Carewest Operational Stress Injury Clinic Telemental Health Outreach

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Carewest Operational Stress Injury Clinic
Telemental Health Outreach

• Laura Caron, Project Coordinator
• Carewest OSI Clinic
• Maureen Wass
• Research and Evaluation Coordinator
• Telemental Health Service, AMHB

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Project Partners

• Carewest Operational Stress Injury (OSI) Clinic
• Department of Veterans Affairs, Canada (Mental
  Health Policy Directorate)
• Calgary Health Region Telehealth
• Telemental Health Service (TMH) of the Alberta
  Mental Health Board

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OSI Defined

• Operational Stress Injury (OSI) is a
  non-stigmatizing term adopted by Veterans Affairs
  Canada, the Canadian Forces and the Royal
  Canadian Mounted police to describe psychological
  difficulties resulting from military and police
  operations.
• It includes diagnosable psychiatric conditions
  and psychological problems

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Common Diagnoses

• Post Traumatic Stress Disorder
• Chronic Pain
• Depression
• Substance Abuse

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Nature of the Project

• To increase access to specialized services that
  comply with the best practice standards in the
  delivery of psychological and psychiatric care of
  Veterans with service related mental health
  conditions.

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The Project Target Group

• Canadian Forces Veterans and their families who
  require assessment and ongoing treatment of
  mental health conditions related to their
  military service
• Residing in rural communities throughout Alberta

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Project Objectives

• establish and evaluate the delivery of mental
  health services to Veterans using secure
  one-to-one videoconferencing
• develop procedures which integrate telemental
  health into the OSI Service delivery model and
  allow for ongoing sustainability of the project
  achievements

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Project Deliverables

• 100 telemental health service events
• 20 unique clients
• 80 client satisfaction
• Satisfaction of OSI Clinic staff
• Stakeholder satisfaction
• Reduced or avoided client travel

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Midterm Progress

• 10 unique clients have received service
• 50 service events have occurred
• High satisfaction rating
• Substantial reduction in client travel
• Successful integration of telemental health into
  existing practice
• Procedures developed to ensure sustainability

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Demographics of OSI Clients Served by TMH

• 90 male
• 70 under the age of 60
• Mental Health Service Utilization One Year Prior
  to Admission only 50

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Client Satisfaction (N29)
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Clinician Satisfaction (N 44)
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Hours/Distance Avoided

• Total 19,105.40 km and 197.36 hours of travel
  have been avoided by receiving service via TMH
  versus attending the clinic
• Note All kilometers and hours are calculated
  based on hypothetical round trip from the
  clients home to OSI clinic and to the far site.

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Clinical Services via TMH

• Assessment for Client Disability/treatment
• Individual Psychotherapy (26/43 sessions)
• Couples counseling
• Psychometric testing
• Documentation review
• Psychiatric follow-up appointments
• Medication Management

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Challenges and Barriers

• Comfort level with the technology
• Decreased level of intimacy between clients and
  clinician
• Decreased ability to complete tasks to an
  acceptable standard of care (e.g.. obtaining
  blood pressures and weight when prescribing
  medications)
• Concerns regarding initiating therapeutic
  relationship between client and clinician

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Lessons Learned

• Increased access
• Efficiency
• Appropriateness/Acceptability
• Effectiveness
• Safety

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Project Significance

• The outcomes and lessons learned that result from
  this pilot project will inform a national
  strategy that aims to remove barriers Veterans
  experience when attempting to gain access to
  required health care services.

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Next Steps

• Continued use of videoconferencing to increase
  access to clinical services
• Continued investigation of scope of services that
  can be offered via TMH
• Ongoing evaluation of client, clinician and
  stakeholder satisfaction
• Refining procedures
• Dissemination of project learning
• Ensure sustainability

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For further information contact

• Laura Caron RPNNurse Clinician/Telehealth
  Coordinator
• Carewest Operational Stress Injury
  Clinic(403) 216-9865laura.caron_at_calgaryhealthreg
  ion.ca
• Maureen Wass
• Research and Evaluation Coordinator
• Telemental Health Service, AMHB
• [phone]