Virtual Emergency Room: Using technology to reach kids in crisis

Every year, thousands of youth experience a mental health crisis, yet Ontario’s Wait Time Strategy data shows that these children can wait up to a year to be seen by a psychiatrist because of the severe shortage of these specialists.

A groundbreaking program, the , was established as a solution to this problem. It involves a partnership between four hospitals in central east Ontario: Lakeridge Health Corporation (Oshawa), Peterborough  Regional Health Centre, Ross Memorial Hospital (Lindsay), and Ontario Shores Centre for Mental Health Sciences (Whitby), with the technical support of Ontario Telemedicine Network (OTN).

The Virtual Emergency Room serves youth 17 years of age and younger with complex mental health issues resulting in serious psychiatric, emotional and/or behavioural disturbances. Using live two-way videoconferencing technology, these children now receive an in-depth consultation provided by a child psychiatrist at a remote site within 72 hours of referral.

“One in five children in Ontario struggle with a diagnosable emotional, mental or behavioral disorder, but accessing help can be a serious challenge for families,” says Wendy Decaire, Mental Health Program Director at the . “There are very few child/adolescent psychiatrists, and they practise in large urban centres. In the past, that has left families in crisis with long waits and exhausting commutes. Now, children can be assessed in their home hospital by a psychiatrist at a partnering hospital.”

Since its implementation in February 2009, more than 300 children have been served through the Virtual ER program at Ross Memorial Hospital. A significant highlight of the program is that only one child has required an inpatient admission. The success of the Virtual ER is attributable to the commitment of Project Coordinator, Jane Thompson, who is a dedicated resource to the program and helps families and staff throughout the region access the service.

Prior to the program going live, a standardized triage process was developed, as well as an assessment tool. Additionally, an education protocol was developed with a needs assessment and training packages for staff at all participating facilities. All crisis staff and psychiatrists were trained, and crisis staff were tested and certified.

The Virtual ER facilitates timely and equitable access to care, particularly in remote regions, capitalizes on scarce psychiatric resources, eliminates barriers created by time and distance and keeps families in their home communities.

The Ross Memorial team knew, even before the evidence started coming in, that the Virtual ER would help meet an enormous local need. And now the team also has the endorsement of Accreditation Canada. The Ross Memorial learned in December that its Virtual ER submission met all the required criteria and was approved as a Leading Practice.