Success Stories in Action: Our virtual world toolkit

This series from the Ontario Mental Health and Addictions Virtual Care Collaborative highlights projects or initiatives across Ontario that have helped to ensure nobody is left behind in the rapid shift to virtual mental health and addictions care in response to COVID-19. Learn more about "Success Stories in Action".

An interview with Betty-Lou Kristy

Director, Centre for Innovation in Peer Support

Support House’s Centre for Innovation in Peer Support provides wellness-based, peer-led self-help and social connections programming to community members, and support to organizations who have peer staff, through training in peer-support program implementation, capacity-building, evaluation, research, knowledge brokerage, and quality improvement.

What was the problem or challenge that your project or initiative responded to?

In March 2020, our agency had to respond to the directive from the province that we would be working from home as a result of the pandemic. Understanding there was a good chance this would be a prolonged period, we immediately got to work on our virtual curriculum to ensure that people who depend on our services weren't left without important connections in an uncertain time. We were fully running in a week and a half and built out over the next six weeks.

The birth of this toolkit was our journey to moving to a fully digital peer support service that included two different streams of virtual group support, one-to-one peer support and navigation, and a warm line in the early months to assist those with digital poverty or an inability to access virtual supports due to limited understanding of the technology they had available.

We also removed the geographic barriers that existed as a result of face-to-face service and made our virtual spaces available to anyone in the province of Ontario, to ensure individuals were able to access peer support during a time when the need for these supports would be extremely high. We increased our weekly program offerings and now facilitate 14 virtual groups per week. In the early days of the pandemic we were offering 20.

As part of this shift, we added in an additional stream of services that we did not offer in face to face settings that focused on psychosocial rehabilitation. We were able to provide this because we had a staff member whose previous work experience included this. These virtual spaces provide an opportunity to come together to discuss interesting topics and play games online with the aim of reducing isolation.

We also added in virtual mindfulness meditation and chair yoga practice to assist in developing wellness routines during the pandemic. We had trained peer staff that were certified in lripalu yoga, applied mindfulness meditation and Mindfulness Based Addictions Recovery (MBAR) that facilitated this.

Our closed wellbeing groups shifted to a low barrier registration process that could be initiated on our website or by simply calling our office which connected them to a peer navigator.  We increased our wellbeing program to have three specific focuses in the digital world, these include:

Wellbeing drop-in groups with open topic discussions:

How did your project or initiative work to reduce the digital divide?

We have two distinct streams of work at the Centre. The Direct Service stream and the Provincial, Systems & Partners stream.

Because our Provincial, Systems & Partners staff had experience working on virtual platforms, we redeployed that team to concentrate on guiding and helping the Direct Service team “pivot” to virtual. This included that team temporarily merging with Direct Service to ensure all services could have enough staff to ensure safe space and facilitation support as we built out the virtual response. Our Zoom “guru” took on the work of exploring any potential privacy issues, connecting with our privacy officer, exploring options & recommending paid Zoom Healthcare accounts. This team also had a staff member with website expertise so we were able to use her expertise to build out the Direct Service website presence and help to negotiate and mitigate any knowledge gaps. This staff member became the internal teacher/facilitator to train staff on the virtual platform. A manager that had previous work experience in Psychosocial Rehabilitation was also part of this team, so we opted to use his expertise to build out a new stream of Direct Service knowing that people were going to need a wider choice of service while negotiating the pandemic.  This is how we addressed the digital divide internally to our agency.

Externally, to the clients we serve, we also worked to narrow the digital divide. All clients/peers” directly impacted were contacted immediately and offered one-to-one telephone support in the interim. Next, we offered access to technological support both within and outside of our virtual group setting. Some individuals found using Zoom overwhelming, so we built out our facilitation team to include a group host who could assist anyone before, during, or after a virtual group. This included warm transfers into groups. In addition to this, we prerecorded a 20 minute participant video outlining the different features in Zoom. That video is now on our YouTube channel and can be used a resource. We also made our groups accessible by phone to remove the barrier that not everyone had access to a compatible device or a device at all.

Creating the warm line option and our one-on-one peer support via the phone with one of our peer navigators was helpful. We shifted all our direct service peer support group facilitator job descriptions from peer group facilitators to peer support navigators so that we could disperse the peer support caseload across the whole direct service team.

Lastly we also created the toolkit to assist staff and other agencies in better understanding our journey to virtual services. This resource has now been shared across Canada and abroad. Moving our programing to virtual has connected us with peer supporters and organizations across the globe that prior to COVID we would never have reached.

To make sure our efforts were working, we continually did quick “pulse” surveys for feedback.  This was done through short surveys sent out, virtual polls, and ongoing conversations with clients.  We acted on the feedback in very quick “plan, do, study, act” (PDSA) cycles.

If you were to scale up your project or initiative to other communities across the province, what barriers would you need to overcome and what resources or processes would you need to have in place?

Depending on the area of the province, internet bandwidth becomes an obstacle to providing digital services. An investment with the provincial government in collaboration with media companies to build the infrastructure may be helpful.

When considering affordability, data plans need to be better regulated by the government so that they are affordable. Without access to wifi, a data plan or an internet connection, virtual groups are available only to those who can afford these luxuries.

Organizations potentially pooling resources of staff to optimize the virtual space is also a consideration. The virtual world presents a lot of opportunity with limited to no geographical barriers. Someone in Ottawa could access a virtual peer support group online that we offer and facilitated out of the Mississauga/Halton area. They just need access to a device and/or a phone and a stable internet/mobile connection.

A government investment in agencies who are doing this work well would enable these agencies to hire more staff and offer more virtual programing across the province. The government understanding that virtual programing eliminates the need for regional funding as it can be spread as a province service not that dissimilar to other supports such as the new psychotherapy programs being offered across the province. With proper thought and consideration, the virtual space could become a relevant, viable option for Ontarians in accessing group support that is cost effective, measurable and with flexibility in offerings.

If you want to know more, Betty-Lou's Contact information is: Betty-LouK@supporthouse.ca

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