Newfoundland and Labrador Aims to ‘Bridge the gapp’ in mental health services

Combining technology with in-person support, integration and accessibility are key.

In the midst of a global public health emergency, the COVID-19 pandemic quickly demonstrated why a focus on mental health and wellbeing was more important than ever. Stress, loneliness, isolation and uncertainty impacted everyone to some degree, but affected some who live with anxiety, depression or substance use even more so.

While a large focus of the COVID-19 health response focused on ensuring the physical safety of the public to flatten the curve, when it came to e-mental health and addiction supports, thankfully Newfoundland and Labrador was ahead of the curve.

Bridge the gapp is a responsive, one-stop website offering a robust suite of programs and services for youth and adults who require mental health and addictions supports from the regional health authorities. It’s a vital component of Towards Recovery: The Mental Health and Addictions Action Plan for Newfoundland and Labrador.

Reading through notes written anonymously on the Worry Jar section of the site is gutting.

“I worry that I’ll never figure out what’s going on in my head.”

“I’m afraid that I’ll hurt myself for the first time in years now that I’m stuck in the house with my two overbearing parents for who knows how long.”

But moving to the Wall of Hope section of the site shows that togetherness brings light.

“I know it’s a tough time right now, and even people in some of the best situations are panicking. That’s okay. No matter where you come from, who your parents are, you are valid. It’s okay to be sad. But don’t let that negativity control your life.”

Face-to-face not always the best option

Travelling to appointments for some people isn’t always possible, either due to their geographic location, a lack of transportation or time, or discomfort with an in-person consultation, meaning face-to-face appointments can sometimes be more of a hindrance than help.

Several of the recommendations from Towards Recovery Action Plan are focused on enhancing mental health and addiction services. Thankfully, people can now access a full range of online supports either in person, through Doorways walk-in clinics, by telephone by calling 811 or by going online to Bridge the gapp.

In-person access has also increased via the Doorways program – rapid-access, walk-in clinics in all four health regions, which require no appointments or waitlists. 

As well, Mobile Crisis Response Teams exist in all four of the province’s health regions. Composed of peer support, clinicians and law enforcement officers who are all highly trained and work as a team, traveling to individuals who may be on the cusp of a crisis.

Preventing hospital visits and reducing reactive responses to crisis situations is key. Saving and improving lives and mental wellness is the ultimate goal.

Newfoundlanders and Labradorians have no need for Dr. Google

Byron Boyd is the Central Regional Health Authority’s e-mental health and addictions manager. He has witnessed exponential growth in the website’s use.

“Originally, Bridge the gapp was created within Eastern Health and was a place where youth could share their creative endeavours (for therapeutic reasons) – artwork, poetry, music or books they found helpful. It worked so well that it was expanded province-wide and an adult stream (of the site) was created. Since then, it has become a very premium product in terms of giving the population well-written, peer informed health information.”

 

Typing symptoms into Google isn’t necessary with Bridge the gapp.

“All of the content is written by clinicians and primary healthcare professionals who work in Newfoundland and Labrador,” says Boyd. “The content is vetted through peers or individuals with Lived Experience of mental illness and addictions. CHANNAL our provincial peer led organization helps to ensure the service continues to meet the needs of the people who are using the service.”

The Strongest Families program has had an exceptionally positive impact on families – children and youth, in particular – who are experiencing behavioural and mental health issues.

The coach-assisted program blends online material for parents and children to partake in.

“It includes homework or videos, combined with telephone coaching,” Boyd explains. “We’ve seen tremendous success in terms of resolving issues, whether it’s a five-year-old having temper tantrums or a 15-year-old with bad anxiety. We’ve seen a 90% success rate from that program. For any clinical mental health service, that is a really good number.”

The number of Bridge the gapp users has skyrocketed during the COVID-19 pandemic.

“So far for this fiscal year, we’ve had 59,256 users go through Bridge the gapp. Just to put that into perspective, for the entire 2019 fiscal year, there was just over 48,000 visitors. So just in the past five months, we’ve had a huge increase.”

Most of that can be attributed to provincial COVID-19 livestream updates, where the website was mentioned almost daily.

“Each time there was a press conference, within 15 or 20 minutes, usership would spike,” says Boyd. “And of those 59,256 users, 51,000 are new to the site. So that’ll tell you something.”

From codfish to Kiwi: NL is New Zealand notable

Niki Legge, provincial director for mental health and addictions has recently presented twice at an invitation-only event with the e-Mental Health International Collaborative (eMHIC).

Legge explains that the employment structure of e-mental health and addictions managers such as Byron Boyd in the province is something New Zealand and other countries are looking to emulate.

“We’ve begun doing things differently because of our learnings from them (New Zealand), and they are now learning from us as well,” says Legge.

“During (the beginning of) COVID-19, we already had a suite of online and telephone services, and we had options clinicians could use quickly as they needed to shift from in-person to virtual care. Byron and his counterparts had already trained practitioners in the delivery of e-health options and could onboard new ones quickly and easily. There is no other model like us in the world that has a designated focus on e-mental health at the provincial and regional level.”

New Zealand and Australia are on top of their game regarding e-mental health, explains Legge. Now they’re taking advice from this province. Newfoundland and Labrador has become a member of eMHIC. The partnership will foster collaboration and collective action to support e-mental health internationally, as well as provide opportunities for learning events, webinars, meetings and matches amongst e-mental health leaders across the world.

A brighter future

Bridge the gapp has set the stage for other provincial mental health and substance use services. Newfoundland and Labrador is not just offering online supports, it’s integrating them within its health system and introducing stepped care which helps connect individuals to the right care, at the right time closer to home.

Imagine a world where instead of spending their existence in and out of hospital emergency rooms, or in an institution, loved ones spend their days in their home community, wrapped in a personalized circle of care.

No matter the modality, whether through telephone, in person or online programs and services, through continued multi-disciplinary collaboration, integration and accessibility, and by practicing preventative versus reactive care, Newfoundland and Labrador is poised to help lead the country, and world, towards flattening a different sort of curve.