A "SMART" way to enhance mental health care

Summer 2012

When Walter Osoka first began experiencing mental health challenges in the late 1980s, cell phones were a novelty and reaching a care provider outside of a scheduled appointment was not common practice.

Now a mental health advocate, he has seen first-hand the challenge for some mental health clients (patients) who are discharged from hospital treatment to communicate regularly with their community-based care provider.

"A lot of mental health care time is wasted on travelling and waiting," says Walter, who adds that many clients don't have a phone or a car, or any easy way to keep in contact which puts them at risk for serious outcomes.

"The most common cause of death among people with psychotic or mood disorders is suicide,"  says Dr. Cheryl Forchuk, assistant director at Lawson Health Research Institute (Lawson). "That is why maintaining communication between patients and community-based care providers is essential to preventing re-admission to treatment, homelessness and worse outcomes."

Two years ago, Dr. Forchuk and Lawson's Mental Health Group held a retreat to collaboratively look for answers to this communications challenge. The team included researchers, clinicians, and clients themselves all working to come up with better and more creative solutions. Recognizing the mobility and increasing functionality of cell phones, the team came up with a solution to develop and evaluate a mental health system that takes advantage of new smart-phone technologies.

Over the last several months, Walter has been working with the team to pilot a new two-year, two-phase project that will see 400 community-based mental health clients receive an iPhone loaded with a custom-designed app that gives them access to the new Lawson "SMART" record. Stored securely online, this record includes their personal health information (i.e. treatment history and a list of medications and care providers), as well as tools, developed in consultation with a care provider, to help continue their recovery. Clients come from the mental health programs at London Health Sciences Centre and St. Joseph's Health Care London, as well as from community agencies.

"With this technology, mental health patients can now just send their care providers a secure text message saying 'This is what's going on right now.' As care providers, we will be much better able to help and intervene earlier," says Dr. Forchuk.

This two-way point of contact between clients and caregivers will give mental health consumers a greater role in managing their own care. Clients will work with their care providers to use the "SMART" record to develop a personal care plan, including prompts and reminders for appointments and activities. It even has a mood monitor and exercise tracker, all available at their fingertips from the iPhone.

"It's empowering people to participate more actively in their own care," says Dr. Forchuk.

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Walter Osoka can easily stay in touch with his care provider and help to manage his care
Walter Osoka can easily stay in touch with his care provider and help to manage his care
Dr. Cheryl Forchuck holds one of the 400 iPhones provided through the "SMART" record pilot project.
One of the 400 iPhones provided through the "SMART" record pilot project.
An iPhone, loaded with a custom designed app, gives access to the new Lawson "SMART" record.
Walter Osoka uses his iPhone to access his "SMART" record.