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The Equity & Lived Experience Working Group of the Ontario Mental Health & Addictions Virtual Care Collaborative are conducting a series of interviews to highlight 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 that has occurred in response to the COVID-19 pandemic. They are highlighting the creative and innovative ways in which groups have addressed the widening digital divide, specifically with issues relating to Connectivity & Equipment, Platforms & Security, Relationships & Interventions, or Training & Policy. They especially want to highlight stories from all regions of Ontario that have ensured access to care for Elders/seniors, Indigenous communities, immigrants and refugees, people with disabilities, people experiencing houselessness, francophone communities, and people living in rural or remote communities.

Find more discussion on the Digital Divide here.

In the posts below, we've highlighted a few such initiatives, and will be compiling more in the weeks and months to come. We welcome you to share other initiatives that you know of which worked to increase access to virtual care. If you have examples to share, you can reply directly to this post, or you can email PhebeAnn.Wolframe-Smith@camh.ca.

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Success Stories in Action:

Championing Access to Technology for Individuals Living in Poverty

An interview with Angie Lynch - Past Chair of Thunder Bay's Barriers to Employment & Training Working Group, ID Services Coordinator, Kinna Aweya Legal Clinic
Angie       


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

We wanted to help bring equity to digital access. The pandemic highlighted an inequity that was already there; a year in, the gap in access is still there. We wanted to get people the basics: phones and wifi access. We were thinking of digital access as a human right.


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

We got phones into people’s hands immediately. We did it at a very grassroots level. We wanted it to be as simple as possible. Not a loan, but a permanent phone for people, with a free data plan. In hindsight, we’d probably assess what they needed first: some people had a phone but not a data plan, for example. But it felt so urgent at the beginning of the pandemic that we just wanted to respond quickly. Even before the pandemic we were trying to get people phones as our group is about reducing barriers to accessing employment and training. We’d done a cell phone drive and collected about 30 phones, but they were all old and some needed to be wiped before distributing. A drive was not actually the quickest way of getting phones in hands, so when the pandemic started we changed direction. Instead, we sought new phones and funding for phones.

It started with a letter to TBayTel asking for a donation of phones, broad internet access, wifi hotspots in parks, social housing developments, and public places. They responded quicky and it was so collaborative. People were keen to jump on board. Those conversations led to getting wifi into five social housing complexes, including one senior’s complex. TBayTel provided the first 61 phones that were distributed through the Thunder Bay DSSAB. Our group then applied for two rounds of funding to be able to provide over 100 phones and data plans to people in need.

We also did advocacy with the provincial and federal governments. White privileged people in positions of power don’t think about not having phone and internet access and what that would mean. We had at least 100 organizations across the province sign onto our advocacy letter, and we helped to raise awareness of this issue.


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

My philosophy is that we shouldn’t even be doing this work. People need adequate income each month so they can make their own decisions about technology. If someone on Ontario Works or ODSP had an adequate income, they would be able to get a phone or a computer, as well as internet service. There are also larger issues of broadband infrastructure in rural and remote communities. That needs to be addressed on a more structural level. The digital divide is a big issue and this is a piecemeal approach. We need more than a band-aid! But we did help some people and that’s a start.

It’s important to have people on the ground giving input, the people who actually have the unmet technology needs. If we did it again, we’d have it driven by them, the people with lived experience. It’s a huge endeavor to equip people in this way. You need people from all the key poverty groups, and from local businesses engaged, as well as funding to properly equip people with working devices. When you are grassroots, you can do things more quickly, because there are fewer layers of approval. That is one advantage. So to management: lighten restrictions around things – let go and trust the process will work.

                                                                                                   

To read more about this initiative and the work of the Breaking Down Barriers Working Group:

https://www.eenet.ca/sites/def...OVID_Innovations.pdf

If you want to know more, Angie's contact information: angie.lynch@tbaytel.net 

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Success Stories in Action:

Our Virtual World Toolkit

An interview with Betty-Lou Kristy - Director, Centre for Innovation in Peer Support

betty-Lou



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

  • Stress and anxiety groups focused on navigating the pandemic, with guided wellness conversations
  • Daily wellness planning which focuses on strategies to assist participants as we all navigated collective isolation


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 case load 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


165 Cross Ave. Suite 201
Oakville, ON L6J 0A9
T 905-299-5604
F 905-844-4961

supporthouse.ca
1-833-845-WELL (9355)

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Success Stories in Action:

Yet Keen Seniors’ Day Centre - Virtual Intervention

Interview with Alvis Choi, Program Coordinator at Yet Keen Seniors’ Day Centre, a program of Somerset West Community Health Centre in Ottawa



Alvis



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

Yet Keen Seniors' Day Centre is a drop-in centre that opens 4 days a week. We mainly serve Chinese speaking seniors in the Greater Ottawa Region. Before the pandemic, our seniors relied on the daily in-person activities and social opportunities at the centre to stay active and engaged. The challenge that we responded to when COVID hit was the fact that most of these seniors (including volunteers who facilitated classes) did not have the digital literacy or resources to use technology to access online services or programs. A lot of the members didn't have the equipment they needed and/or WiFi at home to participate online. In addition, a language barrier was also an issue given that most of our members are Chinese-speaking and digital use typically requires some understanding of English. 



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

We were fortunate that one of our senior volunteers had experience working with digital platforms and he offered to teach Tai Chi on Zoom back in May 2020. From there, we coached seniors who have a smartphone or tablet one-on-one to use their device to join the class.

We started with a small group, and then popularized digital participation amongst our members in the following months. We began running computer classes in Cantonese and Mandarin, and secured resources working with Connected Canadians and our colleagues at Somerset West Community Health Centre to run a tablet loan program to address digital equity issues. So far, over 80 of our seniors have joined programs online and many are confidently using digital devices in the safety of their home on a daily basis. Most of the coaching done in this past year was carried out on the phone and we have developed assessment methods and pedagogy that is effective and empowering for Chinese speaking seniors. We also involved caregivers who live with the seniors to encourage sustainable support. For everyone involved, it is emotional work as much as it is technical support. We work at the seniors' own pace, and new interest in virtual participation continues to develop amongst the seniors as the pandemic goes on.



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?

A key component that led to the success of the program's digital operation during the pandemic is the time, patience, sensitivity and energy of each staff on the team. In order to scale up the initiative to other communities across the province, we would need to identify and hire digital coaches who can offer language-specific and culturally-appropriate support, as well as program facilitators who can run language-specific and culturally-appropriate programs. Aside from tangible resources to secure tablets and data plans, we would want to ensure that frontline workers who possess the skills to work with the racialized immigrant seniors population are adequately recognized and supported. Resources for racialized communities are scarce due to systemic oppression and they too need access to appropriate care and opportunities to thrive during this challenging time and beyond. Yet Keen Seniors' Day Centre has always been run by people in the community for the community and it is an example of how community building and empowerment can bring connections and success. We need to trust that marginalized communities know what they need best and offer ample resources for their work.

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