Online tools promise mental health solutions

But are they as effective as face-to-face therapies?

For all the talk about mental health in the workplace, challenges still remain. And one of the hurdles for troubled employees is finding help — knowing the who, what, where and how.

Technology is one answer, according to panellists at a recent roundtable in Toronto, “Feeling Better at Work,” who each showcased online solutions around mental health.

“It takes so much effort for people to come out of their shells, as it were, and they find they’re not getting their needs met or the wait list is too long for traditional services, that they relapse or are in depression or substance use again,” said Paul Radkowski, CEO and clinical director at the Life Recovery Program.

“More and more people are going on the Internet and identifying what problems they might have initially, and identifying solutions. So 24-7 problems, I think, require 24-7 supports and solutions… The idea was ‘Let’s bring as much (of) those resources to the person in the comfort of their office, living room, what have you.’”

The Life Recovery Program is an online self-directed, peer-reviewed, evidence-based platform for individuals, families and corporations struggling with addiction, mental health, relationship and other stress-related issues. People sign up as members for three to six months, and are introduced to an e-learning-type platform.

“It’s meant to mimic a therapeutic session so it’s prerecorded sessions of myself, basically,” said Radkowski. “Each module is about an hour with short digestible clips, looking at good instructional design from an education standpoint.”

It’s also about encouraging and normalizing what’s going on for these people, which is often “terminal uniqueness,” he said, where people feel like they’re the only one suffering from an issue.

“That just adds more stress, more self-stigma, which usually fuels more alienation and isolation.”

The program also sends members supportive emails on a regular basis that reinforce the content of the modules, along with providing grounding techniques and a peer support forum.

“It basically helps them self-regulate, it gets them from a state of high stress and ‘I’ve got no resources and no one knows what’s going on with me’ to more of a place of ‘Oh, that’s what’s going on, OK, I get it, OK, that’s not so bad,’” said Radkowski. 

Connecting to counsellors
Also showcased was Counsellor Exchange, an e-counselling service looking to provide a convenient option for people suffering from mental health issues.

It’s about a “passion for safety and privacy online,” said co-founder Trish Stenson in Toronto, adding this “cyber office” offers a secure, technologically current platform to facilitate safe, online conversations.

“We have a whole generation of people coming up into adulthood that are going to be requiring therapy and mental health online services because they won’t access services any other way — there’s a preference to be online,” she said.

To partake, employees can go onto the site and search for a counsellor that best fits their needs from a list of professionals. They then register to start an initial dialogue with a counsellor to see if there’s a good match and, if so, the registrant pays for the first session. People can purchase as many “exchanges” as they wish to resolve their concern.

It’s basically back-and-forth e-communication, which can be an extremely effective tool, said Stenson, as people write down their issues and start to problem-solve themselves. They also have the ability to reread the messages before they send them.
“It gives them a lot more control and then with responses coming back, it gives them time to read over it and reflect,” she said.
The site is privacy-compliant and has an encrypted server for files, said Stenson, and companies such as EAP providers or insurance companies can put their own brand front and centre if they wish.

Also offering a way to connect online is Psychotherapy Matters, a site where people can use filters to find the best-matched psychotherapist in their community. There’s also a network of psychiatrists who can be involved through video, providing advice about assessments, services or medications.

The site is meant to deal with problems around a shortage of therapists, mismatches between services and needs, and long waiting lists, according to Allan Steingart, president and CEO of Psychotherapy Matters and an assistant professor of psychiatry at the University of Toronto.

It’s about a tiered approach, he said, so people with simpler problems may be OK with the service while others may need more intense assessment. And while there are lots of people with mental illness who are able to function at work, said Steingart, it’s about making sure they have access to professional help.

An effective solution?
But will people suffering from mental health issues be convinced online is as good as face-to-face encounters?

Years ago, the Internet was considered the Wild West when it came to credentials but now there is evidence, beyond anecdotal, that shows the high-quality nature and efficacy of these self-directed modalities, depending on the severity of the symptoms, said Radkowski.

“Some people are not able to leave their home, for whatever reason, especially if they’re on disability, so it becomes a viable option for them. Basically... research is showing this is equal or comparable… to a lot of traditional models, and this one is far more accessible, it’s far more cost-effective, it’s a 24-7 option versus ‘OK, I might be able to book an appointment with a counsellor in two weeks’ time.’”

The stigma around “online” has changed over the years, said Stenson. 

“Face-to-face is a really good modality but it’s not the modality that everybody wants, and we have now the opportunity to create choices for people that just weren’t there before.”

If someone has a severe mental health diagnosis or psychiatric episode, there needs to be other involvement, for sure, she said. But not everybody has access to these services, so it’s a helpful resource. It’s not a tool for people in crisis, she said, but for people who are functioning OK.

These online tools may be effective as a pre-emptive step if an employer is having an anti-stigma campaign or just doing general education or orientation, said Ann Morgan, a Toronto-based disability solutions specialist who attended the session.

“This is helpful maybe to prevent and increase awareness and educate but this is not the answer — this does not remove or eliminate your responsibility as an employer to have a psychologically safe and supportive workplace, and (as) managers to be aware and show you care.”

Many managers assume an EAP will take care of employees or they don’t see it as their responsibility or an opportunity to step up and show they care, she said.

“Most mental health concerns are dealt with as a performance management concern.” 

The bigger problem is how managers can first broach the conversation with troubled employees, said Morgan.

“We don’t have the communication tools that would make the digital tools optimal, and I think that if we skip to focus on digital tools, then we may think that the human communication tool’s not necessary. And without that, the digital tools are not going to be as effective or I don’t think they’re going to meet the need, or may even backfire.”

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