Successes and Challenges of Transitioning to Remote Service Delivery During the COVID-19 Pandemic: The Experience of Four Mental Health Agencies In Ontario

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This is the third article in a series profiling how four Canadian mental health organizations transitioned their services to adapt to the COVID-19 pandemic. This article will overview the successes and challenges of remote-service delivery.

The mental health organizations included in this series are:

  1. York Hills Centre for Children, Youth and Families
  2. Catholic Family Services of Toronto
  3. Queen Square Family Health Team
  4. DBT Hamilton

York Hills Centre for Children and Families experienced successes and challenges in transitioning to remote service delivery during the COVID-19 pandemic. One key success for the organization was being able to achieve their long-time goal of implementing remote services, primarily to remove any barriers for those families who struggled to make in person sessions work, due to lack of transportation, childcare etc. Prior to the pandemic York Hills did not offer any remote services outside of accessing tele mental health through OTN. However, they wanted to provide an option for online therapy and be able to offer webinars so that community members and service-users could have greater access to information. The pandemic provided the impetus for the organization to make these changes a priority. Another key success was being able to quickly and efficiently transition their walk-in counselling program to a phone counselling program. The program, called ‘Here 2 Help’ provides single-session phone counselling to children, youth, parents, and caregivers who need immediate and timely support. There have been challenges that the organization has had to navigate in their transition to remote service delivery. Clinical director Simone Shindler shared that the work environment now feels very non-stop, as you are constantly on your laptop or in a virtual meeting. She shared, “as much as you are still connecting with people, it is not quite the same. You can miss the workplace environment, seeing your coworkers in person, and being able to pop over to a colleague’s office. Working remotely all day can be very tiring, and it can be hard to turn off at the end of the day”.

            Florence Loh, Manager of Programs at Catholic Family Services of Toronto, shared some of the challenges and successes CFS Toronto has experienced. One significant challenge identified was that some higher risk clinical cases such as issues related to suicidal ideation, violence, or complex mental health issues, can be much harder to navigate through online counselling. She said, “sometimes you don’t get the same feel and read on a client as you would in-person. It can be harder to interpret body language through a screen”. Another challenge has been keeping up with evaluations and progress measurement while working remotely. She shared “A lot of our staff have had to learn new platforms for therapy which has been an adjustment. Adding online evaluation and progress measurement on top of that has been difficult, as it is another new platform the staff need to learn and become comfortable with.” Despite these challenges, CFS Toronto has also seen advantages to remote service delivery. Florence highlighted that remote service delivery has allowed them to expand their services to reach more people who are comfortable with this type of counselling, as their services are no longer restricted by location and attending a physical office.  

            At Queen Square Family Health Team, the clinicians have seen success in terms of client engagement and therapeutic alliance. For group therapy, the clinicians are finding that the clients are opening up more than they would in a traditional face to face group therapy setting. Noreen Syed, Clinic Program Manager shared that, “Clients are participating in therapy in a space where they may feel less anxious and perhaps more likely to contribute. They are home, and in a place that may feel less threatening to them”. Another success the team experienced was they were able to reach transitional youth populations more effectively through virtual services. Noreen shared that “Virtual care was on our radar for transitional youth, age 18-25, however there was never any time pressure to do it. Virtual care has allowed us to increase our engagement with this population, and provide services  that feel natural for transitional age youth to engage with." Noreen shared that a challenge her team experienced in transitioning to remote service delivery was with the technical difficulties that can accompany online therapy. The team had to quickly adjust to virtual service delivery which for some, meant that both the clinicians and the clients had to learn how to use a new online platform. Fortunately, the clinic was able to navigate this challenge effectively by relying on their more technologically savvy clinicians who were able to support their coworkers. Additionally, the admin staff were trained to support clinicians and clients in setting up remote therapy.

DBT Hamilton has also experienced some challenges related to technology in their transition to remote service delivery. Lisa Burckell, the founder of DBT Hamilton shared that “A lot of platforms are not great for therapy in terms of video quality. Sometimes it can be difficult to see the client very well, which can impact the therapeutic relationship”. She also highlighted how for people living in rural areas, the internet connection may be less reliable, and therefore make online therapy less accessible. One key success that DBT Hamilton has experienced as a result of the transition to remote service delivery is that the team was able to move forward in providing assessment paperwork online, prior to the first appointment. Before the pandemic, the clinic asked clients to fill out paperwork in the office on the same day of their first appointment. After connecting with Greenspace, the clinic is now going to use the platform to conduct assessments online prior to the first session. In doing this, clinicians can save time during the initial session and focus more on the client and establishing a strong rapport, as opposed to using part of the first session to finish assessment paperwork. 


The next article will be the final article in the series, focusing on the lasting impacts the COVID-19 pandemic will have on their organizations.