What kind of support is available online while I wait to see a psychiatrist?


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  1. Kim Moran

    Big White Wall is a new tool that is easily accessible for those with mild mental health issues. So is BounceBack (digital and telephone) where the evidence shows it drives strong outcomes for adults with mild to moderate depression. These new, easily accessible mental health services will help a number of people. However, I think we have an opportunity to have a more nuanced conversation about mental health services with the question that was posed at the beginning of this article, the patient is waiting for a psychiatrist referred by the family doctor.

    If the patient actually needs a psychiatrist–and if we agree that psychiatric services should be restricted to those with significant functional problems–then Big White Wall is not the right intervention, as it is targeted to those with mild mental health issues.

    Of course, not everyone with a mental health issue needs a psychiatrist. Many people can be more appropriately treated by a mental health professional (psychologist, social worker, psychotherapist). Using a stepped care approach to mental health issues, a patient should see the professional with the training that matches their needs. Psychiatrists are a precious resource in our mental healthcare system. We need to ensure they see those clients that are most in need. In addition, in a publicly funded system, we need to spend our resources wisely which includes better matching needs to resources.

    Digital tools that are matched to the needs of the patients are a good addition to publicly funded mental health services. However, matching the needs of patients to the right professional (provided traditionally or digitally) along with timely access to that professional is how we will best use limited public dollars.

    • Paul Taylor

      Hello Kim:

      For the record, I think it’s worth mentioning that a pilot study was carried in Ontario before OTN contracted a British company to provide the BWW service province wide.
      “In our pilot, we actually used it when people were on a wait list to see a psychiatrist,” Dr. Ed Brown said in a telephone interview.
      Patients were told, “while you are waiting, this (BWW) might be something that could help you,” Dr. Brown explained.
      The pilot showed that certain patients did benefit from using BWW.
      Dr. Brown noted it’s not for everyone, but it certainly can be helpful to some people as they wait for access to other mental-health services.
      If a person’s condition get worse, regardless of using digital aids, then that individual needs to be “assessed by a health-care professional,” says Dr. Carolyn Boulos, a youth psychiatrist at Sunnybrook.

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