this person I’m thinking of I remember when we took him on into our program um we have an on our intake form one of the questions we ask is how many hours a day do you spend with other people and he puts zero and when our nurse talked him a bit more about what that meant he said her name is Laura he said Laura I’m so lonely it hurts in every part of my body and that just really really resonated with us in terms of we just truly truly lack the ability to even see clients for that you have that feeling thank you Diane I just want to add because as a psychiatrist it seems like like I’m always about drugs and I’m not that’s right uh Psychotherapy has an impact on Gene product we know there are many therapies exercise Mediterranean diet but one of the things we don’t think about enough is the power of connectedness the social connection that people make having really a massive impact on on individuals and that that social isolation that worsened during the pandemic which I think is a big reason why for young people at a time time when they’re they are naturally a little more socially anxious which is why they drink when they go out to get a little bit lubricated right and they were so isolated for so long that I I think really our young people are are finding it very challenging so I’m glad you brought that part up club houses have a lot of data they’re inexpensive to run for severe mental illness creating a clubhouse environment it doesn’t have to be that there are Physicians or Nur nurses they are running the whole thing we need to have a wraparound kind of care that involves all kinds of different providers and I think you know with that with the young people with social is isolation I know in my personal experience what also happened is there was a lot of self- diagnosis a very significant diagnosis when you were talking about personality disorders and and things so you have people coming in and believe that they actually know what their condition is when you know as I’ve said to my own kids well best last I checked you know some people went to school for 10 years to come up with that analysis and diagnosis and it’s super challenging because they really believe it and latch on to those labels Michelle you want to say so so perhaps two things actually um true that disrupting traditional support networks uh isolated had a huge impact during the pandemic and in many ways uh unfortunate that some people are still very much isolating uh today but we need to remember that it affected people differently young women particularly were the most affective particularly between the age of 20 15 to 25 so youth we need to pay particular attention to uh women with young children at home who often had to also uh bear the responsibility of Elder Care have really been overly affected by the pandemic and we’ve seen unfortunately increased usage of of canab is and alcohol within that group so I think we really need to also be mindful that it has affected people differently and certainly uh people with severe uh mental health problems uh felt the isolation felt the disconnect more pronounced and it has affected them severely we at the mental Commission of Canada are quite um in an amazing uh situation where we rely on that lived expertise to inform our work and it was pretty brutal hearing from them in terms of their experience for that period Matt did you want to add to that so my sub specialty training is in child and youth Psychiatry so I’ve I’ve been seeing teens and Families my entire career what you just said you know resonates so strongly with me you know what we’ve certainly learned in throughout the pandemic and and in this current period is that there is a Mis match between the way that the we not just the volume and the amount and the accessibility but the method the way in which we deliver service to people that have mental health and well-being challenges and what they actually want you know and to illustrate this point you know there’s a young woman I recently met who you know this was their experience of getting mental health help you know they were they were experiencing you know quite what I would I say is clinical depression two months to get a visit with their primary care clinician so they waited two months for that then to get a ref referral to a psychiatrist 1 and A2 years wait this is Canada in 2023 um and of course that makes absolutely no sense but I don’t want to just be a downer about that here’s an alternate you know story which is also a true story similar person needs mental health help they work at you know a big company in Canada they able to access support immediately through text M messaging through their their benefits program um start you know working with with a coach the text based coach um when they need in-person counseling they’re able to actually come down to an office and have in-person counseling because that was their preference was you know this is a younger person but you can cannot always assume that a young person wants everything digital sometimes they want in person as well they’re able to come in in for inperson counseling and then they were also able to access navigation support PA navigation support because our our system is very f uted navigation support to help them get to the services that they need now that navigation doesn’t magically make the weights disappear there’s still a lot of waiting to be done but at least there’s somebody that’s on that Journey with them rather than just you know here’s a letter from an office that says your appointments a year and a half from now and you have no idea what what what’s going to happen between now and a year year and a half from now and um you know thank you for bringing that up because I think we’ve framed the problem and my guess is if I asked every single person in this room they probably have a personal experience either their own or a family member right now that has been going through this whether it’s a youth somebody you know our age assuming we’re all somewhat in the same age rocket and um or you know senior members so I think we we’ve framed the problem and sort of how we got here which essentially um was already an issue before probably not talked about enough enough and Co brought it to the surface so what has been the silver lining of where we are because there is a lot of focus on Mental Health today and Diane maybe you want to kick that off I started because of a change in my practice to see my patients virtually years before the pandemic and I was terrified to be honest I thought the people wouldn’t like it I wasn’t sure but I knew that I had to do things differently and I was shocked at how much they loved seeing me virtually because they didn’t have to pay for child care they didn’t have to leave work I saw people in you know Starbucks literally saw someone in a Starbucks bathroom I have seen policemen and squad cars wherever you need to be seing so to me it democratized medicine and you know we’ve obviously through the pandemic we had to be able to see people virtually so I think a silver lining is that we have pushed people to look at medicine differently because even within the first few months of pandemic I was on an advisory board and some of my colleagues were saying you can’t see a psychiatric patient the first time virtually well what if they live somewhere where there is none you we have to change and so I think our big job here is to support Primary Care practitioners where they are to be able to support patients where they are because we Matt and I should never see a patient with depression as an early depression this is not where we should be depression should be cared for by Primary Care practitioners who have the confidence to be able to take care of those patients if they’re running into challenges hey that’s what we’re here for is those next steps and next steps but we should not be seeing most of the people that we end up seeing that’s a failure in the system Michelle thank you for raising that and um for clearly outlining that issue and that’s something that is um a be in my bana we need to provide the right level of care to the individuals in a Ely fion and that’s culturally appropriate and what we need by that is if a pure support is what I need if ental Health Solution that really supports me is what I need then that’s what I should get if it’s a one session that I need I should access it today if that’s what I need and then you don’t and then you escalate and there are many step care models uh out there we’ve validated one that’s called Step care .0 it has reduced weight times in those Community clinics by 68 to 79% including most recently in the Northwest Territories It’s Not the Only Solution out there but it’s a clear example that you can move up or down the steps depending on your needs and it’s so important to liberate those uh key resources to manage the most complex cases and that’s where I I think our system is failing is we’re not providing care at the right level and then jamming uh experts with uh cases that should not be dealt by them so I think that’s a key element emental Health virtual care is a key way to access uh and increase improve access not for everyone I think you’re quite right to raise that but for many including the otherly by the way who are much more technology savvy than we give them credit for well they became that way during Co they didn’t have their children coming over and figuring out their remotes for them anymore so um Chan maybe you want to talk a little bit about this because you uh your organization plays a unique role and how you interact with people that is a little bit outside of the healthare system correct yeah for sure so so uh we’re a social Enterprise by the way and uh we uh we purposely stay outside of the way of the traditional contracts because we believe that that’s part of the reason why we have this Silo communication this inability to collaborate so we’re like hey we’re just going to go on our little bubble do it and then you can point to it and say hey look we’re doing it let’s do more of it that’s that’s kind of why we exist and and so um uh I’ll give an example actually a project that we’re delivering in collaboration with tell uself as well uh with the Hospital in Ontario where we’re actually seeing uh clients um in their own homes where we’re providing kind of like bringing back house calls in a in a more I would say economical way uh we’re repairing them uh with virtual care um enabling uh their virtual care appointments uh and also just ensuring that the person who they’re interacting with on that day-to-day basis is an upskilled community care worker who has an ability to help them navigate their daily life around their mental health concerns and and that’s really I I I think a huge G that we see a lot the times it’s like okay great you see a specialist you see you know your doctor but what about the in between what about in between your appointments what do you do then um and so that’s where we’ve seen a lot of success uh in particular we um you know just the example I gave earlier around that that client who missed his appointments just after even being 3 weeks into the program um he had a 95% adherence to all of his appointments afterwards like just really I I find that what a lot of people need is that reconnection um piece that they’ve been really really missing um and then the last thing I’ll add as well is that there’s this uh really important role for us to think about in terms of how do we responsibly share information and time of information um right now it’s really dependent largely on the client or their family caregiver to do all that information sharing and that’s just not always possible um and I think that that leads us to a great Point um regarding um Innovation and technology so I’ve often heard from experts there are so many articles written about how Mental Health Care is actually well positioned to leverage digital tools and Technology um and as we look ahead we know we have an overburden system so we don’t need to dive deep into that and so thinking about what is actually you know as we have a fragmented Mental Health Care system as well we need to innovate and digital health and Technology seems to be always looked at as a solution for mental health so Matt maybe you can kick us off to talk about what type of innovation you see has been successful and you know and where you see it going maybe first I’ll I’ll offer a point of clarify ification about what I think Innovation is not so digital Innovation mental Healthcare is not simply taking what Diana and I do and putting it online that that is not the same as Innovation and so in other words digital Health Innovation is does not equal tele medicine or telea health digital Health Innovation is a lot more than that it’s actually a lot more about empowering individuals families communities to see their own data to know more about themselves to know more about their resp factors and to make healthier decisions and to enlist the support of professionals that could include people like myself um to to support their their their best health outcomes you know and some of the concrete ways that we’re seeing this throughout you know through through this period are um an expansion of employer supports for example um an expansion of what mental health care means and so Mental Health Care has traditionally meant different types of doctors psychology doctors psychiatry doctors family doctors but now mental healthare digitally online also means peer support it means text messaging it means chat it means engaging with um special interest groups in your in in your employment space um it means using wearable data to learn more about your health habits and how they can be um benefiting or acting as a detriment against against your health it means creating uh digital Health Innovation means increasing access to support so that rather than being gated behind a provider who’s already overburdened as we’ve heard in in other discussions today that you’re able to access instant support on your mobile device from wherever you are um which is a huge Boom for Health Equity because it means that no matter where you live you have access to these uh these services and I suspect increasingly you know you’ve probably heard about ai ai is going to play an increasing role in in health delivery and that’s going to be about about managing risk case finding helping connect people to appropriate resources increasing capacity of our existing resources you know so that someone like me can help 10 times as many people as I as I traditionally do know so it’s a it’s it’s all of all of these uh these these contributions from digital Health Innovation I’m glad to rais the distinction between Innovation and digitizing current practices um because there’s certainly an important role in digitizing current practices files Etc but um really being able to Leverage The Power of some of the tools that exist in an Innovative way to deliver care is is really you know the opportunity that we have ahead of us um Can I Turn to You Michelle because I’m sure you’re doing a lot of work in this area um at the Canadian Mental Health Association uh thank you for that um well said you’ve really scoped out uh what Innovation is in our space and why um it’s a space that is really proper is the efficacy of the treatment is uh there so people are getting the treatment they need for the services they need and I think that’s key let’s always bring it back to those individuals who are accessing uh the services I mentioned step care uh 2.0 earlier for those of you who have not gone to the wellness together Canada portal uh develop in the span of six weeks at the beginning of the pandemic and has grown since then stepcare solution and stepcare 2.0 is the foundation of Wellness together Canada it provides timely resources to individuals uh and can go into uh having a voice or a person at the other end to provide services so I think those elements are key and they’re a great examp example in Eastern Canada and Deputy Minister Lucas referenced uh the activities that declares we’ve worked with the Atlantic provinces they have all adapted the same kind of an approach uh they call it bridge the gap and it really Bridges the gap between your needs and the service offering so those are are key examples um I think uh organizations like uh kids he phone are doing an amazing level of work as well uh because they are leveraging technology to provide services uh I’ll give you another example is um strongest families uh provide supports to families and children and uh it is based on machine learning so it has really proven itself it’s been uh built over the last four or five years so you’re quite right AI Mach learning is right to support uh practitioners and also help inform individuals as they’re accessing Services that’s great and speaking of you know continuing down this vein of the provider so Diane maybe you can talk about you you mentioned you know going online and virtual visits and meeting people where they are but also you’re using technology and you know evolving technology as an entrepreneur maybe you can talk about how you see the of technology and digital tools um get incorporated into these practices for sure so I I have learned that medicine moves at a glacial Pace whereas the corporate world moves at lightning speed and so I I that that is why I sort of moved out of my medical world because when I became a very burned out psychiatrist I realized I how do I use what I have inside my brain what Matt has inside his brain that comes quite naturally after doing it for 25 years and help more people because in the Run of a day I can only see eight nine people whereas I know I can help a whole lot more and that was where this idea came from for Rapids which is my Innovative technology and the I idea behind this is how do I support a clinician a nurse practitioner a a fellow psychiatrist a family doctor at the point of care to make sure they’ve got the right diagnosis we miss psychiatric diagnosis 95% of the time up to 95% of the time right out of the gate we’ve got the wrong diagnosis so how do we validate a diagnosis and then provide guidance and that’s an important word it’s not recommendations you should do this it’s if you agree that we have validated this diagnosis here are some choices you want to consider with your patient and we give bioc psychosocial guidance not just here’s the drugs if they don’t need drugs if it’s not meeting that level then there’s no drugs here’s the psychotherapeutic interventions that have evidence dis support here are some alternative therapies that always work physical movement 30 minutes a day mild to moderate exercise grows brain cells and is a treatment for depression and anxiety the Mediterranean diet has empirical data to supported maybe they’re really sick and they need ECT maybe they need ketamine treatment all of these treatments outlined in a very simple to use almost like a recipe card that someone can follow bioc psychosocial Guidance with all of the why would you pick one drug over another so we personaliz to that individual it’s a female she’s already struggling with her weight I don’t want to give her a drug that causes significant weight gain I have a young man who says if you give me a drug that’s going to mess with my sexual functioning I ain’t taking it well let me tell you that’s at the bottom of the list and the ones that are least likely to impact his sexual function would be at the top of the list so we’re trying to personalize all of the treatment guidance but it always goes back to the clinician to have the conversation with the patient and come up with what works best for that individual because every brain is unique so that’s the technology that I’m working on shamie yeah I’m I’m so glad you brought up personalization because it is a huge part of what uh what allows for adherence that we see on our side um and so for example uh on our side we work with family physicians as well as our nursing team and the patient and family directly to co-create what their care plan is and often when they get to that part of our process they’re like what I I get a have to say it’s it’s crazy even just that experience alone where they you’re they feel like they’re actually truly partic you’re talking about the patient being shocked that they have said say yeah they’re they you know they’re they’re like oh wow asking me and and so just and I think part of why that’s important is that then we can use technology to in to help ensure that their own plan comes to life so for examp example and part of it is that they say hey I want to uh introduce more exercise into my life and we ensure that you know we we deliver a virtual tablet in the home uh that H’s exercise exercise regime for them if they don’t do that we then know and then we can also have someone send them a text message just to say hey how’s it going what you know basically understand why they miss that and and really just putting that person in the driver’s seat just really allows them to take so much more control over their own healthare because then they have a concern over medication they’re much more Brave and courageous to even bring up their concern as well there’s just so many spill benefits of that I just to add to that I have to beg my patients to reach out to me please tell me if you’re struggling with this cuz no no treatment will work if it’s not taken so and they don’t I didn’t want to bother you I’m like I told you to bother me I want you to tell me because the only way I can fix this is if if we talk about it and work through it but I wanted to ask Michelle because one of the concerns I have everything that is in a Rapids guidance report is rooted in science absolutely everything so I feel so confident about this because I know that there’s not a word in there that is you know pulled out of the sky or just out of my brain but one of the things I think you guys are working on is all of these technologies that are out there how do we make sure that they’re they’re safe they’re appropriate they follow gu guidelines uh empirically based thank you for that um what we’ve designed is we’ve worked with experts for the last 3 years develop a series of criteria to evaluate apps and apps is one tool in the mental health tool camp and uh we’re now at a point where we’re able to uh roll out this through a partnership with Orca which is the organization for review of care and health act at the mental health Commission in Canada we don’t try to reinvent the wheel all the time we learn from others uh in this case from UK they’ve applied this in 12 or 13 other jurisdictions and what the end result is is for a jurisdiction and this gatchan just signed on which is to create a library of validated evidence in apps that the general public can access or practitioners can uh provide to uh their patients so again there isn’t a week and I’m serious there isn’t a week when two or three people reach out to say they have created the most amazing app out there unfortunately many are well-intentioned or just a means to access funds from vulnerable people in a vulnerable moment so different differentiating between what is evidence space people can then make informed decisions about what’s safe and what works and I think that’s important in this space as well thanks for raising that well I think um you know we can’t underline the importance of the statement of it needs to be rooted in the science and in the research and that the treatment has to evolve from that because to your point especially in the world of digital Health there are a lot of apps out there um and so connecting the apps that have that empirical evidence that is going to demonstrate outcomes is important another piece of this that is all of course goes without saying that is so critical to this the topic near and dear to my heart is data integration which will be another panel so I want more of this panel into Data integration since we have only 15 minutes late left but I mean what you just talked about was you know data of how many steps have you taken data what have you eaten data around What treatments are you on and what other healthare providers are happen are involved in a person’s treatment because there could be lots of other issues going on that are Broad in the mental health of which they often are um and bringing that together and often patients don’t even have their own version of the world and then in a world where multiple providers are together that may or may not be connected and then if they don’t have a GP it’s a very overwhelming situation to navigate so I’m going to turn back to you Matt cuz I know Talis grapples with this a lot and are trying to help provide Solutions not only to healthcare professionals but also patients on on this topic yeah so I mean telis is involved in a number of areas to really you know improve mental health wellbeing outcomes one of one of the things most involved in is access providing basic access to folks so making it easy you know making it as easy as downloading an app and being able to immediately see a doctor or immediately a nurse practitioner or immediately see a mental health counselor and not gating them because we do a lot of gatekeeping in our system which I think is fair because we want to have appropriate use of resources but that’s actually a barrier to folks if you’re having trouble getting out of bed the last thing you need is another barrier um and that barrier could be as simply as simple as having to drive down to somewhere and find parking um so tell us really believes in Access and so we make it easy for people so so as easy as downloading an um another way we we make it easy is you know we make it comprehensive so we talked about how Mental Health Care is more than just you know different types of doctors so for us mental health care is about counseling and psychology and the traditional moments of mental healthare but but mental health and wellbeing is also help the financial wellbeing so we incorporate your financial help because if you’re having trouble making rent if you’re worried about saving enough for retirement that’s going to have an incredibly detrimental impact on your mental health if you’re worried about how in affordability huge huge effect especially in our young people these days um so Financial wellbeing and and we also incorporate physical wellbeing so that we’re not siloing off physical mental Financial social family wellbeing we’re actually putting it into one comprehensive you know Suite or platform so that people can access um all of these things we’re also helping people with their with their own data to have more visibility into you know their their health habits their weight um their sleeping habits uh you know we have platforms available now for people to initiate you know healthy behavioral changes um using using their own data with with you know with with privacy of course Incorporated so we’re we’re we’re involved in a lot of these elements um and then finally because our parent companies also happens to be a a telecom you know we’re also trying to make sure that everyone’s got access to broadband because that’s that’s like basically a Health Equity issue at this point right having access to broadband I’ve worked in communities where there is no internet access um that’s hard to believe now in the in the 21st century that is that’s actually a huge Health Equity issue so we’re working on making sure that people have access to wireless and Broadband so they can have access equable access um to all these services and resources thanks I’m just I’m conscious of the time and want to open it up for Q&A um quite a lineup oh we have a lineup okay we’ll start with you other panel um quavo here undergrad student but also a um a foster parent I worked in Supportive Housing and um in various roles um with indigenous populations and the kids and one in particular um a little bit of a background story um currently I’ve got a couple kids they need a psych ad they need various assessments um took a year to see a pediatrician we have to wait another three years to go through e children’s Sunny Hill um so just a question on wait time and even just between say DC and Alberta there’s different requirements for um psychologist and psychiatrist here is like me PhD Alberta and M W do right with capap or APA um so question for for Tellis and whatnot to given the weight time the cost it’s what four grand AP for a psych test will you Mr Dr Chow take on some of these vulnerable populations and kids instead say branching out to Asia I mean we can’t even fix the war at home I don’t know if I would even go outside of BC but again a question for that or you a question for mishelle too right you’re the head of the CMH CCM would you consider maybe changing some of those regulations here if Dr Lucas is still around maybe he would consider it too just the disparity between the provinces right so not sure if that’s a question or a comment or maybe B of both but yeah for the panel why don’t we let you take that one um on the concept of equity and access and wait times and I’m sure you have lots of data about it and some thoughts about how it can be addressed thank you for raising that thank you for sharing uh your experience and I will say um we also need to realize that there’s a reason why we accept today in Canada that we will put Machan on a weight list of one year or year and a half to access services for mental health services it’s called stigma and it’s it’s how we make decisions on where we will appropriate resources and what is acceptable and often we forget mental health is health I think you raised that quite appropriately so that’s the unfortunate reality at this point it is is a frustrating reality I will rly ad the Silver Lining is we’re starting to at least have conversations we know what the issue is governments um organizations Healthcare organizations are also focusing on youth mental health and providing key services but at this point they’re just not keeping up and collectively we haven’t put the resources to build that up that’s the sad that’s situation at this point and there is a Health Equity item here I’m fortunate I have access to an employment EAP program so uh we can access Services if you can’t well good luck and that’s an unfortunate no because you you did you you did directly address me and ask your question so you know you know I I empathize with your situation my daughter is on a waight list to see a specialist right now um I’ve been told it’ll take one and a half years for her to get onto that on see that person so she was referred in grade three she’ll probably be in grade six before she’s seen so I completely empathize um and and want to make that situation better and certainly the organization I work for invests heavily at home in Canada to make sure that people have access to services and for example we’re we’re supporting the primary care system in BC right now seeing of thousands of people to make sure that they have access to primary care so we’re investing in that but at the same time I also want to point out because you asked about why why Asia if people are struggling in DC why why why are we interested in Asia well if there’s if there’s something we’ve certainly learned about from co9 is that the world is interconnected and what happens beyond our borders is just as important as what happens inside our borders and we have to we have to think about the entire Global context and so there are there are places in the world world where there’s one person like me for every 10 million people where there’s zero access at all and so I think that those those people as someone that cares will help those people deserve access as well and also what we learn in Asia and Africa in the Middle East and in Europe and United States and elsewhere in the world comes back here at home as well there are there are Innovations there are different ways of caring for people and leveraging resources um that are happening in other parts of the world that we can learn from that can that we can take advantage of here in Canada and we know from you know data from for example Comm Commonwealth um fund that Canada is actually one of the poorest performing Healthcare Systems in the entire world second only to the bottom with the United States and so there are a myriad other health systems that we can learn from that are performing better than us and we take those Innovations we we we bring them back home so so there’s a reason why we’re involved globally it is also Health Equity but it’s also about bringing bringing Innovation back home and helping the folks back here thank you um I think we have to move we’ve got like 10 people that questions I’ll go to I’m sorry make it quick um separate know from what you were just saying 900 million people in Africa don’t have energy um Chris Geisler from fluid medical a question about providing mental health supports virtually so care services benefits of managing data completely agreed how do you build trust in the virtual space Diane how don’t you take that right in our core statement our beag our big hairy audacious goal is that we want to innovate Healthcare starting with mental healthcare because that’s my wheelhouse and we do that Innovation through education as well as through compassion compassion is missing in our Health Care system and so every time I engage with my patient at the po has to be compassion trying to see and meet them where they are but this is the problem that you brought brought up the stigma part stigma lives in medicine it lives in our health care System it lives in our hospitals it lives in our government decisions and you know the two areas we’re allowed to stigmatize still seem to be mental illness and obesity two areas that oh you’re obese stop eating so much exercise more we know that obesity is inflammatory illness why why are we still stigmatizing that area so for me the compassion for the individual and the education around the core of what is the Psychopathology underlying these psychiatric illnesses it is inflammation these are chronic illnesses we need to treat them because if we don’t treat them we have an aging population we will have medically ill people who have chronic psychiatric illnesses and we’re ignoring them so I I think we have to you know we we Cobble together um addiction and mental health and addiction you know our opioid crisis is all over the front page because it’s horrifying we need to stand up parents uh loved ones kids are standing up they’re they’re good at standing we all need to stand up and get this on the front page because otherwise it’s ignored and unfortunately the people who are most vulnerable who are most stigmatized are the least likely to stand up and say I’ve got bipolar I’ve got this I’ve got that and that that’s why we’re not getting the kind of response that we need so I think uh compassion and empathy is how you how you build trust through that relationship with the patient and chenie I’ll let you up just one more thing I want to build on that which we haven’t had a chance to talk about is the labor crisis but consistency like if you don’t have consistency of the providers that you’re seeing how are you supposed to build trust and given the turnover rates that we’re seeing right now that’s part of the issue um it’s it’s the it’s for us it’s the number number one thing that we come across when we when we see people for the first time they’re like how do I know that you are going to be there the next time I see you why should I even share this information with you as a result and so I think that a huge part of what we all need to focus on is how do we keep folks in these fields how do you know I like to say you don’t have to go further than Tik Tok to see healthcare workers leaving in dros um and and this is where I think we can really use technology and AI to reduce the burden of being a healthcare worker especially when it comes to administrative and documentation type tasks so that we can focus more of our time directly on interactions and we can also use technology to ensure that the worker that they just saw is also going to be the same healthcare worker that they see the best which takes us back to the importance of to chill tools and innovative ways of delivering it I think Greg how much time do we have I think we have a couple of minutes five minutes okay we have time for one more question to go back the microphone and I apologize to others that you’re not going to have the opportunity to ask your question but I know my fellow panelists will be around so please connect with them your question please yes um hello uh Hon should your student with Simon PR University um you touched a little bit on how uh the disconnect from other people and the loneliness that people felt during the pandemic um really increased their mental health concerns and their um um yeah just that and so I was uh I was wondering with the way that virtual health is going people are going to be spending more and more time online even for their health needs and that will cause a further disconnect from other people because they wouldn’t see their psychologist or the therapist in person it would all be online so it’s kind of a positive and a negative effect with virtual health and I’m wondering how we plan on navigating that situation I’m going to thank you for that question and I’m going to evolve that question to be what is it that makes you feel optimistic about as you look ahead we spent a lot of time talking about some of the challenges within the Health Care System we’ve also talked about some of the things that are critical whether they be you know formalized care or also the whole person care exercise eating social engagement potentially Therapeutics um and and seeing things ahead we know we have a lot of tools we know we have a very fragmented system so where you sit where you all uniquely sit in this um delivery platform I’d like to take your question and evolve it to be what is it that makes you feel hopeful or excited as you look ahead and we address this uh enormous yet you know treatable problem um if I can start I think the first element out of the gate is uh it’s not something that we’re dreaming about it’s here we have uh the right tools we have the technology we simply need to Ure to train practitioners so they are comfortable with providing uh virtual care and we need to perhaps um eliminate a lot of the pilot projects that we do and scale up what works so I’m really enthusiastic about that I’m enthusiastic about many people in Canada now recognizing that is a mental health crisis out there and we need to tackle it all we need to do now is bridge that gap between uh acknowledging it and taking clear action to solve the situation and in some parts of our country that’s taking place so it is uh quite enthusiastic to see that thank you Diane coming back to the science there’s a lot of data showing the power of loneliness and how it impacts people’s mental health and I think through education to your point making sure that you know I know know all of my colleagues are aware that part of my interaction with my patient is social prescribing are you going to the senior’s place that you could throw a stone and hit it it’s just down the street and there’s all kinds of places I spend a lot of my appointments talk going online with them and saying you know what carale community center is right next door and they have set things going on all day long that you can interact with there’s volunteer opportunity so that’s part of my job with my most ill patients who maybe aren’t able to work work but have other they and they are so isolated so part of it is education and what makes me most hopeful are people like you young people who really are are more and more open to talking about mental illness and I’m not speaking specifically about you but I do do know that that young people are are much more open to talking about their diagnosis to sharing what they’re experiencing and this is the way you kill stigma is by people saying yeah okay I got it now what thank you Tiana jie for me what makes me feel hopeful are all of the healthc Care Professionals who’ve left the sector that want to come back to the sector but they just want to see a little bit of change um change yeah I just said a lot of change um and uh and and really that’s that’s what we’ve been focusing on at goare is transforming the role of Community Health so that people want to work back in the sector um and the thing that always gives me hopeful is when we get a call from someone who just joined our team and says I’m excited to be a social worker again I’m excited to be a PSM again I’m like yes because it’s it until we yes you know there are lots of digital Solutions out there but we also need people to support the enablement of these digital Solutions um and and I also I also I also feel that the the um just there is that underlying empathy that we haven’t actually unlocked in every single person in this room and this entire conference that deeper level of our ability to train together uh that also gives me a lot of Hope too all right and Matt so what gives me the most optimism is that you know the private sector is just getting warmed up when it comes to getting involved in a big way in the mental health and well being physical health and Healthcare challenges in in our country and globally you know I’ve worked in the public sector for a long time and I have to admit I developed a bit of a scarcity mindset when I worked there because it always seemed like we didn’t have enough resources didn’t have enough money we’re always just triaging people putting in bandaid Solutions and that’s that’s really hard um and and joining the private sector what I realized is that there is a massive amount of investment Capital Talent social entrepreneurs like yourself really talented individuals they just raring to go to help and contribute to the solutions to these problems if only we’d be willing to let them do that so so I have a message actually to to to folks especially the public sector out there is let’s partner let’s work together to solve these challenges because together we have enough resources people Talent knoow ideas and vision um to give people the type of mental health and well-being care that they deserve thank you well I wasn’t going to ask myself the question I’m going to answer it anyway but what makes me hopeful is that we’re actually having these conversations and um yes there’s stigma but we’re breaking the stigma um and we are empowering people but we have to recognize that some of the people we’re talking about are not in the best position to empower themselves so to provide that empathy empathy to see entrepreneurs and healthare profession professionals coming together and the collaboration that we can have within the healthare system and those operating in it it’s still very fragmented and we have the opportunity to really bring it together and that that is what makes me me hopeful and um yes it’s a bit scary where we are but we also have a lot of the tools and resources and as long as we have the will and the and part of that will is to collaborate then I’m really confident that we’re going to be be able to address this problem and so with that I want to thank my panelists everybody round of applause thank you all for your uh attention again I apologize that we ran out of uh time for the questions I was given a housekeeping uh responsibility so we’re going to move directly into another concurrent keynote session unleashing the potential of data governance for data driven decision making by CIO olera in room a which I think we’re in room a um and how connecting a provincial Health System elevates care orchestration and improves access for all patients by Steven Goldsmith next door thank you very much and enjoy the rest of the [Applause] conference

Wendy Hulbert (LifeSciences BC) mediates 1 hour panel with Michel Rodgrigue (President/CEO MHCC), Dr. Diane McIntosh, Chenny Xia (CEO, Gotcare), Dr. Matthew Chow (Chief Mental Health Officer, TELUS Health) at 2023 Healthcare Summit in Vancouver, BC. Thanks to Reboot Communications for organizing the 2-day conference. The discussion was entitled, “The Power of Digital Health to Transform Mental Healthcare.” #mentalhealth #mentalhealthcare