The pandemic has reshaped how and where we work, play, shop, engage with our communities, and access services – including mental and physical health care. Going virtual has represented a convenient, low- or no-cost way for many people to access health services and enabled more people connect to the care they need.
CMHA Toronto shifted several programs online during the lockdowns in early 2020 and – like so many organizations that have seen the benefits and desire on the part of its clients to remain virtual – hasn’t looked back. Its Virtual Community Care Hubs (VCCHs) is one of those programs – it has flourished, and continues to grow with new technology, new content, and new community partners.
We were doing virtual services prior to COVID, but since 2022, we’ve been able to partner with other community agencies to see what they were offering within their own spaces not only to their participants, but also to community members.
NEW FUNDING LAUNCHED A NEW PHASE OF GROWTH
CMHA Toronto’s Jennifer Pettigrew, Manager, Primary Health Care & NP (Nurse Practitioner) Stepped Care, and Michelle Rehder, Chief Clinical Officer, have overseen the growth of the VCCHs.
In early 2022, Michelle collaborated with a group of partnering agencies to successfully secure funding to set up hub spaces at CMHA Toronto’s locations and those of Scarborough Health Network, Centre for Immigration and Community Services, Unison Community Health Centre, and Addiction Services Central Ontario. Since then, Black Creek Community Health Centre has also joined the VCCH program.
VCCHs are spaces where clients, service providers, and the public can engage in mental health, addictions, primary care, peer support, social and vocational programming, and health-related services in the justice system. The hubs are equipped with video and audio-conferencing technology, creating a private, supportive environment that makes distanced communication feel as personal as in-person care.
The goal is to make it possible for program participants who have limited access to care due to unstable housing, poor or no access to technology, internet, or a private and safe space to “come in, use the space, use the technology to have virtual meetings and access virtual programming,” says Jennifer.
Jennifer adds that “part of primary health care is expanding education with clients and participants in our programs.” While CMHA Toronto has long delivered one-on-one education with clients in-person and virtually, even prior to the pandemic, the COVID-19 lockdowns expedited the need to ramp these up and also deliver group sessions. Agencies in the community health care sector quickly realized that joining forces would enable everyone to pivot faster by developing and sharing resources together.
NEW TECHNOLOGIES EXPAND OPTIONS
As the pandemic went on, people became more accustomed and comfortable with virtual interactions and the supporting technology was also evolving. There were both supply and demand dynamics at play: more clients were interested in online options, and more community partners were looking for ways to build and deliver them.
The multi-agency team invested in better technology and equipped spaces to deliver virtual and hybrid programming to groups even more effectively. “We could have several people in a room and several people at home using a camera called the Meeting Owl. It can turn 360 degrees and see everybody in the room and that way everybody can participate. It allowed us to do more hybrid care when there were still some COVID restrictions in place,” Michelle says.
The funding also enabled the acquisition of iPads, made available through a lending library. The iPads are set up with a data plan and allow people who don’t have or can’t afford the technology to connect with health services and information sessions from their own homes.
As Michelle Westin, Senior Analyst of Planning, Quality and Risk at Black Creek Community Health Centre, a VCCH partnering agency, says “digital equity is a social determinant of health now.”
I am so very grateful to you and your team that help organize and implement these sessions. They have helped me and continue to help me in my daily struggle to stay positive and keep moving forward!
MORE PEOPLE AND MORE CONTENT
There has been ongoing growth of the VCCHs on three fronts: the number of participants who are using the various VCCH services – from signing out an iPad, to participating in a group session from home or from a hub, to using one of the hub spaces to access care; the number of community partners involved; and the amount of content available through the VCCH course catalogue.
“The response has been great,” says Jennifer. “Clients who maybe didn't access in-person services are accessing virtual services. We still have clients today who prefer to connect virtually because of the convenience, because they don't need to travel, and because it's not an expense for them. So many people haven't gone back to in-person. We offer a monthly calendar so [people] can pick and choose what groups and what programs are of interest to them, and then connect at that time to that particular group.”
Being able to attend these virtual courses has been lifesaving. To interact with fellow participants and the facilitators from the comfort and safety of my home has been amazing. What a great way to ward off loneliness. I have met so many more people that I didn't know from Pathways and from the west which was terrific. They are great people.
While initially an open registration process was used – anyone with a link could join – a new registration system is being implemented to more precisely track the growth in enrollment. “Initially, we didn’t care who came as long as they got the information,” said Jennifer. “Now we're able to set it up so that people can register, and we can send that information to our partnering agency who can take over and decide who they want to send the link to and then can track, report, and get credit for the numbers,” Jennifer adds. This is also important to make sure that cross-agency sharing adheres to whatever privacy, consent or other protocols the hosting agency might have in place.
Each of the growing number of community partner agencies contributes content to the monthly calendar and promotes it to their own clients, other agencies’ clients, and in some cases, the public. CMHA Toronto also hosts the calendar on their own website. This has widened the net of who can participate and, as a result, increased the number of people taking part. It’s also allowing CMHA Toronto to extend virtual programs to more of its own clients.
For example, CMHA Toronto’s Multicultural Women’s Wellness content is now available to clients participating in the VCCHs. Kerri Glover, who leads CMHA Toronto’s Pathways, Recovery College and Holiday Gift Program, will frequently co-facilitate a VCCH session drawing upon Recovery College content.
It really does expand the offerings beyond even what CMHA Toronto can provide, but it also tapped into some resources within CMHA Toronto that we weren't offering as widely before to our own clients.
“It’s such a far-reaching opportunity. So many people can join. Some of the Multicultural Women’s Wellness groups have had hundreds of people at one time,” says Michelle. She adds that it also has tapped into many more resources around primary care from CMHA Toronto’s community partners. “It's really expanded beyond what CMHA Toronto would offer to being able to get the support of our community partners to provide care to our clients and then for us to reach out to their clients. It goes both ways,” Michelle says. “So, for example, to get Addiction Services Central Ontario involved in supporting additional addictions programming or the Centre for Immigrant Services to increase what CMHA Toronto could provide in the way of settlement services, that increased the offerings right away. It’s been great.”
COMMUNITY BUILDING
The VCCHs are also playing a role in building community, not just among the collaborating agencies, which have developed their own community of practice, but also among the clients they serve together.
“We have lots of participants who have met one another, their peers, online but have never met them face to face. So new friendships are developing through the virtual community care groups. There's a lot of sharing, there's a lot of learning. Sometimes we do a group on a specific topic and we find out other things that are happening in the city and other resources that could be helpful to others. So it's knowledge exchange,” says Jennifer.
“Everybody involved has benefitted in a different way,” says Michelle. “But overall, it's the clients that are benefitting most from the services that they now have access to.”
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