McGrath & Lingley-Pottie: Applying science to delivering mental health programs

This is one in a series of profiles of the winners of the 2018 Governor General’s Innovation Awards. See all honourees. 

Young people in need of psychological care often encounter long wait times for appointments and then have difficulty keeping them, given Canada’s overloaded mental health system and the inevitable time and financial pressures that families face.

Dr. Patricia Lingley-Pottie and Dr. Patrick McGrath have applied science to the task, coming up with a timely and effective way to offer mental health services to children and youth across vast distances. The Strongest Families Institute, a charitable organization in Halifax, delivers e-health programs using trained coaches through telephone support, removing barriers and stigmas that families face in traditional clinic-based care.

“You can do your banking by distance and trade stocks by distance and book your airline flights by distance; why can’t you do mental health by distance?” asks McGrath, a clinical psychologist who is vice-president of research at the IWK Health Centre, a research hospital in Halifax. McGrath, chair of the board of Strongest Families, is an ardent advocate of using research to improve healthcare at such facilities.

“Innovation comes out of solving a need. Our public institutions, especially our research hospitals, are hotbeds of innovation. We have to liberate innovators and support innovation in our public institutions.” — PATRICK McGRATH

“We have to regard our research health centres and systems as hotbeds for innovation in health,” he says. “We think of innovation in business and startups, but it also happens in research hospitals, because that’s where the patients are.”

The idea for Strongest Families originated in McGrath’s experience 35 years ago as a clinician at the Children’s Hospital of Eastern Ontario, where he found “long waiting lists for mental health care and high dropout levels once families got to care.” After over a decade of research together, McGrath and Lingley-Pottie co-founded the institute in 2011.

“It has just expanded exponentially since then,” says Lingley-Pottie, who is president and CEO as well as an adjunct professor of psychiatry at Dalhousie University and a scientist at the IWK Health Centre.

“We now have a proven distance delivery system that can rapidly reduce waitlists and is scalable,” she says, noting that the service currently includes 4,200 children and youth in five provinces, and has expanded into Finland and Vietnam. “Families receive timely services in the comfort and privacy of their home at convenient times. We measure and report outcomes; our outcome success rate overcoming presenting issues is 85 percent. Less than 10 percent drop out and families are highly satisfied.”

“Innovation is exciting and rewarding. It is our responsibility to inspire and encourage ongoing research and innovation to keep the momentum going, keep ahead of the times and find effective solutions.” — PATRICIA LINGLEY-POTTIE

She says that Strongest Families helps children ages three to 18 who have moderate problems with disruptive behaviour and anxiety. They developed an e-system called IRIS that is the backbone of their operations; it decreases organizational waste and increases efficiencies by providing a smart user interface for staff and families. Research has shown that families form stronger bonds than in a face-to- face situation, because of “the privacy offered by visual anonymity,” Lingley-Pottie says.

Despite the success of the program, government funds have not kept up with needs. “Often when new funding is allocated, more of the same is done instead of adopting a new, proven and cost-effective service delivery model,” she explains. “Because this is a relatively new field, there have been little specific investments supporting technology in health or mental health care.”

It’s essential for innovators to be persistent, understand their market and ensure their product or service is scalable, says McGrath. The institute is currently investigating covering additional types of mental health problems and segments of the population. For example, it is planning to expand services geographically within Canada as well as abroad, and will be expanding the anxiety program for emerging adults as well as developing a PTSD program for Syrian refugees, one for military and veteran families and a program for children with developmental delays and mental health problems.

McGrath, who is carrying out research on the expansion of the Strongest Families services, believes that with hundreds of thousands of young people in need of mental health services in Canada alone, there’s no limit to how big the institute can grow. “Just watch us,” he says.